Risk Factors Of Neonatal Sepsis For Preterm Prelabor Rupture Of Membranes

Objective:To investigate the risk factors of neonatal sepsis of 24~33+6W gestational weeks of preterm prelabor rupture of membranes(PPROM).Methods:A retrospective study of 880 pregnant women at gestational week of 24~33 +6W with PPROM were involved in the study from January 2016 to April 2018 in our hospital,of which 118 were diagnosed with sepsis while 762 cases were not.The clinical data of the two groups were compared,and multivariate Logistic analysis was used to find out the independent risk factors of neonatal sepsis in expectant treatment.Results:The rate of preterm birth history,cervical cerclage,in vitro fertilization-embryo transfer technique(IVF-ET),maternal heart rate>100 beats/min,time of expectant management>5d,amniotic fluid less than 1cm in depth or<2cm of index at birth of the sepsis group were significantly higher than those of the non-sepsis group,the differences are of statistically difference(P<0.05).Gestational weeks and white blood cell(WBC)counts were also different between the two groups,which is also statistically significant(P<0.05).Multivariate Logistic regression analysis showed that IVF-ET,latency period>5d,a gestational week of 28~31+6W at labor,and amniotic fluid index<2cm at birth were independent risk factors of neonatal sepsis(OR>1).Conclusion:Preterm birth history,cervical cerclage,in vitro fertilization-embryo transfer technique(IVF-ET),maternal heart rate>100 beats/min,time of expectant management>5d,amniotic fluid less than 1cm in depth or<2cm of index at birth,gestational weeks and white blood cell(WBC)counts are statistically different among the two group,these are the risk factors of neonatal sepsis.Among them,IVF-ET,latency period > 5d,a gestational week of 28~31+6W during labor,an amniotic fluid index<2cm at birth are independent risk factors of neonatal sepsis(OR>1).For patients with PPROM,especially those after receiving IVF-ET or with relatively small gestational weeks,by strengthening the management and monitoring the amount of amniotic fluid strictly as well as prolonging the gestational week rationally can effectively reduce the morbidity of neonatal sepsis.