Outcomes in Twins Compared With Singletons Subsequent to Preterm Prelabor Rupture of Membranes
| Autor: | William A. Grobman, Michal Fishel Bartal, Michael W. Varner, George R. Saade, Steve N. Caritis, Dwight J. Rouse, John M. Thorp, Mona Prasad, Ronald J. Wapner, Alan T.N. Tita, Uma M. Reddy, Lynda G. Ugwu, Jennifer L. Bailit |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Fetal Membranes Premature Rupture medicine.medical_specialty Gestational Age Prom Chorioamnionitis Article Cohort Studies Young Adult Enterocolitis Necrotizing Pregnancy Interquartile range Sepsis Outcome Assessment Health Care medicine Humans Rupture of membranes Perinatal Mortality Obstetrics business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Venous Thromboembolism medicine.disease Intraventricular hemorrhage Bronchopulmonary dysplasia Pregnancy Twin Wound Infection Premature Birth Gestation Female Endometritis business Infant Premature |
| Zdroj: | Obstet Gynecol |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/aog.0000000000004561 |
| Popis: | OBJECTIVE To compare maternal and neonatal outcomes after preterm prelabor rupture of membranes (PROM) from 23 to 34 weeks of gestation in twin compared with singleton gestations. METHODS We conducted a secondary analysis of an obstetric cohort of 115,502 individuals and their singleton or twin neonates born in 25 hospitals nationwide (2008-2011). Those with preterm PROM from 23 0/7 through 33 6/7 weeks of gestation were included; neonates with major fetal anomalies were excluded. The coprimary outcomes for this analysis were composite maternal morbidity (chorioamnionitis, blood transfusion, postpartum endometritis, wound infection, sepsis, venous thromboembolism, intensive care unit admission, or death) and composite major neonatal morbidity (persistent pulmonary hypertension, intraventricular hemorrhage grade III or IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II or III, bronchopulmonary dysplasia, stillbirth subsequent to admission, or neonatal death before discharge). Logistic regression was used to estimate unadjusted and adjusted odds ratios (ORs) with 95% CIs for twin compared with singleton gestations. RESULTS Of 1,531 (1.3%) individuals who met eligibility criteria for this analysis, 218 (14.2%) had twin gestations. The median gestational age at preterm PROM was similar between those with twins and singletons (31.2 weeks [interquartile range 27.4-32.9] vs 30.6 weeks [interquartile range 26.9-32.7], P=.23); however, those with twin gestations had a shorter median latency period (2.0 days [interquartile range 1.0-5.0] vs 3.0 days [interquartile range 2.0-8.0], P |
| Databáze: | OpenAIRE |
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