Risk factors associated with neonatal infectious and respiratory morbidity following preterm premature rupture of membranes

Abstract

Objectives: Preterm premature rupture of membranes (pPROM) is associated with the increased risk of chorioamnionitis, foetal exposure to inflammation, and respiratory complications in preterm neonates. The aim of the study was to identify patients at highest risk of developing neonatal infectious and respiratory morbidity following pPROM and preterm birth. Material and methods: It was a retrospective cohort study including 299 consecutive patients in singleton pregnancies complicated by preterm premature rupture of membranes and giving birth between 22nd and 36th gestational week. Analysed factors included maternal characteristics, obstetric history, gestational age at pPROM and at delivery, latency and management. Multivariate logistic regression models were applied in order to identify risk factors for severe infectious and respiratory neonatal complications. Results: Earlier gestational age at pPROM is associated with increased probability of developing early-onset neonatal sepsis and pulmonary hypertension. Earlier gestational age at birth and lower birth weight were independent factors associated with neonatal respiratory distress syndrome. Positive cervical culture was identified as a risk factor for acute neonatal respiratory failure. Conclusions: Gestational age at pPROM, gestational age at birth and birth weight were the leading factors influencing the risk of developing neonatal infectious and respiratory morbidity following preterm premature rupture of membranes.