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早产胎膜早破会增加需要有创呼吸支持的风险吗?一项回顾性单中心研究。

Does Preterm Prolonged Rupture of Membranes Increase the Risk of Needing Invasive Respiratory Support? A Retrospective Single-Centre Study.

作者信息

Jeffreys Eleanor, Bhat Ravindra, Greenough Anne, Dassios Theodore

机构信息

Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, UK.

Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.

出版信息

Children (Basel). 2024 Jul 5;11(7):823. doi: 10.3390/children11070823.

Abstract

(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King's College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7-35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78-293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM ( < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13-1.92, adjusted = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33-0.43, adjusted < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56-0.66, adjusted < 0.001] and antenatal corticosteroid use (adjusted = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation.

摘要

(1) 背景:胎膜早破早产(PPROM)与围产期发病率增加相关,但PPROM对呼吸系统疾病的影响此前尚未得到量化。我们假设PPROM会与有创通气的更高发生率相关。(2) 方法:在英国伦敦国王学院医院国民保健服务信托基金新生儿科进行了一项回顾性队列研究,研究对象为妊娠37周前出生的婴儿。PPROM定义为胎膜破裂超过48小时。(3) 结果:我们回顾了1901名婴儿(434名患有PPROM),中位(四分位间距)胎龄为32.4(28.7 - 35.0)周。患有PPROM的婴儿胎膜破裂的中位(四分位间距)持续时间为129(78 - 293)小时。患有PPROM的婴儿有创通气发生率为56%,未患PPROM的婴儿为46%(P<0.001)。经过回归分析,在调整出生体重[比值比 = 0.34;95%置信区间:0.33 - 0.43,调整后P<0.001]、10分钟时的阿氏评分[比值比 = 0.61;95%置信区间:0.56 - 0.66,调整后P<0.001]和产前使用糖皮质激素(调整后P = 0.939)后,PPROM与有创通气的更高发生率显著相关(比值比:1.48;95%置信区间:1.13 - 1.92,调整后P = 0.004)。(4) 结论:PPROM与需要有创通气的风险高1.48倍相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f65/11275225/2203c7ac3c56/children-11-00823-g001.jpg

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