Context: Premature rupture of membrane is a serious complication in pregnancy and responsible for one third of preterm labors associated with the neonatal and delivery outcomes.Objective: The current study aimed at investigating the risk factors of premature rupture of membrane on delivery and neonatal implications. Data Sources:The articles on the databases, including PubMed, Cochrane Library, ISI and Google Scholar up to 2017 were searched to conduct the current study. The keywords used were "premature rupture of membrane", "neonatal," "risk factors", "maternal", and "delivery". Study Selection:The inclusion criteria were articles on the relationship between maternal risk factors and Premature Rupture of Membrane (PROM), neonatal outcomes of PROM, the delivery outcomes of PROM, the study of mothers and infants, English and Persian language articles, and sufficient information on the PROM. The articles investigating amniotomy or the ones that only their abstracts were available were excluded from the study.Data Extraction: The data extracted from the above mentioned databases were fed with the following titles in the Excel software: Authors' names and surnames, year of study, type of study, place of study, case group, control group, maternal risk factors, delivery outcomes, neonatal outcomes of PROM, and the results of the study. Results:Out of 90 articles, 15 articles were finalized including one prospective study, five crosssectional papers, six retrospective articles, and three historical cohort studies. Maternal risk factors included age; parity; education; occupation; diabetes; blood pressure; cervical length along with abortion history; history of infection, upper urinary tract infection, and sexually transmitted diseases. Moreover, delivery complications were cesarean section, oligohydramnios, chorioamnionitis, and placental abruption. Neonatal complications included prematurity, respiratory distress syndrome, asphyxia, infection, meningitis, sepsis, pneumonia, perinatal mortality, patent arterial duct, necrotizing enterocolitis, IVH, pulmonary hypoplasia, hyperbilirubinemia, and antibiotic intake. Conclusions:Based on the results of the current study, the most important risk factors for PROM were diabetes and maternal hypertension associated with neonatal and maternal complications. Infection was the most important maternal and neonatal complication. Citation: Boskabadi H, Zakerihamidi M. Evaluation of Maternal Risk Factors, Delivery, and Neonatal Outcomes of Premature Rupture of Membrane: A Systematic Review Study. Journal of Pediatrics Review. 2019; 7(2):77-88. http://dx.

Background:Asphyxia is considered an important cause of morbidity and mortality in neonates. This condition can affect many vital organs including the central nervous system and may eventually lead to death or developmental disorders.Objectives:Considering the high prevalence of asphyxia and its adverse consequences, the present study was conducted to evaluate the risk factors for birth asphyxia and assess their correlation with prognosis in asphyxiated infants.Patients and Methods:This two-year follow-up cohort study was conducted on 260 infants (110 asphyxiated infants and 150 healthy neonates) at Mashhad Ghaem Hospital during 2007 - 2014. Data collection tools consisted of a researcher-designed questionnaire including maternal and neonatal information and clinical/laboratory test results. The subjects were followed-up, using Denver II test for 6, 12, 18, and 24 months (after discharge). For data analysis, t-test was performed, using SPSS version 16.5. P value ≤ 0.05 was considered statistically significant.Results:Of 260 neonates, 199 (76.5%) and 61 (23.5%) cases presented with normal neonatal outcomes and with abnormal neonatal outcomes (developmental delay), respectively. Variables such as the severity of asphyxia (P = 0.000), five-minute Apgar score (P = 0.015), need for ventilation (P = 0.000), and severity of acidosis at birth (P = 0.001) were the major prognostic factors in infants with asphyxia. Additionally, prognosis was significantly poorer in boys and infants with dystocia history (P = 0.000).Conclusions:Prevalence of risk factors for developmental delay including the severity of asphyxia need for mechanical ventilation, and severity of acidosis at birth, dystocia, and Apgar score were lower in surviving infants; therefore, controlling these risk factors may reduce asphyxia-associated complications.

Objective: Nucleated-red-blood-cells (NRBC) count in umbilical cord of newborns is been suggested as a sign of birth asphyxia. The present study was conducted to explore the value of NRBC count in prognosis of asphyxiated neonates. Methods: Sixty-three neonates with asphyxia were followed up for two years. Maternal and neonatal information was recorded follow by clinical and laboratory evaluation. NRBC-level was determined per 100 white-blood-cells (WBC). After discharge, follow-up of asphyxiated infants was performed using Denver II test at 6, 12, 18 and 24 months. Neonates were divided into two groups, with favorable and unfavorable outcome based on developmental delay or death. Results: We observed that NRBC count with more than 11 per 100 WBC, had sensitivity of 85% and specificity of 90% in predicting complications of asphyxia, while in absolute NRBC count with more than 1554, the sensitivity and specificity were 85% and of 87%, respectively. Combination of NRBC + HIE (hypoxic ischemic encephalopathy) grade had a high-predictive power for determining the prognosis of asphyxia in neonates. Conclusion: We demonstrate that NRBC/100 WBC and absolute NRCB count can be used as prognostic marker for neonatal asphyxia, which in combination with the severity of asphyxia could indicate high infant mortality, and complications of asphyxia. Further studies in a larger and multi center setting trail are warranted to investigate the value of NRBC and HIE in asphyxiate term infants.

Background: Biochemical markers including interleukins (ILs) has been proposed for early diagnosis of asphyxia. Objective: This study has aimed to systematically review the significance of IL measurements in the diagnosis of perinatal asphyxia. Materials and Methods: PubMed, Cochrane Library, Web of Science, Embase, and Scopus databases before 2017 were searched for the following keywords: asphyxia, neonatal, interleukin, and diagnosis. A total of 13 out of 300 searched papers were finally selected for evaluation. Interleukins under study were IL6 and interleukin 1

Neonatal sepsis is a dangerous and common disease among infants which is associated with high morbidity and mortality. Interleukins may be helpful for diagnosis of neonatal sepsis. Therefore, this study is conducted to investigate the role of interleukins in the diagnosis of neonatal sepsis. In this study, databases including PubMed, Cochrane Library, ISI and Google Scholar were searched up to 2016. Keywords were: Sepsis, neonatal, interleukins, prediction and diagnosis. Study inclusion criteria were: Articles about the relationship between the diagnosis of neonatal sepsis and interleukins; studies on babies; English and Persian articles and enough information from test results. Articles that had focused on adult sepsis or had used other markers except ILs or just their abstracts were available were excluded from the study. Of 100 searched studies, eventually, 16 articles were considered including 12 prospective studies, 3 cross-sectional studies and 1 retrospective study. IL6 has been studied more than other interleukins (50% of articles). ILs 6, 8 and 10 are among the initial markers of neonatal sepsis diagnosis. IL6 above 68 pg/ml had 85% sensitivity and 80% specificity, IL8 above 269.51 pg/ml had 80% sensitivity and 50% specificity, IL10 above 27 pg/ml had 60% sensitivity and 87% specificity and combined interleukins above 186.83 pg/ml had 75.63% sensitivity and 71.49% specificity in sepsis diagnosis. Interleukins can be helpful in the diagnosis of neonatal sepsis based on the results of this study. IL6 had the most sensitivity and IL10 had the most specificity for diagnosis of sepsis.