Premature rupture of membranes and preterm labor: neonatal infection and perinatal mortality risks

The purpose of this study was to analyze neonatal infection rates and perinatal mortality in births complicated by premature rupture of membranes (PROM) and spontaneous labor before term (less than 37 weeks' gestation). Neonatal infection occurred more commonly in preterm compared with term infants. The risk of infection due solely to PROM was insignificant compared with the risk attributable to preterm birth. Perinatal mortality and cause-specific mortality varied inversely with gestational age. These rates were not significantly different between groups with or without PROM or with or without associated development of maternal endometritis. Although the mortality due to infection was higher in preterm compared with term groups, most preterm deaths were attributed to other factors, particularly anoxia and respiratory causes. The diverse fetal risks associated with PROM and the associated maternal infection risks analyzed support expectant management when PROM occurs preterm.