Neonatal outcome following early onset preterm premature rupture of the membranes - A case controlled study

A case-controlled study was performed to determine whether preterm premature rupture of the membranes (PPROM), particularly if occurring in the second trimester, increased the duration of ventilatory support or hospital admission. Infants born after membrane rupture of at least 24 hours duration and prior to 37 weeks of gestation were identified. It was possible to match for gestational age and birthweight 40 PPROM infants, 15 of whom had onset of rupture of the membranes (ROM) prior to 27 weeks of gestation, with a control (an infant whose mother had not suffered PPROM). A greater proportion of the mothers of the PPROM infants had received antenatal steroids (p<0.01), had an antepartum hemorrhage (p=0.06) or delivered vaginally (p<0.02). More PPROM infants had pulmonary hypoplasia (p<0.03) or infection (p<0.01). Overall, however, and if only those matched pairs where membrane rupture had occurred prior to 27 weeks of gestation were considered, there were no statistically significant differences in the duration of ventilatory support or hospital admission. Step-wise regression analysis confirmed that in the study population overall and in the matched pairs where membrane rupture had occurred at less than 27 weeks of gestation, neither the duration of ventilation nor hospital admission significantly related to PPROM. These findings have implications when counselling parents.