title: Adverse respiratory outcome after premature rupture of membranes before viability.
abstract: OBJECTIVE
  To determine whether preterm premature rupture of membranes (PPROM) before 24 weeks is an independent risk factor for poor outcome in preterm neonates.
  
  
  METHODS
  A retrospective comparative cohort study was conducted, including viable premature infants born between 25 and 34-weeks gestation. Each preterm case with early PPROM was matched with two preterm controls of the same gestational age at birth, sex and birth date and who were born spontaneously with intact membranes. Logistic regression was performed to identify independent risk factors associated with composite respiratory and perinatal adverse outcomes for the overall population of preterm infants.
  
  
  RESULTS
  Thirty-five PPROM cases were matched with 70 controls. Extreme prematurity (26-28 weeks) was an independent risk factor for composite perinatal adverse outcomes [odds ratio (OR) 43.9; p = 0.001]. Extreme prematurity (OR 42.9; p = 0.001), PPROM (OR 7.1; p = 0.01), male infant (OR 5.2; p = 0.02) and intrauterine growth restriction (IUGR, OR 4.8; p = 0.04) were factors for composite respiratory adverse outcomes.
  
  
  CONCLUSIONS
  Preterm premature rupture of membranes before viability represents an independent risk factor for composite respiratory adverse outcomes in preterm neonates. Extreme prematurity may represent the main risk factor for both composite respiratory and perinatal adverse outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France; Region-INSERM Team (ERI28) Neovasc, Perinatal Handicap, Institute for Biomedical Research and Innovation (IRIB), School of Medicine, University of Rouen, Rouen, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Verspyck
authors.forename: Violene
authors.initials: V
authors.lastname: Bisson
authors.forename: Horace
authors.initials: H
authors.lastname: Roman
authors.forename: Stéphane
authors.initials: S
authors.lastname: Marret
mesh_terms: D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D005602:France / Q000453:epidemiology; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Perinatal outcome; Prematurity; Preterm premature rupture of membranes