INTERNATIONAL MULTICENTER TERM PROM STUDY - EVALUATION OF PREDICTORS OF NEONATAL INFECTION IN INFANTS BORN TO PATIENTS WITH PREMATURE RUPTURE OF MEMBRANES AT TERM

OBJECTIVE: Our objective was to determine significant predictors for t he development of neonatal infection in infants born to patients with premature rupture of membranes at term. STUDY DESIGN: Multivariate ana lysis was used to determine the significant predictors of neonatal inf ection in infants born to women with premature rupture of the membrane s who were enrolled in the Term FROM Study. In a randomized, controlle d trial, the Term FROM Study recently compared induction of labor with expectant management for premature rupture of membranes at term. RESU LTS: The following variables were identified as independent predictors of neonatal infection: clinical chorioamnionitis (odds ratio 5.89, P< .0001), positive maternal group B streptococcal status (vs negative or unknown, odds ratio 3.08, P <.0001), 7 to 8 vaginal digital examinati ons (vs 0 to 2, odds ratio 2.37, P=.04), 24 to <48 hours from membrane rupture to active labor (vs <12 hours, odds ratio 1.97, P=.02), great er than or equal to 48 hours from membrane rupture to active labor (vs <12 hours, odds ratio 2.25, P=.01), and maternal antibiotics before d elivery (odds ratio 1.63, P=.05). CONCLUSIONS: Among infants born to p atients with premature rupture of membranes at term, clinical chorioam nionitis and maternal colonization with group B streptococci are the m ost important predictors of subsequent neonatal infection.