Limits...
Latency after preterm prelabor rupture of the membranes: increased risk for periventricular leukomalacia.

Denzler A, Burkhardt T, Natalucci G, Zimmermann R - J Pregnancy (2014)

Bottom Line: GA was not a risk factor if birth weight was included.Risk decreased with increasing fetal weight despite a prolonged pPROM-delivery interval. pPROM-delivery interval is the single most important prenatally available risk factor for the development of cPVL.In the absence of clinical chorioamnionitis fetal weight gain may offset the inflammatory risk of cPVL caused by a prolonged pPROM-delivery interval.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics, Zurich University Hospital, Frauenklinikstraße 10, 8091 Zurich, Switzerland.

ABSTRACT

Objective: To identify the risk factors for cystic periventricular leukomalacia (cPVL) and their implications for deciding between immediate delivery and conservative management of preterm prelabor rupture of the membranes (pPROM).

Methods: The following risk factors were compared between cPVL infants and 6440 controls: chorioamnionitis, sex, gestational age (GA), birth weight, pPROM, and pPROM-delivery interval. Factor impact on cPVL risk and clinical decision-making was determined by multivariate logistic regression.

Results: Overall cPVL prevalence (n = 32) was 0.99/1000 births. All cPVL infants but one were born <34 weeks of gestation and were <2500 g; 56% had histological chorioamnionitis versus 1.1% of controls (OR 35.9; 95%-CI 12.6-102.7). Because chorioamnionitis is a postnatal diagnosis, logistic regression was performed with prenatally available factors: pPROM-delivery interval >48 hours (OR 9.0; 95%-CI 4.1-20.0), male gender (OR 3.2; 95%-CI 1.4-7.3). GA was not a risk factor if birth weight was included. Risk decreased with increasing fetal weight despite a prolonged pPROM-delivery interval.

Conclusion: pPROM-delivery interval is the single most important prenatally available risk factor for the development of cPVL. Immediate delivery favors babies with chorioamnionitis but disfavors those with non infectious pPROM. In the absence of clinical chorioamnionitis fetal weight gain may offset the inflammatory risk of cPVL caused by a prolonged pPROM-delivery interval.

Show MeSH

Related in: MedlinePlus

Exponential decrease in periventricular leukomalacia risk with increasing birth weight.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4127227&req=5

fig1: Exponential decrease in periventricular leukomalacia risk with increasing birth weight.

Mentions: cPVL prevalence among preterm infants was 5.3‰. All 32 infants with PVL were delivered preterm and all but one before 34 0/7 weeks. cPVL risk decreased exponentially with increasing birth weight (Figure 1) and increasing gestational age. Males were 3 times more affected than females (male : female ratio 24 : 8). All birth weights in newborns with cPVL were less than 2500 g (Table 1). The individual pPROM-delivery intervals of all PVL cases are shown in Figure 2.


Latency after preterm prelabor rupture of the membranes: increased risk for periventricular leukomalacia.

Denzler A, Burkhardt T, Natalucci G, Zimmermann R - J Pregnancy (2014)

Exponential decrease in periventricular leukomalacia risk with increasing birth weight.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4127227&req=5

fig1: Exponential decrease in periventricular leukomalacia risk with increasing birth weight.
Mentions: cPVL prevalence among preterm infants was 5.3‰. All 32 infants with PVL were delivered preterm and all but one before 34 0/7 weeks. cPVL risk decreased exponentially with increasing birth weight (Figure 1) and increasing gestational age. Males were 3 times more affected than females (male : female ratio 24 : 8). All birth weights in newborns with cPVL were less than 2500 g (Table 1). The individual pPROM-delivery intervals of all PVL cases are shown in Figure 2.

Bottom Line: GA was not a risk factor if birth weight was included.Risk decreased with increasing fetal weight despite a prolonged pPROM-delivery interval. pPROM-delivery interval is the single most important prenatally available risk factor for the development of cPVL.In the absence of clinical chorioamnionitis fetal weight gain may offset the inflammatory risk of cPVL caused by a prolonged pPROM-delivery interval.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics, Zurich University Hospital, Frauenklinikstraße 10, 8091 Zurich, Switzerland.

ABSTRACT

Objective: To identify the risk factors for cystic periventricular leukomalacia (cPVL) and their implications for deciding between immediate delivery and conservative management of preterm prelabor rupture of the membranes (pPROM).

Methods: The following risk factors were compared between cPVL infants and 6440 controls: chorioamnionitis, sex, gestational age (GA), birth weight, pPROM, and pPROM-delivery interval. Factor impact on cPVL risk and clinical decision-making was determined by multivariate logistic regression.

Results: Overall cPVL prevalence (n = 32) was 0.99/1000 births. All cPVL infants but one were born <34 weeks of gestation and were <2500 g; 56% had histological chorioamnionitis versus 1.1% of controls (OR 35.9; 95%-CI 12.6-102.7). Because chorioamnionitis is a postnatal diagnosis, logistic regression was performed with prenatally available factors: pPROM-delivery interval >48 hours (OR 9.0; 95%-CI 4.1-20.0), male gender (OR 3.2; 95%-CI 1.4-7.3). GA was not a risk factor if birth weight was included. Risk decreased with increasing fetal weight despite a prolonged pPROM-delivery interval.

Conclusion: pPROM-delivery interval is the single most important prenatally available risk factor for the development of cPVL. Immediate delivery favors babies with chorioamnionitis but disfavors those with non infectious pPROM. In the absence of clinical chorioamnionitis fetal weight gain may offset the inflammatory risk of cPVL caused by a prolonged pPROM-delivery interval.

Show MeSH
Related in: MedlinePlus