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Prelabor rupture of membranes (PROM) is a common event in obstetrics that has a major impact in pregnancy outcome. This condition is linked to a number of pregnancy and birth complications with early-onset neonatal infection (EONI) being one of the major threats. This study was undertaken to determine the rate of neonatal infection in newborn infants with a maternal history of PROM and to evaluate the association of risk factors with neonatal infection following PROM. A cross-sectional descriptive design was used to analyze a population of 200 pregnant women presenting to the Obstetrics and Gynecology Tertiary Center in Kosovo (between 2013 and 2015) with PROM who gave birth to single newborns. Data including demographic characteristics, neonatal outcome, and risk factors for infectious neonatal morbidity were recorded and analyzed. The study included 200 pregnant women with PROM and their newborns. Participant demographics included: the majority were young, aged between 20 and 29 years (67%), primiparous (67.5%), unemployed (92%), completed secondary level of education (83%), and with middle socioeconomic status (86%). Overall, 13% of the newborns had early-onset neonatal infection, and sepsis was proven in 5% of cases. Newborns of mothers with risk factors such as preterm (<37 weeks) PROM, low gestational weight at birth, prolonged rupture of membranes, maternal colonization, and low Appearance, Pulse, Grimace, Activity, Respiration score at birth had higher rates of infection compared with newborns of mothers without these risk factors. The rate of EONI in pregnancies complicated with PROM continues to be a global challenge in perinatology, and as this study reports, also a major challenge for Kosovo. Future research, revision and improvement on prenatal care and practices, timing of delivery, medical treatment, and prophylactic use of antibiotics in PROM are needed to reduce rates.

Nearly all cervical cancers are caused by persistent high-risk human papillomavirus (hrHPV) infection. There are 14 recognized hrHPV genotypes (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), and hrHPV genotypes 16 and 18 comprise approximately 66% of all cases worldwide. An additional 15% of cervical cancers are caused by hrHPV genotypes 31, 33, 45, 52, and 58. Screening patients for hrHPV as a mechanism for implementation of early treatment is a proven strategy for decreasing the incidence of HPV-related neoplasia, cervical cancer in particular. Here, we present population data from an HPV screening initiative in Kosovo designed to better understand the prevalence of the country’s HPV burden and local incidence of cervical cancer by hrHPV genotype. Nearly 2000 women were screened for hrHPV using a real-time polymerase chain reaction (real-time PCR) assay followed by melt curve analysis to establish the prevalence of hrHPV in Kosovo. Additionally, DNA was extracted from 200 formalin-fixed, paraffin embedded cervical tumors and tested for hrHPV using the same method. Cervical screening samples revealed a high prevalence of hrHPV genotypes 16 and 51, while cervical cancer specimens predominantly harbored genotypes 16, 18, and 45. This is the first comprehensive screening study for evaluating the prevalence of hrHPV genotypes in Kosovo on screening cervical brush samples and cervical neoplasms. Given the geographic distribution of hrHPV genotypes and the WHO’s global initiative to eliminate cervical cancer, this study can support and direct vaccination efforts to cover highly prevalent hrHPV genotypes in Kosovo’s at-risk population.

Objective: Prelabor rupture of membranes (PROM) is a common event in obstetrics that has a major impact in pregnancy outcome. This condition is linked to a number of pregnancy and birth complications with early-onset neonatal infection (EONI) being one of the major threats. This study was undertaken to determine the rate of neonatal infection in newborn infants with a maternal history of PROM and to evaluate the association of risk factors with neonatal infection following PROM. Materials and Methods: A cross-sectional descriptive design was used to analyze a population of 200 pregnant women presenting to the Obstetrics and Gynecology Tertiary Center in Kosovo (between 2013 and 2015) with PROM who gave birth to single newborns. Data including demographic characteristics, neonatal outcome, and risk factors for infectious neonatal morbidity were recorded and analyzed. Results: The study included 200 pregnant women with PROM and their newborns. Participant demographics included: the majority were young, aged between 20 and 29 years (67%), primiparous (67.5%), unemployed (92%), completed secondary level of education (83%), and with middle socioeconomic status (86%). Overall, 13 % of the newborns had early-onset neonatal infection, and sepsis was proven in 5% of cases. Newborns of mothers with risk factors such as preterm (<37 weeks) PROM, low gestational weight at birth, prolonged rupture of membranes, maternal colonization, and low Appearance, Pulse, Grimace, Activity, Respiration score at birth had higher rates of infection compared with newborns of mothers without these risk factors. Conclusion: The rate of EONI in pregnancies complicated with PROM continues to be a global challenge in perinatology, and as this study reports, also a major challenge for Kosovo. Future research, revision and improvement on prenatal care and practices, timing of delivery, medical treatment, and prophylactic use of antibiotics in PROM are needed to reduce rates. Keywords: Prelabor rupture of membranes, early-onset neonatal infection, risk factors Oz Amac: Obstetride erken membran rupturu (EMR), gebelik sonuglannda onemli bir etkiye sahip olan yaygrn bir durumdur. Bu durum bir dizi gebelik ve dogum komplikasyonu ile baglantilidir ve erken baslangicli neonatal enfeksiyon baslica tehditlerden biridir. Bu galismada, maternal EMR oykusu olan yenidogan infantlarda neonatal enfeksiyon orammn belirlenmesi ve EMR'yi takiben neonatal enfeksiyon ile risk faktorleri iliskisinin degerlendirilmesi amaclanmistir. Gerec ve Yontemler Kosova'da 3. Basamak Kadrn Dogum ve Jinekoloji Merkezi'ne EMR ile basvuran (2013-2015 yillari arasinda) ve tek yenidogan dunyaya getiren 200 gebe kadrn populasyonunu analiz etmek igin kesitsel tammlayici tasarim kullamldi. Demografik ozellikleri, neonatal sonuglari ve enfeksiyoz neonatal morbidite igin risk faktorlerini igeren veriler kayit ve analiz edildi. PRECIS: The purpose of this study was to determine the rate of neonatal infection in newborn infants with a maternal history of prelabor rupture of membranes and to evaluate association of risk factors with neonatal infection in pregnancies complicated with prelabor rupture of membranes. Bulgular: Calismaya, EMR'si olan 200 gebe kadin ve yenidoganlari dahil edildi. Katilimcilarin demografk ozellikleri incelendiginde; co u unlugunun genc, yas araliginin 20-29 (%67), primipar (%67,5), issiz (%92), ortaogretim duzeyinde egitim tamamlamis (%83) ve orta sosyoekonomik statde (%86) oldugu saptandi. Genel olarak, yenidoganlarin %13'unde erken baslangicli neonatal enfeksiyon mevcuttu ve olgularin %5'inde sepsis varligi kanitlandi. Preterm EMR (<37 hafta), dogumda dusuk gestasyonel agirlik, uzamis membran rupturu, maternal kolonizasyon ve dogumda dusuk APGAR skoru gibi risk faktorleri olan annelerin yenidoganlari, bu risk faktorleri olmayan annelerin yenidoganlari ile karsilastirildiginda daha yuksek enfeksiyon oranina sahipti. Sonuc: EMR ile komplike gebeliklerde erken baslangicli neonatal enfeksiyon orani, perinatolojide kuresel bir sorun olmaya devam etmektedir ve bu calismanin bildirdigi gibi Kosova icin de onemli bir sorundur. Oranlarin azaltilmasi icin; daha ileri arastirmalar, prenatal bakim ve uygulamalarin revizyonu ve gelistirilmesi, dogru dogum zamanlamasi, EMR'de proflaktik antibiyotik kullanimi ve medikal tedavi gerekmektedir. Anahtar Kelimeler: Erken membran rupturu, erken baslangicli neonatal enfeksiyon, risk faktorleri