{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:16:01Z","timestamp":1790136961334,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004270","name":"Kungliga Tekniska H\u00f6gskolan","doi-asserted-by":"publisher","award":["FoUI\u2010966336"],"award-info":[{"award-number":["FoUI\u2010966336"]}],"id":[{"id":"10.13039\/501100004270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004270","name":"Kungliga Tekniska H\u00f6gskolan","doi-asserted-by":"publisher","award":["FoUI\u2010955531"],"award-info":[{"award-number":["FoUI\u2010955531"]}],"id":[{"id":"10.13039\/501100004270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Early\u2010onset neonatal sepsis (EONS) is an important cause of neonatal morbidity and mortality and is strongly associated with intra\u2010amniotic infection. The risk of intra\u2010amniotic infection increases after preterm prelabor rupture of membranes (PPROM). Better tools are needed for monitoring women with PPROM for intra\u2010amniotic infection and identifying those at high risk of EONS so that intervention can be made timely. This study aimed to identify antepartum risk factors for EONS in a PPROM population and develop a risk\u2010indicating model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>We performed a historical cohort study on PPROM pregnancies delivering between gestational weeks 24\u2009+\u20090 and 33\u2009+\u20096 in Stockholm, Sweden. Using logistic regression, we evaluated the risk of the outcome EONS associated with maternal background characteristics, symptoms and signs, and cardiotocography. We combined variables associated with high risk into a risk\u2010indicating model and estimated its performance by calculating its sensitivity, specificity, accuracy, positive and negative predictive values, positive likelihood ratio, and area under the ROC curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 709 women and their neonates, out of which 29 developed EONS. Variables most strongly associated with EONS were maternal diabetes (OR 4.37, 95% CI 1.41\u201313.56), maternal temperature\u2009\u2265\u200938\u00b0C (OR 6.42, 95% CI 2.94\u201314.02), positive urinary or vaginal\/cervical culture (OR 2.62, 95% CI 1.14\u20136.03), and cardiotocography parameters. Fetal baseline frequency above 160\u2009bpm was associated with a 3.75 times increased risk of EONS (95% CI 1.51\u20139.33). Meanwhile, short\u2010term variation was negatively associated with EONS risk, and a value below 4\u2009ms had a 4.17 times increased risk of EONS (95% CI 1.77\u20139.83). A risk\u2010indicating model for EONS combining the mentioned variables had an area under the ROC curve of 0.7348. This model performed better at indicating risk for EONS than the clinicians' suspicion of intra\u2010amniotic infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal diabetes, maternal fever, positive urinary or vaginal\/cervical culture, fetal tachycardia, and decreasing short\u2010term variation were associated with an increased risk for EONS in a PPROM population. A risk\u2010indicating model combining these risk factors performed better than the clinicians' suspicion of intra\u2010amniotic infection in identifying high\u2010risk pregnancies for EONS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15168","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T02:16:25Z","timestamp":1748830585000},"page":"1475-1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors and risk\u2010indicating model for early\u2010onset neonatal sepsis after preterm prelabor rupture of membranes: A historical cohort study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-3084","authenticated-orcid":false,"given":"Brynhildur Tinna","family":"Birgisdottir","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Division of Pregnancy and 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Stockholm Sweden"},{"name":"Division of Pregnancy and Childbirth, Department of Women's Health Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Abtahi","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Physiology Karolinska University Hospital  Stockholm Sweden"},{"name":"Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health KTH Royal Institute of Technology  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrika","family":"\u00c5den","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Division of Neonatal Medicine, Department of Pediatrics Karolinska University Hospital  Stockholm 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