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Amniocentesis for threatened preterm labor with intact membranes and the impact on adverse outcome in infants born at 22 to 28 weeks of gestation.

Abstract：

BACKGROUND:It remains unclear whether performing amniocentesis to detect intra-amniotic infection is useful for improving neonatal outcomes. AIMS:To determine the efficacy of amniocentesis on the neonatal outcomes in women exhibiting threatened preterm labor and intact membranes. STUDY DESIGN:Retrospective cohort study SUBJECTS:A total of 174 women with threatened preterm labor and intact membranes at 22 to 33 weeks of gestation. Women with obvious clinical chorioamnionitis, multifetal pregnancy and/or major anomalies were excluded. OUTCOME MEASURES:Neonatal short- and long-term outcomes RESULTS:Sixty-seven women underwent amniocentesis (Tap group), while the remaining 107 did not. The prevalence of a positive Gram stain or a positive culture result was 10% in the Tap group. The overall outcomes were not statistically different between the two groups, with the exception of borderline significance (p=0.052) in long-term outcomes, favoring the Tap group. We performed a subgroup analysis focusing on infants born at 22-28 weeks of gestation. Consequently, the Tap group had better neonatal outcomes than the no-Tap group with respect to both short-term (OR 0.19, 95%CI 0.07-0.55) and long-term (OR 0.15, 0.05-0.46) outcomes. A multivariate analysis revealed that after adjusting confounding factors, the gestational age at delivery (OR 0.4, 0.3-0.7) and amniocentesis (OR 0.1, 0.02-0.3) remained significantly different. CONCLUSIONS:Amniocentesis is useful for improving neonatal outcomes in infants born at 22-28 weeks of gestation to women exhibiting preterm labor and intact membranes.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Maki Y,Furukawa S,Kodama Y,Sameshima H,Ikenoue T

doi

10.1016/j.earlhumdev.2015.03.006

subject

Has Abstract

pub_date

2015-05-01 00:00:00

pages

333-7

issue

5

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(15)00065-1

journal_volume

91

pub_type

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