(965) The Effect of Antibiotic Treatment in Late Preterm Premature Rupture of Membranes on pregnancy Outcomes

Friday, January 31, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Anat Pardo, MD (she/her/hers)

MFM Fellow
Sunnybrook Health Science Center
Toronto, ON, Canada

Coauthor(s)

RQ

Raud Qassim, MD

Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva
Petach-Tikva, HaMerkaz, Israel
MA

Michal Axelrod, MD, MPH (she/her/hers)

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel HaShomer
Ramat Gan, HaMerkaz, Israel
SB

Shiri Barabash Hazan, MD

Helen Schneider Hospital for Women, Rabin Medical Center
petach tikwa, HaMerkaz, Israel
Noam Pardo, BSc, MD (he/him/his)

MFM Fellow
Maternal Fetal Medicine Division, Sheba Medical Center, Tel Hashomer
Toronto, ON, Canada
Ohad Houri, MD (he/him/his)

Doctor
Rabin Medical Center
Petach Tikva, HaMerkaz, Israel
AS

Anat Shmueli, MD

Helen Schneider Hospital for Women, Rabin Medical Center
petach tikwa, HaMerkaz, Israel
EH

Eran Hadar, MD

Rabin Medical Center
Petach Tikva, HaMerkaz, Israel

Objective: To Compare pregnancy outcomes in women with late preterm premature rupture of membranes (PPROM) between 34+0 and 36+6 weeks, treated with antibiotics versus those not receiving antibiotics, to assess its efficacy in the late preterm period

Study Design: Retrospective cohort study at a single tertiary center between 2020 and 2023, included 228 women who presented with late PPROM. The outcomes of 95 treated with antibiotics were compared to 133 untreated with antibiotics. Primary outcomes were duration of latency period, chorioamnionitis and neonatal sepsis. Secondary outcomes included maternal complications (Post partum hemorrhage, Fever, Endometritis, Operative deliveries) and neonatal complications ( 5-min Apgar< 7, umbilical cord pH< 7.1, and neonatal intensive care unit admission). The groups were compared using demographic and clinical independent variables in a univariate and multivariate analysis

Results: Baseline characteristics did not significantly differ between the groups. In a univariate analysis the group treated with antibiotics demonstrated longer latency period in comparison to the non-treated group (2 vs.1 day, p< 0.001). Despite an earlier gestational age (GA) at PPROM (p=0.01) in the treated group, no difference was observed at gestational age at delivery. No difference in chorioamnionitis or neonatal sepsis rate was seen between the groups, however the group treated with antibiotic demonstrated less positive placental cultures compared to untreated women (p=0.04). No other significant adverse maternal or neonatal outcome was significantly different. Same pattern of longer latency but without significant difference in delivery GA was observed in a sub analysis of women who progressed to active labor spontaneously (p=0.005). A multivariate analysis of the latter which included parity, GBS status, GA and cervical dilatation at diagnosis failed to show that antibiotic treatment prolonged latency (aOR=0.70, 95% CI 0.27-1.79, p=0.46)

Conclusion: Antibiotic treatment in the management of late PPROM did not prolong latency period nor influenced maternal and neonatal outcomes