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Am J Perinatol 2024; 41(S 01): e2279-e2285
DOI: 10.1055/a-2109-4109
Original Article

Exposure to Prolonged Rupture of Membranes at Term Increases the Risk for Ventilatory Support in Uninfected Neonates

Anna L. Tramontano
1   Obstetrics Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Daniela Menichini 
1   Obstetrics Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Sara Lazzarin
1   Obstetrics Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Alessandra Sponzilli
1   Obstetrics Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Isotta Zinani
2   Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Fabio Facchinetti
1   Obstetrics Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
,
Alberto Berardi 
2   Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
› Author Affiliations
Funding None.
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Abstract

Objective The effects of prolonged rupture of membranes (ROMs) on perinatal outcomes are still unclear, and it remains controversial for the management of those labors. This study aims to evaluate how the exposure of pregnant women to a prolonged ROM (≥ 24 hours) affects maternal and neonatal outcomes.

Study Design This retrospective cohort study included singleton pregnant women at term delivering between January 2019 and March 2020 in a tertiary hospital. All relevant sociodemographic, pregnancy, and perinatal variables (maternal age, prepregnancy body mass index, labor, and delivery outcomes) were collected anonymously. Data were compared between the “ROM < 24 hours” and “ROM ≥ 24 hours” study groups.

Results A total of 2,689 dyads were included in the study and divided according to their ROM-delivery time: ROM <24 hours (2,369 women, 88.1%), and ROM ≥ 24 hours (320 women, 11.9%). Maternal baseline characteristics were comparable except for the rate of nulliparous women, which was significantly higher among patients with ROM ≥ 24 hours. No significant differences were found regarding infectious neonatal outcomes. However, mechanical ventilation and continuous positive airway pressure were more common among neonates born after ROM ≥ 24 hours. The greater likelihood of neonatal respiratory distress was also confirmed among infants born to Group-B Streptococcus-negative women with ROM ≥ 24 hours (15 out of 267 neonates, 5.6% vs. 52 out of 1,529 with ROM < 24 hours, 3.4%, p = 0.04).

Conclusion According to the actual expectant policy, prolonged ROM is associated with an increased risk of respiratory support in noninfected neonates. Further investigations are required to explain such an association.

Key Points

  • The management of women with prolonged rupture of membranes is controversial.

  • The exposure of pregnant women to a prolonged rupture of membranes affects neonatal outcomes.

  • Prolonged rupture of membranes is associated with an increased risk of respiratory support, in group-B Streptococcus-negative neonates.

Keywords

ROM - GBS - neonatal outcomes - ventilatory support

Authors' Contributions

F.F. and A.B. conceived the study. A.L.T., D.M., I.Z., and A.S. managed the data collection. A.L.T. and D.M. managed the analysis of the data. Drafting of the manuscript was led by D.M. and A.L.T. with input from F.F. and A.B. who give the final approval of the version to be published. All authors have read and approved the final manuscript.


Informed Consent

Informed consent was obtained from pregnant women as a routine procedure to ensure data availability and use for retrospective studies. Patient privacy was ensured during the phase of data collection and analysis.


Ethical Approval

Ethical approval was waived by the local Ethics Committee of Policlinic Hospital of Modena in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.


Data Availability Statement

The data that support the findings of this study are available from the corresponding author, D.M., upon reasonable request.




Publication History

Received: 21 January 2023

Accepted: 08 June 2023

Accepted Manuscript online:
13 June 2023

Article published online:
10 July 2023

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