A long interval between the rupture of membranes and delivery is risky both for the newborn and the mother. The interval between membrane rupture and delivery has been associated with a high risk of serious infections in newborns. Deadly infections (also called neonatal sepsis) affect as many as 1 percent of newborns and carry a death rate approaching 50 percent. In most women, rupture of the membranes occurs after labour has already started, while in some, this happens before labour starts. This extended time between rupture of the membranes and delivery is a recognised risk factor for infection in mothers and newborns, but whether the duration of labour influences this risk, is still a matter of contention. To assess the risk of infections in newborns, researchers at the Lund University in Sweden studied the records of 113,568 children born at term. The incidence of a diagnosis of sepsis during the neonatal period was correlated to the interval between membrane rupture and delivery. The results showed that the incidence of newborn infections increased progressively with increasing intervals between membrane rupture and delivery, ranging from 0.3 percent for an interval less than 6 hours to 1.1 percent for longer than 24 hours. An increased time between membrane rupture and delivery was the most significant independent risk factor for infection in the newborn, conferring a 29 percent increased risk per 6-hour increase. The duration of labour, however, was not independently associated with the risk for newborn infections. Thus, to avoid the risk of infections in newborns, pregnant women are advised to go to the hospital immediately when their water breaks.
Obstetrics and Gynecology ,
September 2007