Objectives
Prophylactic broad-spectrum antibiotic administration in women with preterm premature rupture of membranes (PPROM) after 24 weeks is associated with a reduction in neonatal morbidity and prolonged latency. Equipoise exists regarding the benefits of antibiotics in previable PPROM. The objective of this study is to measure the effect of prophylactic antibiotics on latency in women with previable PPROM.
Methods
A retrospective cohort of singleton, non-anomalous pregnancies with PPROM <23 0/7 weeks at a single center (2000-14) was studied. Women who elected immediate termination or had a contraindication for expectant management (e.g. fever, labor, hemorrhage) were excluded. Prophylactic antibiotic administration was at the discretion of the clinician; the majority of antibiotics utilized were combination of ampicillin/azithromycin. The primary outcome was latency (days) from diagnosis of PPROM to delivery. Secondary outcomes included perinatal mortality, neonatal morbidity, and maternal morbidity. Univariate analysis was performed with χ2/Fischer’s exact test or Mann-Whitney-U as appropriate. The effect of antibiotics on latency was modeled using Kaplan-Meier/Cox proportional hazards ratio using covariates that were significant (p<0.1) in univariate analysis. Significance was defined as p<0.05. SPSS (v22) was used for analysis.
Methods
A retrospective cohort of singleton, non-anomalous pregnancies with PPROM <23 0/7 weeks at a single center (2000-14) was studied. Women who elected immediate termination or had a contraindication for expectant management (e.g. fever, labor, hemorrhage) were excluded. Prophylactic antibiotic administration was at the discretion of the clinician; the majority of antibiotics utilized were combination of ampicillin/azithromycin. The primary outcome was latency (days) from diagnosis of PPROM to delivery. Secondary outcomes included perinatal mortality, neonatal morbidity, and maternal morbidity. Univariate analysis was performed with χ2/Fischer’s exact test or Mann-Whitney-U as appropriate. The effect of antibiotics on latency was modeled using Kaplan-Meier/Cox proportional hazards ratio using covariates that were significant (p<0.1) in univariate analysis. Significance was defined as p<0.05. SPSS (v22) was used for analysis.
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