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Time between membrane rupture and delivery and septicemia in term neonates

Herbst, Andreas LU and Källén, Karin LU (2007) In Obstetrics and Gynecology 110(3). p.612-618
Abstract
OBJECTIVE: To investigate how the interval between membrane rupture and delivery affects the risk of neonatal sepsis and whether duration of labor influences the risk. METHODS: A registry study included 113,568 singleton infants born at term after a trial of labor (elective cesarean deliveries excluded). The incidence of a diagnosis of sepsis during the neonatal period was correlated to the interval between membrane rupture and delivery. Multiple logistic regression analysis was done with adjustments for maternal age, parity, infant gender, gestational age, birth weight, and duration of labor. Receiver operating characteristics curves were created to estimate the optimal cutoff of membrane rupture time associated with an increased risk of... (More)
OBJECTIVE: To investigate how the interval between membrane rupture and delivery affects the risk of neonatal sepsis and whether duration of labor influences the risk. METHODS: A registry study included 113,568 singleton infants born at term after a trial of labor (elective cesarean deliveries excluded). The incidence of a diagnosis of sepsis during the neonatal period was correlated to the interval between membrane rupture and delivery. Multiple logistic regression analysis was done with adjustments for maternal age, parity, infant gender, gestational age, birth weight, and duration of labor. Receiver operating characteristics curves were created to estimate the optimal cutoff of membrane rupture time associated with an increased risk of neonatal septicemia. RESULTS: The rate of neonatal sepsis was 0.3% at a membrane rupture,to delivery interval below 6 hours, 0.5% at 6-18 hours, 0.8% at 18-24 hours, and 1.1% after 24 hours. The risk of neonatal sepsis increased independently and nearly linearly with duration of membrane rupture up to 36 hours, with an odds ratio of 1.29 for each 6-hour increase in membrane rupture duration. The risk also increased with birth weight, gestational age, primiparity, and male infant gender. Duration of labor was not an independent risk factor for neonatal sepsis. Receiver operating characteristics curve analysis revealed an area under the curve of 0.66, but a superior cutoff time limit for the risk of sepsis was not found. CONCLUSION: The risk of neonatal sepsis increases with duration of membrane rupture in a linear fashion during the first 36 hours, independently of labor duration. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obstetrics and Gynecology
volume
110
issue
3
pages
612 - 618
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000249132700012
  • scopus:34548456776
ISSN
1873-233X
language
English
LU publication?
yes
id
f370a581-4994-4acd-a3f3-c37bfcd1f36d (old id 688779)
alternative location
http://www.greenjournal.org/cgi/content/abstract/110/3/612
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17766608&dopt=Abstract
date added to LUP
2007-12-12 13:28:53
date last changed
2017-02-22 10:46:47
@article{f370a581-4994-4acd-a3f3-c37bfcd1f36d,
  abstract     = {OBJECTIVE: To investigate how the interval between membrane rupture and delivery affects the risk of neonatal sepsis and whether duration of labor influences the risk. METHODS: A registry study included 113,568 singleton infants born at term after a trial of labor (elective cesarean deliveries excluded). The incidence of a diagnosis of sepsis during the neonatal period was correlated to the interval between membrane rupture and delivery. Multiple logistic regression analysis was done with adjustments for maternal age, parity, infant gender, gestational age, birth weight, and duration of labor. Receiver operating characteristics curves were created to estimate the optimal cutoff of membrane rupture time associated with an increased risk of neonatal septicemia. RESULTS: The rate of neonatal sepsis was 0.3% at a membrane rupture,to delivery interval below 6 hours, 0.5% at 6-18 hours, 0.8% at 18-24 hours, and 1.1% after 24 hours. The risk of neonatal sepsis increased independently and nearly linearly with duration of membrane rupture up to 36 hours, with an odds ratio of 1.29 for each 6-hour increase in membrane rupture duration. The risk also increased with birth weight, gestational age, primiparity, and male infant gender. Duration of labor was not an independent risk factor for neonatal sepsis. Receiver operating characteristics curve analysis revealed an area under the curve of 0.66, but a superior cutoff time limit for the risk of sepsis was not found. CONCLUSION: The risk of neonatal sepsis increases with duration of membrane rupture in a linear fashion during the first 36 hours, independently of labor duration.},
  author       = {Herbst, Andreas and Källén, Karin},
  issn         = {1873-233X},
  language     = {eng},
  number       = {3},
  pages        = {612--618},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Obstetrics and Gynecology},
  title        = {Time between membrane rupture and delivery and septicemia in term neonates},
  volume       = {110},
  year         = {2007},
}