Correlation Between Premature Rupture Of Membranes And Complications Of Preterm Infants ≤34 Weeks

Objective: To investigate the effects of Premature rupture of membranes(PROM)on complications of premature infants aged 34 weeks or less,and to provide a basis for clinical prevention and treatment of premature rupture,early prevention of complications and improvement of prognosis.Methods: The retrospective study method was used to select the preterm infants with gestational age ≤ 34 weeks who were hospitalized in the neonatology Department of the Affiliated Hospital of Youjiang Medical College for Nationalities from January 2018 to December 2022 as the research objects.According to whether there is premature rupture of fetal membrane,it is divided into PROM group and non-PROM group.General and clinical data of the two groups of children and their mothers were collected,including gestational age,birth weight of the children,whether the mother had diabetes,hypertension,hyperthyroidism,cholestasis syndrome and infection during pregnancy.Complications from hospitalization,including Intracranial hemorrhage(ICH),white matter damage,were recorded and analyzed.WMD),sepsis,pulmonary hemorrhage,infectious pneumonia,or bronchopuldysplasia.BPD),respiratory distress syndrome(RDS),patent ductus arteriosus,PDA),neonatal necrotizing enterocolitis(NEC),etc.,analyzed and compared the incidence of complications of the two groups of children,and imported into SPSS for statistical analysis.Results:(1)A total of 630 preterm infants met the inclusion criteria,including 256 preterm infants in PROM group(40.63%)and 374 preterm infants in non-PROM group(59.37%).Intracranial hemorrhage(ICH)occurred in 107 cases(16.98%),including 55 cases(51.4%)in PROM group and 52 cases(48.6%)in non-PROM group.The incidence of white matter injury(WMD)was 7.30% in 46 cases,including 18 cases(39.1%)in PROM group and28 cases(60.9%)in non-PROM group.A total of 112 cases were diagnosed with sepsis(17.78%),including 45 cases(40.2%)in PROM group and 67 cases(59.8%)in non-PROM group.A total of 515 cases were infected with pneumonia(81.75%),including 207 cases(40.2%)in PROM group and 308 cases(50.9%)in non-PROM group.A total of 13 patients with pulmonary hemorrhage(2.06%)were diagnosed,including 5 patients in PROM group(38.5%)and 8 patients in non-PROM group(61.5%).There were 38 cases of bronchial dysplasia(BPD),the incidence of which was 6.03%,including 10 cases(26.3%)in PROM group and 28 cases(73.7%)in non-PROM group.Necrotizing enterocolitis(NEC)occurred in22 cases(3.49%),including 8 cases(36.4%)in PROM group and 14 cases(63.6%)in non-PROM group.There were 90 cases of patent ductus arteriosus(PDA),the incidence rate was 14.29%,including 27 cases(30.0%)in PROM group and 63 cases(70.0%)in non-PROM group.There were 347 cases of neonatal respiratory distress syndrome(RDS)with an incidence of 55.08%,including 123 cases(35.4%)in PROM group and 224 cases(64.6%)in non-PROM group.There were significant differences in ICH and RDS between the two groups(P < 0.05).There was no significant difference in WMD,sepsis,infectious pneumonia,pulmonary hemorrhage,BPD,NEC and PDA between the two groups(P > 0.05).(2)The comparison of maternal complications during pregnancy between the two groups was as follows: There was no statistical significance in the comparison between the two groups of mothers with gestational diabetes(P > 0.05);There was statistically significant difference between the two groups(P < 0.01).The comparison between the two groups with hyperthyroidism during pregnancy was statistically significant(P < 0.05).(3)There was no statistical significance in the occurrence of complications between the two groups at different gestational ages(P > 0.05).(4)PROM time was divided into three groups: < 24 h,24-72 h and > 72 h.Further analysis of the relationship between PROM time and complications showed that PROM time had statistical significance with RDS and infectious pneumonia(P <0.05).There was no significant difference between PROM time and sepsis,white matter injury,ICH,BPD,NEC and PDA(P > 0.05).(5)There was no statistical significance between PROM and intracranial hemorrhage(P > 0.05).(6)A total of 630 preterm infants ≤34 weeks were included,and then Logistic regression analysis was performed.The results showed that PROM was not associated with infectious pneumonia,sepsis,WMD,NEC,BPD,PDA,cholestasis,apnea,asphyxia,and pulmonary hemorrhage(P > 0.05).PROM was associated with ICH(P < 0.05,OR=1.727).PROM was associated with RDS(P < 0.05,OR=0.679).Conclusion:(1)There is a correlation between the occurrence of PROM and ICH,and PROM is a risk factor for ICH.(2)The incidence of infectious pneumonia increased with the prolongation of PROM time.