Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model

D.P. van der Ham, S. van Kuijk, B.C. Opmeer, C. Willekes, J.J. van Beek, A.L.M. Mulder, A.J. van Loon, M. Groenewout, G.D. Mantel, K.W.M. Bloemenkamp, M. Porath, A. Kwee, B.M.C. Akerboom, D.N.M. Papatsonis, G.C.H. Metz, J.G. Nijhuis, B.W.J. Mol, the PPROMEXIL trial group

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Abstract

Objective: Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. Study design: We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. Results: We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per degrees C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. Conclusions: Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM.
Original languageEnglish
Pages (from-to)90-95
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume176
DOIs
Publication statusPublished - 1 Jan 2014

Cite this

van der Ham, D. P., van Kuijk, S., Opmeer, B. C., Willekes, C., van Beek, J. J., Mulder, A. L. M., van Loon, A. J., Groenewout, M., Mantel, G. D., Bloemenkamp, K. W. M., Porath, M., Kwee, A., Akerboom, B. M. C., Papatsonis, D. N. M., Metz, G. C. H., Nijhuis, J. G., Mol, B. W. J., & PPROMEXIL trial group, T. (2014). Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model. European Journal of Obstetrics & Gynecology and Reproductive Biology, 176, 90-95. https://doi.org/10.1016/j.ejogrb.2014.02.003