American Journal of Epidemiology Vol. 147, No. 2: 111-116
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Characteristics of Women with Clinical Intra-Amniotic Infection Who Deliver Preterm Compared with Term
1 Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Pittsburgh, PA
2 Department of Obstetrics and Gynecology, University of Massachusetts Worcester, MA
The authors sought to determine whether demographic factors, labor characteristics, and labor management for intra-amniotic infection (IAI) are different for IAI cases who deliver preterm compared with IAI cases who deliver at term. From 1990 through 1994, 610 women with intra-amniotic infection and 747 controls were enrolled from five hospitals in King County, Washington state. Intra-amniotic infection was diagnosed by fever 37.8°C with two of the following signs: maternal or fetal tachycardia, uterine tenderness, elevated peripheral white blood cell count, and purulent amniotic fluid. Preterm IAI cases were significantly more likely than term IAI cases to have membrane rupture before contractions (odds ratio (OR) = 6.1) and prolonged membrane rupture (>24 hours) (OR = 31.0). Term cases were more likely to experience a prolonged second stage of labor. After accounting for differences in labor characteristics, preterm IAI was less likely to be managed with a cesarean delivery, prolonged internal monitoring, or induction of labor and more likely to be managed with antimicrobials and antipyretics. When compared with preterm births without IAI, preterm IAI cases were more likely to be managed with labor augmentation. The authors believe that labor characteristics of women with preterm IAI and the risk of neonatal sepsis deserve further study. Am J Epidemiol 1998;147:111–16.
case-control studies; chorioamnionitis; infant, premature; life style; pregnancy complications, infectious; women