The effect of premature rupture of membranes to the morbidity and mortality of preterm babies

Abstract

Objective: The incidence of neonatal infection after premature rupture of membranes (PROM) more than 24 hours is approximately 1% and it increases to 4% in preterm premature rupture of membranes (P-PROM). This study was conducted to evaluate the effects of P-PROM on the incidence of sepsis and mortality. Materials and Methods: 191 preterm babies with P-PROM of more than 18 hours were evaluated between January 2000 to December 2001. A gestational age-matched patient admitted on the same day to our neonatal care unit without PPROM was enrolled to control group for every study group infant. The diagnosis of sepsis was based on clinical assessment, infection markers and culture results of patients. The mortality and morbidity of the P-PROM and control group were compared. Results: Of 2060 preterm babies, 191 had P-PROM. In P-PROM group, 52% of babies were female, 48% were male and, female and male rates were 50% in the control group. Abdominal delivery was seen in 60% of P-PROM group and 54% in controls. No significant difference regarding the rates of birth weight, sex, route of delivery and asphyxia of patients were identified. The range of duration of the PROM was changed from 18 hours to 53 days and there was not seen any significant relation between PROM duration and sepsis. The rate of early onset sepsis was 5.2% in P-PROM group and 2.1% in control group. P-PROM had a significant relation to early onset sepsis in preterm infants and it was associated with lower incidences of transient tachypnea of newborn and respiratory distress syndrome but, had no effect on incidence of necrotising enterocolitis. Conclusion: P-PROM is an important risk factor in aetiology of early onset sepsis in preterm babies. Identification and close follow up of the risk factors are needed to decrease the morbidity and mortality.