EP11.20: Maternal and infant microbiology findings as prognostic factors in very or extreme preterm neonates after PPROM: a retrospective analysis of data

The aim of this study is to further investigate the association between PPROM and certain pathogens in the maternal vaginal microbiome, and to present it in relation to potential adverse neonatal outcomes. There have been certain predefined microbial groups to assess the specific impact on parameters like signs of sepsis, neonatal death, positive blood cultures and others. This single-centre study is a retrospective cohort study with data from 2009 to 2018. A total of 551 premature, liveborn singletons and twins after pPROM at less than 29 weeks of gestation and their mothers vaginal and placental microbiome were analysed. The following microbial groups were statistically significant in the analysis: 42% of neonatal deaths were associated with Escherichia coli (p = 0.001) and 8.7% were associated with β-hemolytic streptococci (other than group B) (p = 0.017) in the maternal vaginal swabs. E. coli is notable with further statistically significant results for clinical signs of sepsis (30%, p = 0.001), elevated serologic inflammatory markers (30%, p = 0.001) and positive blood cultures in the preterm newborns (10.9%, p = 0.001). The neonatal mortality rate for preterm born children with positive maternal vaginal swabs for E. coli was 26.4%, compared to only 9.1% for those with negative maternal vaginal swabs (p = 0.001). This study showed that, if maternal swabs tested positive for certain pathogens, especially regarding Escherichia coli, the incidence of mortality as well as morbidity in newborns increased. The results of this study are largely consistent with data from the existing research. However, this work also provides new insights that may be useful as a basis for further studies or possibly for the evaluation of new prognostic values in the management of pPROM.