Premature rupture of membranes and neonatal respiratory morbidity at 32–41 weeks’ gestation: A retrospective single‐center cohort study

Abstract

Aim: To ascertain whether premature rupture of membranes (PROM) independently affects the risk of neonatal respiratory morbidity at 32-41 weeks' gestation because previous reports have given insufficient consideration to the mode of delivery and labor onset. Methods: Data on 4,629 consecutive singleton infants were retrospectively collected. Respiratory morbidity was limited to respiratory distress syndrome and transient tachypnea of the newborn, both of which are related to prematurity. Delivery modes were divided into four groups based on the existence of PROM and of labor onset, and the respiratory morbidity was examined according to the number of weeks of gestational age. Multivariate analysis including PROM and delivery mode was conducted to examine the association of respiratory morbidity. Results: Respiratory morbidity or a positive pressure requirement delivered after PROM and intact amniochorionic membranes accompanied by labor were similar at all weeks. Around 37 weeks, the absence of labor onset was associated with a risk of respiratory morbidity or positive pressure requirement. Significant respiratory risk was not associated with the incidence of PROM (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.52-1.83), interval from rupture to delivery (aOR, 1.00; 95% CI, 0.99-1.01), clinical chorioamnionitis, induction management, pregnancy-related complications, or neonatal sex. Delivery by Cesarean section and early gestational age presented a significant risk for respiratory morbidity. Conclusions: Neither PROM nor latency after PROM at 32-41 weeks affected neonatal respiratory morbidity. Avoiding Cesarean section instead of simply increasing the time to delivery may help to reduce respiratory morbidity.

Preterm pre-labor rupture of membranes and perinatal outcome: a prospective cohort study

“…They also concluded that PPROM was associated with adverse neonatal outcome with most common complication being Respiratory distress syndrome followed by neonatal sepsis [17]. Many other studies also reported a significant correlation between PPROM and adverse perinatal outcome [18][19][20][21]. On contrary to this, a recent study reported that PPROM per se was not associated with adverse perinatal outcome, neither was it associated with increased risk of sepsis [5].…”

Respiratory Distress Syndrome in Infants Delivered via Cesarean from Mothers with Preterm Premature Rupture of Membranes: A Propensity Score Analysis

“…Treatment with prenatal corticosteroids, the onset of labor, and histological chorioamnionitis have been shown to decrease the incidence of RDS [8][9][10][11]. Although a randomized trial would be the ideal research method for determining whether CD is a risk factor for RDS, such a trial would require the selection of optimal cases of CD based on clinical practice.…”

A associação da cardiotocografia intraparto com a Dopplervelocimetria fetal aumenta a capacidade preditiva de resultados adversos perinatais?

“…Este estudo demonstrou que MNT dobra se o parto for CS. A relação entre IG, peso ao nascer e morbimortalidade neonatal após cesárea é conhecida (Shimokaze et al, 2015;Prefumo et al, 2016;Yi Wen et al, 2020;Pires-Menard et al, 2021). Ao considerarmos apenas os RNs pré-termo (<37 semanas), a presença de centralização hemodinâmica é uma característica que aumenta MNT em maior magnitude quando a resolução da gestação se faz por parto cesárea, quando comparados àqueles que nasceram de parto vaginal.…”