May respiratory support requirements of very low birth weight (VLBW) premature newborns due to preterm premature membrane rupture (PPROM) be different from other vlbw babies ?

Introduction and Purpose: Preterm prelabor rupture of membranes (PPROM)'s effects on very low birth weight(VLBW) has contradictory reports. Newborns that is affected by PPROM may have different respiratory support need but data is not enough to make conclusions. The aim of this study to find out PPROM's effects on respiratory support requirement and prematurity major morbidities by compering VLBW newborns that is categorized by PPROM. Study Format: Retrospective, cross-sectional design Materials and Method: Very low birth weight newborns that born in Dokuz Eylül University Medical Faculty and treated in neonatal intesive care unit between 01.0.2014 and 31.12.2018 added to the study. Prelabor rupture of membranes latency period limit for prolonged PPROM has been defined for 18 hours. Prolonged PPROM group and others compared with each other for mechanical ventilation parameters and duration and major morbidities of premature infants. We used standart statistics for analyses and multivariable logistic regression analyses for the signifcant results. Results: 203 newbors included into study. 50 (%24) of them had prolonged PPROM. There was no diffrence for gestational age, birth weight, multiparity, APGAR scores, gender, delivery room resisutation requirement between two groups. Antenatal korticosteroids and chorioamnionitis was detected more on prolonged PPROM group. There was no diffrence between two groups for surfactant therapy, invazive/non-invazive mechanical ventilation, FiO2 and hospitalization durations. Only pneumothorax in major morbidites was significantly higher on non-PPROM group other major morbidities had no diffrence between two groups. We compared the ventilation parameters and FiO2 levels for first hour after delivery room care and the maximum ventilation parameters and FiO2 levels for first ten days that has been used for at least 3 hours persistantly. Non-Prolonged PPROM group had more cases that required more than 6 non-invasive PEEP pressure and more than %30 FiO2 level needed for first ten days. Multivariate logistic regression analyses signify that Prolonged PPROM is not associated with mortality, early and late neonatal sepsis, RDS and BPD. Birth weight is independently associated with mortality and BPD. Gestational age has independent effect on RDS. Prolonged PPROM has independent effect on invasive mechanical ventilation support and high FiO2 concentration that needed at first hour after delivery and peak FiO2 and non-invasive mechanical ventilation PEEP pressure that is needed for at least 3 hours. Conclusion: Prolonged PPROM has no effect on mortality, BPD and RDS but it has independent positive effects on first hour and first ten days peak ventilation support parameters and FiO2 levels.