LAUSR

chorioamnionitis and with an amniocentesis to rule out infection or IAI. Diagnosis of IAI was based on AF IL-6 Levels ( 13.4ng/mL). In addition to standard management of PTL, women with amniotic fluid glucose levels <5 mg/dL and/or with microorganisms at Gram stain and/or positive cultures, were treated with antibiotics being tocolysis discontinued and magnesium sulfate administered <32 weeks if delivery was imminent. Induction of labor was only considered if clinical chorioamnionitis, gestational age >34 weeks and depending on the virulence of microorganism isolated. An adverse neonatal outcome was defined by the occurrence of stillbirth/neonatal death or moderate/severe bronchopulmonary dysplasia or gastro-intestinal perforation or necrotizing enterocolitis or intra-ventricular haemhorrage grade III/IV or periventricular leukomalacia or early-onset sepsis or retinopathy of prematurity needing laser treatment. We evaluated the independence of infection or IAI to explain an adverse neonatal outcome by logistic regression analysis. RESULTS: Two-hundred sixty-three women were included: 35(13%) with microbial-associated IAI (infection with IAI), 37(14%) with sterile IAI (IAI without infection), 12(5%) with microbial invasion of amniotic cavity (infection without IAI) and 179 (68%) women with non-infection/non-IAI. We found significant differences on latency to delivery between women with or without infection or IAI. The presence of infection or IAI was associated with an adverse neonatal outcome mainly due to a high rate of stillbirth. However, when we selected from women who achieved 24 weeks (n 257) those who were managed with antenatal steroids and antibiotics (n 128), the significant influence of infection or IAI on neonatal outcome disappeared. CONCLUSION: In women with PTL, the information of infection or IAI may be useful to individualize our management targeting those women who are inevitably going to deliver in the following days and avoiding unnecessary overtreatments (e.g. transfer to NICU hospitals, need of antenatal steroids) in those with non-infection/non-IAI.