Table 3

Previous studies of PROM indicating incidence of neonatal sepsis

StudyCountry and settingDefinition of term PROMCases of term PROM enrolled (n)Definition of neonatal sepsisCases of neonatal sepsis (n)Incidence (%)Antibiotics given routinely
Seaward et al 9 Canada, UK, Australia, Israel, Sweden, Denmark.Rupture at any time prior to onset of labour.5028Definite—bacteriologically confirmed infection.
Probable—clinical signs of infection plus neutrophilia, neutropaenia, high immature to total neutrophil ratio, or other lab evidence of sepsis.
133 (definite
or probable)
2.6For probable or definite infection, but not specified whether antibiotic prophylaxis was given to all PROM as defined.
Wolf and Olinsky11 Johannesburg, South Africa,
Transvaal Memorial Hospital for Children.
Rupture that lasted longer than 24 hours before delivery.51 total: 20 preterm, 31 termBacteriologically confirmed infection.
Clinical signs of infection.
8 (6 had positive blood cultures and 2 had clinical signs of infection)17.6 (EONS)Infants randomly assigned to treatment group with penicillin and kanamycin for 7 days or non-treatment group in the study (not specified whether prophylactic antibiotics were given routinely).
Alam et al 7 Pakistan, Aga Khan University Hospital, Karachi.Rupture lasting more than 18 hours.428, term babies n=307; 72%Culture-positive EONS.174 (EONS)Not specified whether prophylactic antibiotics were routinely given.
Jackson et al 15 Texas, USA, Parkland Memorial Hospital Newborn Nursery.Rupture lasting 18 hours or more.206 (not specified how many term babies)Positive blood culture and/or clinical signs of infection.5 (clinical signs of infection)2.4 (EONS)For those with neonatal sepsis whether culture-positive or had clinical signs, they received >4 days of intravenous antibiotics.
For asymptomatic infants they received stat dose intramuscular penicillin G.
Al-Qaqa and Al-Awaysheh24 Jordan,
Queen Alia Military Hospital, Paediatric and Neonatology Hospital.
Rupture at least 18 hours.225 (85 term, 38%)Positive blood culture associated with two positive CRP readings.35 (10 in those whose mothers received antibiotics and 25 in those whose mothers did not receive)15 (EONS)All received intravenous antibiotics (ampicillin and amikacin) for 3–4 days, then continued Augmentin until culture result was known. Intravenous antibiotics continued for those who showed clinical or laboratory evidence of sepsis.
  • CRP, C reactive protein; EONS, early-onset neonatal sepsis; PROM, prolonged rupture of membranes.