Van Reempts P, Kegelaers B, Van Dam K, Van Overmeire B
Department of Pediatrics, University Hospital Antwerp, Belgium.
Am J Perinatol. 1993 Jul;10(4):288-91. doi: 10.1055/s-2007-994742.
Very premature and prolonged rupture of the membranes (VPPROM) for at least 5 days is associated with an increased incidence of perinatal infection and lung hypoplasia. There is, however, limited information about outcome of premature neonates born after VPPROM uncomplicated by oligohydramnios. The present study compared the outcome, in three categories of neonates born before 34 weeks gestation: group I, VPPROM without oligohydramnios (n = 28); group II, VPPROM with oligohydramnios (n = 14); and group III, the comparison group without VPPROM (n = 39). Mortality in group I (2 of 28) was similar to that in group III (6 of 39) and was lower than that in group II (5 of 14). Lung hypoplasia and limb deformities were not more frequent in group I than in group III (2 of 28 and 0 of 28 versus 3 of 39 and 1 of 39, respectively) but occurred more frequently only in group II (5 of 14 and 4 of 14). All deaths in groups I and II were accounted for by lung hypoplasia. There was no difference between the groups for asphyxia, (respiratory distress syndrome, air leaks, bronchopulmonary dysplasia, or intracranial bleeding. Neonatal infection was more frequent in group I (4 of 14, 28.6%) and group II (7 of 28, 25%) when compared with group III (2 of 39, 5%). Within groups I and II rupture of the membranes was not more prolonged in the neonates with infection (median, 9.7 days) compared with the neonates without infection (median, 9.6 days). In conclusion, when VPPROM is not complicated by oligohydramnios, mortality, lung hypoplasia, and limb deformities are not more frequent than in control neonates of similar gestational age. As shown by others, the present data support the fact that VPPROM is associated with an increased risk of perinatal infection, but this is not responsible for the poor outcome.
胎膜过早且长期破裂（VPPROM）持续至少5天与围产期感染和肺发育不全的发生率增加相关。然而，关于VPPROM后出生且无羊水过少并发症的早产新生儿结局的信息有限。本研究比较了妊娠34周前出生的三类新生儿的结局：第一组，无羊水过少的VPPROM（n = 28）；第二组，有羊水过少的VPPROM（n = 14）；第三组，无VPPROM的对照组（n = 39）。第一组（28例中有2例）的死亡率与第三组（39例中有6例）相似，且低于第二组（14例中有5例）。第一组的肺发育不全和肢体畸形发生率并不高于第三组（分别为28例中有2例和28例中有0例，而39例中有3例和39例中有1例），但仅在第二组中更频繁出现（14例中有5例和14例中有4例）。第一组和第二组的所有死亡均由肺发育不全导致。各组在窒息、呼吸窘迫综合征、气漏、支气管肺发育不良或颅内出血方面无差异。与第三组（39例中有2例，5%）相比，第一组（14例中有4例，28.6%）和第二组（28例中有7例，25%）的新生儿感染更频繁。在第一组和第二组中，感染新生儿的胎膜破裂时间（中位数为9.7天）与未感染新生儿（中位数为9.6天）相比，并无更长。总之，当VPPROM无羊水过少并发症时，死亡率、肺发育不全和肢体畸形的发生率并不高于相似孕周的对照新生儿。如其他人所示，本数据支持VPPROM与围产期感染风险增加相关这一事实，但这并非导致不良结局的原因。
