Unit policies regarding tocolysis after preterm premature rupture of membranes: association with latency, neonatal and 2-year outcomes (EPICE cohort)

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Barros H (Author) FMUP; Bonamy, AK (Author) Other; Norman, M (Author) Other; Wilson, E (Author) Other; Boyle, E (Author) Other; Draper, ES (Author) Other; Manktelow, BN (Author) Other; Fenton, AC (Author) Other; Milligan, DWA (Author) Other; Zeitlin, J (Author) Other; Bonet, M (Author) Other; Piedvache, A (Author) Other; Lorthe, E (Author) Other; Moreira, C (Author) Other; Weber, T (Author) Other; Huusom, LD (Author) Other; Schmidt, S (Author) Other; Maier, RF (Author) Other; Jarreau, PH (Author) Other; Cuttini, M (Author) Other; Draper, ES (Author) Other; Zeitlin, J (Author) Other; Barros, H (Author) Other; Martens, E (Author) Other; Martens, G (Author) Other; Van Reempts, P (Author) Other; Boerch, K (Author) Other; Hasselager, A (Author) Other; Huusom, L (Author) Other; Pryds, O (Author) Other; Weber, T (Author) Other; Toome, L (Author) Other; Varendi, H (Author) Other; Ancel, PY (Author) Other; Blondel, B (Author) Other; Burguet, A (Author) Other; Jarreau, PH (Author) Other; Truffert, P (Author) Other; Maier, RF (Author) Other; Misselwitz, B (Author) Other; Schmidt, S (Author) Other; Gortner, L (Author) Other; Baronciani, D (Author) Other; Gargano, G (Author) Other; Agostino, R (Author) Other; Croci, I (Author) Other; Franco, F (Author) Other; Carnielli, V (Author) Other; Cuttini, M (Author) Other; DiLallo, D (Author) Other; Koopman Esseboom, C (Author) Other; Van Heijst, A (Author) Other; Nijman, J (Author) Other; Gadzinowski, J (Author) Other; Mazela, J (Author) Other; Graça, LM (Author) Other; Machado, MC (Author) Other; Rodrigues, C (Author) Other; Rodrigues, T (Author) Other

Journal

Title: Scientific Reports

Vol. 10

ISSN: 2045-2322

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00S-AG5

DOI: 10.1038/s41598-020-65201-y

Abstract (EN): After preterm premature rupture of membranes (PPROM), antibiotics and antenatal steroids are effective evidence-based interventions, but the use of tocolysis is controversial. We investigated whether a unit policy of tocolysis use after PPROM is associated with prolonged gestation and improved outcomes for very preterm infants in units that systematically use these other evidence-based treatments. From the prospective, observational, population-based EPICE cohort study (all very preterm births in 19 regions from 11 European countries, 2011-2012), we included 607 women with a singleton pregnancy and PPROM at 24-29 weeks' gestation, of whom 101, 195 and 311 were respectively managed in 17, 32 and 45 units with no-use, restricted and liberal tocolysis policies for PPROM. The association between unit policies and outcomes (early-onset sepsis, survival at discharge, survival at discharge without severe morbidity and survival at two years without gross motor impairment) was investigated using three-level random-intercept logistic regression models, showing no differences in neonatal or two-year outcomes by unit policy. Moreover, there was no association between unit policies and prolongation of gestation in a multilevel survival analysis. Compared to a unit policy of no-use of tocolysis after PPROM, a liberal or restricted policy is not associated with improved obstetric, neonatal or two-year outcomes.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12