Kacperczyk-Bartnik Joanna, Bartnik Pawel, Teliga-Czajkowska Justyna, Malinowska-Polubiec Aneta, Dobrowolska-Redo Agnieszka, Romejko-Wolniewicz Ewa, Bienko Malgorzata, Czajkowski Krzysztof
2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland.
Ginekol Pol. 2020;91(9):528-538. doi: 10.5603/GP.a2020.0085.
The aim of this study was to evaluate pregnancy outcome of patients with prelabor rupture of membranes receiving expectant management and giving birth prematurely in comparison to preterm births of patients with intact membranes.
It was a retrospective cohort study comparing maternal and neonatal outcome in two groups of preterm births. The first group included 299 consecutive singleton preterm births complicated by prelabor rupture of membranes. The second group consisted of 349 consecutive singleton preterm births without prelabor rupture of membranes.
Patients without pPROM underwent Caesarean sections more often than women from the pPROM group (65.3% vs 45.2%; p < 0.001). No statistically significant differences regarding the gestational age during delivery were identified. Lower birth weight was detected in the group with no history of pPROM (p < 0.001). No differences regarding early-onset sepsis were identified and higher percentage of late-onset infections was observed in infants with no history of pPROM (8.9% vs 4.7%; p = 0.04). Pulmonary hypertension was more common in the infants from the pPROM group (4% vs 1.4%; p = 0.049). Neonatal respiratory distress syndrome and respiratory failure were more prevalent in cases of no pPROM history - 20% vs 12.7% (p = 0.02) and 40% vs 25.8% (p < 0.001), respectively.
Development of multiple complications in preterm neonates may be more associated with the management, gestational age at birth, and birth weight than with the occurrence of preterm prelabor rupture of membranes.
本研究旨在评估胎膜早破患者接受期待治疗并早产的妊娠结局，并与胎膜完整的早产患者进行比较。
这是一项回顾性队列研究，比较两组早产患者的母婴结局。第一组包括299例连续的单胎早产患者，伴有胎膜早破。第二组由349例连续的单胎早产患者组成，无胎膜早破。
无胎膜早破早产的患者剖宫产率高于胎膜早破组患者（65.3% 对45.2%；p < 0.001）。分娩时孕周方面未发现统计学显著差异。无胎膜早破早产史的组出生体重较低（p < 0.001）。在早发性败血症方面未发现差异，无胎膜早破早产史的婴儿晚发性感染百分比更高（8.9% 对4.7%；p = 0.04）。胎膜早破组婴儿肺动脉高压更常见（4% 对1.4%；p = 0.049）。无胎膜早破早产史的病例中新生儿呼吸窘迫综合征和呼吸衰竭更普遍，分别为20% 对12.7%（p = 0.02）和40% 对25.8%（p < 0.001）。
早产新生儿多种并发症的发生可能与管理、出生孕周和出生体重的关联更大，而非胎膜早破早产的发生。
