Premature infants born after preterm premature rupture of membranes with 24-34 weeks of gestation: a study of factors influencing length of neonatal intensive care unit stay.

Objectives: To determine the factors influencing length of neonatal intensive care unit (NICU) stay among premature infants born after preterm premature rupture of membranes (PPROM) with 24-34 weeks of gestation.

Methods: Characteristic parameters of the pregnant women with PPROM and their premature infants were analyzed retrospectively using univariate and multivariate analysis.

Results: The overall rate of PPROM was 1.3% (323/24,173), of which 19.2% (62/323) were premature infants with sepsis. Overall, the median NICU stay of the premature infants was 11 days. Multiple factor regression analysis identified factors influencing length of stay in premature infants: gestational age (β = -0.172, P = 0.000), parturition modes (β = -0.115, P = 0.000), infant's birth weight (β =  -0.728, P = 0.000), infant's discharge weight (β = 0.443, P = 0.000), bacterial culture of cord blood (β = -0.100, P = 0.011) and sepsis (β = 0.192, P = 0.000). Additionally, latency period of sepsis diagnosis in neonatal sepsis between negative and positive cord blood culture was significantly discrepant, and 98.1% specificity and 84.4% positive predictive value for cord blood culture.

Conclusion: We have identified several predictive factors for length of stay in cases of premature infants after PPROM, of which cord blood culture can be used as an additional diagnostic test to detect newborns at risk of infections, and be valuable in clinical application and generalization among neonate sepsis.