The Effects of Tocolysis on Neonatal Septic Death in Women With PPROM: A Retrospective Cohort Study [21Q]. (May 2017)

• Record Type: Journal Article
• Authors: Chackowicz, Ariel; Spence, Andrea R.; Abenhaim, Haim A.
• Is Part Of: Obstetrics and gynecology. Volume 129 (2017)Supplement 1
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514130.16751.04
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: The use of tocolysis in women with preterm premature rupture of membranes (PPROM) remains uncertain, particularly in suspected chorioamnionitis. The purpose of our study was to evaluate the effect of tocolysis on neonatal septic death in women with PPROM +/- chorioamnionitis. METHODS: Using the Linked Birth and Infant Death data files (2009-2013) from the National Center for Health Statistics, we conducted a retrospective cohort study on all registered live births between 24-32 weeks' of pregnancy in order to evaluate the effect of tocolysis on neonatal septic death at 7 and at 28 days among women with PPROM between 24 and 32 weeks' gestation. Logistic regression models were used to evaluate the effect of tocolysis on neonatal septic death at 7 and at 28 days in births with and without chorioamnionitis. RESULTS: There were 46, 968 births that met study criteria, and of which 6, 264 (13.3%) received tocolysis. Tocolysis was more commonly administered to women who were Caucasians, smokers, and with multiple birth pregnancies and previous preterm births. There was no significant association between tocolysis and neonatal septic death at 7 days (OR 0.66, 95% CI 0.39-1.13) and at 28 days (OR 0.85, 95% CI 0.60-1.19). This was consistent in pregnancies complicated by chorioamnionitis and those without chorioamnionitis. CONCLUSION: In the setting of PPROM, tocolysis does not appear to increase the risk of neonatal septic death. Therefore, consideration can be given to its administration if clinically indicated.