Impact of Extended Membrane Rupture on Neonatal Inflammatory Responses and Composite Neonatal Outcomes in Early-Preterm Neonates—A Prospective Study
<b>Background/Objectives</b>: Prolonged prelabour rupture of membranes (PROMs), and the resulting inflammatory response, can contribute to the occurrence of adverse neonatal outcomes, especially for early-preterm neonates. This prospective study aimed to measure neonates’ inflammatory ma...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
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| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/2/213 |
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| Summary: | <b>Background/Objectives</b>: Prolonged prelabour rupture of membranes (PROMs), and the resulting inflammatory response, can contribute to the occurrence of adverse neonatal outcomes, especially for early-preterm neonates. This prospective study aimed to measure neonates’ inflammatory markers in the first 72 h of life based on ROM duration. The second aim was to examine the relationship between PROMs, serum inflammatory markers, and composite adverse neonatal outcomes after controlling for gestational age (GA). <b>Methods</b>: Data from 1026 patients were analyzed considering the following groups: group 1 (ROM < 18 h, <i>n</i> = 447 patients) and group 2 (ROM > 18 h, <i>n</i> = 579 patients). These groups were further segregated depending on the GA at the moment of membranes’ rupture into subgroup 1 (<33 weeks of gestation and 6 days, <i>n</i> = 168 patients) and subgroup 2 (at least 34 completed weeks of gestation, <i>n</i> = 858 patients). Multiple logistic regressions and interaction analyses adjusted for GA considering five composite adverse neonatal outcomes and predictors were employed. <b>Results</b>: PROMs and high c-reactive protein (CRP) values significantly increased the risk of composite outcome 1 occurrence by 14% (95%CI: 1.03–1.57, <i>p</i> < 0.001). PROMs and high CRP values increased the risk of composite outcome 5 by 14% (95%CI: 1.07–1.78, <i>p</i> < 0.001), PROM and leukocytosis by 11% (95%CI: 1.02–1.59, <i>p</i> = 0.001), and PROMs and high PCT values by 21% (95%CI: 1.04–2.10, <i>p</i> < 0.001). <b>Conclusions</b>: The combination of PROMs and high CRP values significantly increased the risk of all evaluated adverse composite outcomes in early-preterm neonates and should point to careful monitoring of these patients. |
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| ISSN: | 2075-4418 |