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Respiratory outcomes of neonates born after previable premature rupture of membranes and treated with gentle ventilation



We aim to describe neonatal respiratory outcomes following previable preterm premature rupture of membranes(PPROM) when gentle ventilation is utilized. We also report maternal morbidity and mortality.

Study design

This is a retrospective single-center cohort study of infants delivered between 2016 and 2020 that included infants born at ≥23 weeks without major congenital anomaly after a pregnancy complicated with PPROM before 23 weeks gestation. Statistical analysis utilized unpaired Student’s t-test or Mann–Whitney U-test when appropriate.


35 infants from 33 pregnancies were included. 91.4% of infants survived until discharge and 12.1% developed Bronchopulmonary Dysplasia (BPD). Those who developed BPD had significantly lower amniotic fluid levels prior to delivery (p < 0.05). There was no significant maternal morbidity or mortality in this cohort.


This cohort had high survival and low rates of respiratory morbidities. This suggests the use of gentle ventilation might be the optimal strategy for patients born after previable PPROM.

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Fig. 1: Flowchart displaying the study cohort and those excluded from the study.
Fig. 2: Length of stay analysis.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Authors and Affiliations



Drs Brady and Parravicini conceptualized and designed the study, led the multidisciplinary team, analyzed data, drafted the initial manuscript, and reviewed and revised the manuscript. Drs Keerthy and Liao helped design the study, perform data collection, and reviewed and revised the manuscript. Dr. Breslin helped inform the study design, helped draft sections of the manuscript, and reviewed and revised the final manuscript. Mary Martin helped with data collection, drafting the initial manuscript, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Sinead Brady.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the Institutional Review Board at CUIMC (IRB-AAAS0452). Due to the retrospective study design parental consent was not required.

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Brady, S., Martin, M., Keerthy, D. et al. Respiratory outcomes of neonates born after previable premature rupture of membranes and treated with gentle ventilation. J Perinatol (2024).

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