Impact of duration of rupture of membranes on outcomes of premature infants.
OBJECTIVE
The primary aim of the study was to determine how the risk of adverse outcomes was related to the duration of the latency period and gestational age at birth following preterm premature rupture of the fetal membranes (PPROM).


METHODS
Retrospective review of infants discharged from 330 neonatal intensive care units. We defined four subgroups based on gestational age: 23 to 25, 26 to 28, 29 to 31 and 32 to 34 weeks. Each gestational age group was evaluated by duration of ROM: <24 h, 1 to 7 days, 8 to 14 days, 15 to 21 days, 21 to 28 days and >28 days and compared with a referent group (PPROM of >24 h but <7 days).


RESULTS
In all, 239 808 non-anomalous infants 23 to 34 weeks' gestational age were identified; 37 233 (15.5%) had rupture of membranes (ROM) >24 h. Compared with a reference group (PPROM of >24 h but <7 days), the risk of mortality for PPROM of 8 to 14, 15 to 21 and 21 to 28 days varied depending on gestational age at birth. Only PPROM >28 days was consistently associated with increased mortality and decreased likelihood of survival without morbidity in all gestational age subgroups.


CONCLUSIONS
PPROM for >28 days is associated with an increased risk of death and morbidity.
Division of Neonatology, Children's Hospital, Greenville Health System, Greenville, SC, USA.
M W
MW
Walker
Department of Maternal-Fetal Medicine, Greenville Health System, Greenville, SC, USA.
A H
AH
Picklesimer
1] Division of Neonatology, Children's Hospital, Greenville Health System, Greenville, SC, USA [2] Departments of Education, Research and Quality Improvement, Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA.
R H
RH
Clark
Departments of Education, Research and Quality Improvement, Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA.
A R
AR
Spitzer
Departments of Education, Research and Quality Improvement, Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA.
T J
TJ
Garite
D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000401:mortality / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors