Incidence and Risk Factors of Neonatal Sepsis in Preterm Premature Rupture of Membranes before 34 Weeks of Gestation

Thitiporn  Sirivunnabood; Prapat  Wanitpongpan; Piengbulan  Yapan

doi:10.33192/Smj.2022.21

Authors

Thitiporn Sirivunnabood Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University
Prapat Wanitpongpan Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University
Piengbulan Yapan Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University

DOI:

https://doi.org/10.33192/Smj.2022.21

Keywords:

Early-onset neonatal sepsis, incidence, PPROM, risk factors

Abstract

Objective: Early-onset neonatal sepsis (EONS) is a leading cause of newborn morbidity and mortality, particularly in preterm premature rupture of membranes (PPROM) before 34 weeks of gestation, in which expectant management was performed until reaching 34 weeks of gestation, evidence of maternal chorioamnionitis, or unfavorable fetal conditions. The interval between membrane rupture and delivery has a positive correlation with neonatal sepsis. The purpose of this study was to investigate the incidence and risk factors of EONS in PPROM.
Materials and Methods: This was a retrospective cross-sectional study. The medical records of pregnant women who gave birth between 2005 and 2018 and their newborns were reviewed. The inclusion criterion was singleton pregnancies complicated by PPROM between 24 and 33+6 weeks of gestation. Multifetal pregnancies, fetal malformation, stillbirths, and records with incomplete data were excluded. PPROM was diagnosed by obstetricians while EONS was diagnosed by neonatologist.
Results: The incidence of EONS in with PPROM was 24%. Risk factors included excessive maternal weight gain based on IOM (OR = 2.40, 95% CI = 1.16-4.94), extremely preterm at admission (before 28 weeks of gestation) (OR = 3.38, 95% CI 1.12-10.21) and very low birth weight (≤ 1,500 g) (OR 3.68, 95% CI = 1.86-7.30). Maternal hematologic laboratory results were not associated with neonatal sepsis.
Conclusion: The incidence of EONS in PPROM was similar to data provided by other studies. Obstetricians and pediatricians should be cautious about neonatal sepsis, especially in cases of excessive maternal weight gain, extremely preterm admissions, and very low birth weight.

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