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Does Preterm Prolonged Rupture of Membranes Increase the Risk of Needing Invasive Respiratory Support? A
Eleanor Jeffreys1, Ravindra Bhat2, Anne Greenough1
1Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, UK.
Insights
Preterm premature rupture of membranes (PPROM) increases the risk of respiratory problems. Infants with PPROM were 1.48 times more likely to require invasive ventilation, highlighting a significant association with respiratory distress.
Area of Science:
- Neonatology
- Perinatal Medicine
- Respiratory Medicine
Background:
- Preterm premature rupture of membranes (PPROM) is linked to increased perinatal morbidity.
- The specific impact of PPROM on respiratory disease incidence, particularly the need for invasive ventilation, remains underquantified.
Purpose of the Study:
- To investigate the association between PPROM and the incidence of invasive ventilation in preterm infants.
- To quantify the risk of respiratory support requirements in neonates exposed to PPROM.
Main Methods:
- Retrospective cohort study of 1901 infants born before 37 weeks gestation.
- PPROM defined as membrane rupture >48 hours.
- Analysis included regression to adjust for birth weight, Apgar score, and antenatal corticosteroid use.
Main Results:
- A total of 434 infants had PPROM, with a median rupture duration of 129 hours.
- Invasive ventilation incidence was 56% in the PPROM group versus 46% in the non-PPROM group (p < 0.001).
- PPROM was significantly associated with a 1.48-fold higher risk of invasive ventilation (adjusted p = 0.004).
Conclusions:
- PPROM is a significant risk factor for requiring invasive ventilation in preterm neonates.
- The findings underscore the importance of monitoring respiratory status in infants exposed to PPROM.
Abstract:
(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King's College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7-35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78-293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM (p < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13-1.92, adjusted p = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33-0.43, adjusted p < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56-0.66, adjusted p < 0.001] and antenatal corticosteroid use (adjusted p = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation.
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