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Outcomes of hypoxic respiratory failure at birth associated with previable rupture of membranes

Journal of Perinatology volume 38, pages 1087–1092 (2018)Cite this article

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Abstract

Objective:

To characterize clinical outcomes of infants born after previable rupture of membranes (pROM, < 23 weeks gestation and latency period ≥ 2 weeks) in relation to refractory hypoxic respiratory failure (rHRF).

Study Design:

pROM neonates categorized as rHRF (FiO2 > 0.6 for ≥ 2 h) and treated (high frequency ventilation + inhaled nitric oxide) were compared with no rHRF group. Primary outcome was survival until discharge. Factors associated with rHRF and mortality were identified.

Result:

Overall, mortality and disability rates were 28% and 22%, respectively. Treated rHRF group (n = 32) had longer period of ROM, mortality was (31% vs. 14%; p = 0.20), with similar survival-without-disability (54% vs. 47%; p = 0.67). Higher gestational age at birth [1.57 (1.03,2.39)] and cesarean delivery [12.6 (1.22,125)] were associated with increased survival.

Conclusion:

Birth after pROM is associated with high rates of adverse outcomes, independent of latency period. Following treatment, rHRF infants may have similar long-term outcomes as those without rHRF.

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Authors and Affiliations

  1. Department of Respiratory Therapy, Mount Sinai Hospital, Toronto, ON, Canada

    Michelle Baczynski & Shannon Ginty

  2. Department of Newborn and Developmental Paediatrics, Sunnybrook Health Science Center, Toronto, ON, Canada

    Dany Weisz

  3. Department of Paediatrics, University of Toronto, Toronto, ON, Canada

    Dany Weisz, Patrick J McNamara, Edmond Kelly, Prakesh S Shah & Amish Jain

  4. Division of Neonatology, Hospital for Sick Children, Toronto, ON, Canada

    Patrick J McNamara

  5. Department of Physiology, University of Toronto, Toronto, ON, Canada

    Patrick J McNamara & Amish Jain

  6. Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada

    Edmond Kelly, Prakesh S Shah & Amish Jain

  7. Lunnenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada

    Prakesh S Shah & Amish Jain

Authors
  1. Michelle Baczynski
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  2. Shannon Ginty
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Correspondence to Amish Jain.

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Baczynski, M., Ginty, S., Weisz, D. et al. Outcomes of hypoxic respiratory failure at birth associated with previable rupture of membranes. J Perinatol 38, 1087–1092 (2018). https://doi.org/10.1038/s41372-018-0131-x

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  • DOI: https://doi.org/10.1038/s41372-018-0131-x

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