{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:15:26Z","timestamp":1790129726357,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T00:00:00Z","timestamp":1401148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["152002026"],"award-info":[{"award-number":["152002026"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["94506553"],"award-info":[{"award-number":["94506553"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["94507212"],"award-info":[{"award-number":["94507212"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether vaginal Group B\u00a0<jats:italic>Streptococcus<\/jats:italic> (<jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content>) colonisation or other baseline characteristics of women with preterm premature rupture of membranes (<jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>) can help in identifying subgroups of women who would benefit from immediate delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of the <jats:styled-content style=\"fixed-case\">PPROMEXIL<\/jats:styled-content> trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sixty hospitals in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> between 34 and 37\u00a0weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Random assignment of 723 women to immediate delivery or expectant management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Early onset neonatal sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vaginal <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content> colonisation status was the only marker which was significantly associated with the benefit of immediate delivery (<jats:italic>P<\/jats:italic> for interaction: 0.04). <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content> colonisation was observed in 14% of women. The risk of early onset neonatal sepsis in <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content>\u2010positive women was high (15.2%) when they were managed expectantly but this risk was reduced to 1.8% with immediate delivery. The early onset neonatal sepsis risk was much lower in neonates of <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content>\u2010negative women: 2.6% after expectant management and 2.9% with immediate delivery. We estimated that by inducing labour only in <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content>\u2010positive women, there would be a 10.4% increase in term delivery rate, while keeping neonatal sepsis and caesarean delivery rates comparable to a strategy of labour induction for all.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our <jats:italic>post hoc<\/jats:italic> findings suggest that women with <jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content> between 34 and 37\u00a0weeks might benefit from immediate delivery if they have <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content> vaginal colonisation, while in <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content>\u2010negative women labour induction could be delayed until 37\u00a0weeks.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12889","type":"journal-article","created":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T06:36:58Z","timestamp":1401172618000},"page":"1263-1272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Using vaginal Group B\u00a0<i>Streptococcus<\/i> colonisation in women with preterm premature rupture of membranes to guide the decision for immediate delivery: a secondary analysis of the <scp>PPROMEXIL<\/scp> trials"],"prefix":"10.1111","volume":"121","author":[{"given":"P","family":"Tajik","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Academic Medical Centre Amsterdam the Netherlands"},{"name":"Department of Epidemiology, Biostatistics &amp; Bioinformatics Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DP","family":"van der Ham","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology GROW \u2013 School for Oncology and Developmental Biology Maastricht University Medical Centre Maastricht the Netherlands"},{"name":"Department of Obstetrics &amp; Gynaecology Martini Hospital Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MH","family":"Zafarmand","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Academic Medical Centre Amsterdam the Netherlands"},{"name":"Department of Public Health Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MHP","family":"Hof","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics &amp; Bioinformatics Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Morris","sequence":"additional","affiliation":[{"name":"Clinical &amp; Population Perinatal Health Research Kolling Institute of Medical Research University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MTM","family":"Franssen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University Medical Centre Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CJM","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology VU University Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Duvekot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Erasmus Medical Centre Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MA","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University Medical Centre Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Willekes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology GROW \u2013 School for Oncology and Developmental Biology Maastricht University Medical Centre Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KWM","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Porath","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology M\u00e1xima Medical Centre Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Woiski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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