We read with interest the article of Pasquier et al. “Neonatal outcomes after elective
delivery management of preterm premature rupture of the membranes before 34 weeks’
gestation (DOMINOS study)” in which they presented the result of a multicenter prospective
study of women with pPROM between 241/7 and 336/7 weeks’ gestation (weeks). This study shows after logistic regression that elective
delivery (OR 0.41, 95%CI: 0.19–0.87, P = 0.02) is associated with decreased neonatal morbidity. This conclusion suggests that
elective delivery may be a better choice than expectant management before 34 weeks.
We have however, some concerns about the methodology of the study and the factors
introduced in the logistic regression that led to this conclusion.
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References
- The relationships between antenatal management, the cause of delivery and neonatal outcome in a large cohort of very preterm singleton infants.Bjog. 2000; 107: 877-884
- Effect of inborn versus outborn delivery on clinical outcomes in ventilated preterm neonates: secondary results from the NEOPAIN trial.J Perinatol. 2005; 25: 270-275
- Gestational age at preterm premature rupture of membranes: a risk factor for neonatal white matter damage.Am J Obstet Gynecol. 2005; 193: 947-951
- Neonatal and 5-year outcomes after birth at 30–34 weeks of gestation.Obstet Gynecol. 2007; 110: 72-80
Article info
Publication history
Published online: June 19, 2009
Received:
March 9,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
