Contribution of vaginal culture to predict early onset neonatal infection in preterm prelabor rupture of membranes.

Chorioamnionitis / diagnosis Dysbiosis / diagnosis Female Fetal Membranes, Premature Rupture Gestational Age Humans Infant, Newborn Pregnancy Retrospective Studies
Bacterial vaginosis Early onset neonatal infection Intra uterine infection Preterm delivery Preterm prelabor rupture of membrane Vaginal dysbiosis Vaginal swab

Journal

European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654
Titre abrégé: Eur J Obstet Gynecol Reprod Biol
Pays: Ireland
ID NLM: 0375672

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 26 12 2020
revised: 04 04 2021
accepted: 11 04 2021
pubmed: 27 4 2021
medline: 1 6 2021
entrez: 26 4 2021
Statut: ppublish

Résumé

Preterm prelabor rupture of membranes (PPROM) is a major cause of morbidity and mortality for both the mother and the newborn. The vaginal germ profile in PPROM is poorly known, particularly regarding the risk of early-onset neonatal infection (EONI). To determine microbiological risk factors for EONI in case of PPROM before 34 weeks of gestation (WG). A retrospective single-center cohort of patients with PPROM before 34 W G from 2008 to 2016. Vaginal swabs were obtained at admission and at delivery as per usual care and were analyzed by Gram stain and culture for vaginal dysbiosisi.e lactobacilli depletion and/or presence of potential pathogens. Among 268 cases of PPROM, 39 neonates had EONI 14.55 %; (95 %CI 0.11 - 0.19) Overall, vaginal samples culture was positive in 16.67 % (95 %CI 11.95 %-22.32 %) at the time of rupture and 24.76 % (95 %CI 19.02 %-31.23 %) at delivery, with no significant differences between EONI and no-EONI groups (p = 0.797 and 0.486, respectively), including for Group B Streptococci (GBS) and Escherichia coli. EONI was significantly associated with dysbiosis at the time of rupture (23.94 % versus 10.35 % in the absence of dysbiosis, p = 0.009) and at delivery (19.70 % versus 3.90 % if no dysbiosis, p < 0.001). Clinical intra-uterine infection was present in 78.5 % (n = 31) of the EONI group versus 37.2 % (n = 85) in the non-EONI group (p < 0.001) and chorioamnionitis and/or funisitis were found in 97.3 % and 91.9 %, respectively in the EONI group, versus 56.11 % and 53.96 %, respectively, in the non-EONI group (p < 0.001). Dysbiosis following rupture and at delivery, but not the presence of pathogens in the VS culture, was associated with the risk of EONI in case of PPROM.

Sections du résumé

BACKGROUND BACKGROUND
Preterm prelabor rupture of membranes (PPROM) is a major cause of morbidity and mortality for both the mother and the newborn. The vaginal germ profile in PPROM is poorly known, particularly regarding the risk of early-onset neonatal infection (EONI).
OBJECTIVE OBJECTIVE
To determine microbiological risk factors for EONI in case of PPROM before 34 weeks of gestation (WG).
STUDY DESIGN METHODS
A retrospective single-center cohort of patients with PPROM before 34 W G from 2008 to 2016. Vaginal swabs were obtained at admission and at delivery as per usual care and were analyzed by Gram stain and culture for vaginal dysbiosisi.e lactobacilli depletion and/or presence of potential pathogens.
RESULTS RESULTS
Among 268 cases of PPROM, 39 neonates had EONI 14.55 %; (95 %CI 0.11 - 0.19) Overall, vaginal samples culture was positive in 16.67 % (95 %CI 11.95 %-22.32 %) at the time of rupture and 24.76 % (95 %CI 19.02 %-31.23 %) at delivery, with no significant differences between EONI and no-EONI groups (p = 0.797 and 0.486, respectively), including for Group B Streptococci (GBS) and Escherichia coli. EONI was significantly associated with dysbiosis at the time of rupture (23.94 % versus 10.35 % in the absence of dysbiosis, p = 0.009) and at delivery (19.70 % versus 3.90 % if no dysbiosis, p < 0.001). Clinical intra-uterine infection was present in 78.5 % (n = 31) of the EONI group versus 37.2 % (n = 85) in the non-EONI group (p < 0.001) and chorioamnionitis and/or funisitis were found in 97.3 % and 91.9 %, respectively in the EONI group, versus 56.11 % and 53.96 %, respectively, in the non-EONI group (p < 0.001).
CONCLUSION CONCLUSIONS
Dysbiosis following rupture and at delivery, but not the presence of pathogens in the VS culture, was associated with the risk of EONI in case of PPROM.

Identifiants

DOI: 10.1016/j.ejogrb.2021.04.016 PMID: 33901775
pubmed: 33901775
pii: S0301-2115(21)00185-8
doi: 10.1016/j.ejogrb.2021.04.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

78-84

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Imane Ben M'Barek (I)

Assistance Publique-Hôpitaux de Paris Hôpital Louis Mourier Service de Gynécologie-Obstétrique, Colombes, France; Université de Paris, F-75006, Paris, France.

Luce Landraud (L)

Université de Paris, F-75006, Paris, France; INSERM, IAME, F-75018, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Service Microbiologie, Colombes, France.

Luc Desfrere (L)

Assistance Publique-Hôpitaux de Paris, Service de Néonatalogie, Hôpital Louis Mourier, Colombes, France.

Kankoé Sallah (K)

Assistance Publique-Hôpitaux de Paris, URC PNVS, CIC1 1425, INSERM P7, Hôpital Bichat, Paris, France.

Camille Couffignal (C)

Université de Paris, F-75006, Paris, France; INSERM, IAME, F-75018, Paris, France; Assistance Publique-Hôpitaux de Paris, URC PNVS, CIC1 1425, INSERM P7, Hôpital Bichat, Paris, France.

Marion Schneider (M)

Assistance Publique-Hôpitaux de Paris, URC PNVS, CIC1 1425, INSERM P7, Hôpital Bichat, Paris, France.

Laurent Mandelbrot (L)

Assistance Publique-Hôpitaux de Paris Hôpital Louis Mourier Service de Gynécologie-Obstétrique, Colombes, France; Université de Paris, F-75006, Paris, France; INSERM, IAME, F-75018, Paris, France. Electronic address: laurent.mandelbrot@aphp.fr.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Maladies foetales › Chorioamnionite › Contribution of vaginal culture to predict...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Dysbiose › Contribution of vaginal culture to predict...
questionsmedicales.fr › Maladies urogénitales › Maladies de l'appareil urogénital féminin et complications de la grossesse › Complications de la grossesse › Complications du travail obstétrical › Rupture prématurée des membranes foetales › Contribution of vaginal culture to predict...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Âge gestationnel › Contribution of vaginal culture to predict...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Contribution of vaginal culture to predict...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › Contribution of vaginal culture to predict...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Contribution of vaginal culture to predict...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Contribution of vaginal culture to predict...