Objectives
Prophylactic antibiotic administration in women with preterm premature rupture of membranes (PPROM) > 24 weeks is associated with reduction in neonatal morbidity and prolonged latency. The role of latency antibiotics prior to viability in multifetal gestation is largely unknown. The objective of this study is to determine the association of prophylactic antibiotics and latency following previable PPROM in multifetal pregnancies
Methods
A retrospective cohort of multifetal, non-anomalous pregnancies at a single center (2000-14) with PPROM <23 weeks undergoing expectant management was examined. Prophylactic antibiotic administration was at the clinician’s discretion; majority of antibiotics utilized included ampicillin/azithromycin. The primary outcome was latency from ROM to delivery of the presenting fetus. Secondary outcomes included latency to delivery of second twin, perinatal mortality, and neonatal/maternal morbidity. Univariate analysis was performed with χ 2 /Fischer’s exact test or Mann-Whitney-U as appropriate. The effect of antibiotics on latency was modeled using Cox-hazard proportional ratio modeling using covariates significant (p<0.1) in the univariate analysis. Significance defined as p<0.05.