早产儿长时间破膜是否会增加需要侵入性呼吸支持的风险?一项回顾性单中心研究

Children Pub Date : 2024-07-05 DOI:10.3390/children11070823
Eleanor Jeffreys, R. Bhat, Anne Greenough, T. Dassios
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摘要

(1) 背景:早产胎膜早破(PPROM)与围产期发病率升高有关,但此前尚未量化 PPROM 对呼吸系统疾病的影响。我们假设早产胎膜早破与较高的有创通气发生率有关。(2)方法:英国伦敦国王学院医院 NHS 基金会信托基金会新生儿科对妊娠 37 周前出生的婴儿进行了一项回顾性队列研究。胎膜早破是指胎膜破裂时间超过 48 小时:我们对 1901 名婴儿(434 名患有 PPROM)进行了复查,其胎龄中位数(IQR)为 32.4(28.7-35.0)周。胎膜早破婴儿的中位(IQR)破膜时间为 129(78-293)小时。胎膜早破婴儿的有创通气发生率为 56%,无胎膜早破婴儿的有创通气发生率为 46%(P < 0.001)。回归分析显示,在调整出生体重后,PPROM 与侵入性通气的发生率显著相关(几率比:1.48;95% CI:1.13-1.92,调整后 p = 0.004)[几率比 = 0.34;95% CI:0.33-0.43,调整后 p <0.001]、10 分钟 Apgar 评分[几率比 =0.61;95% CI:0.56-0.66,调整后 p <0.001]和产前使用皮质类固醇(调整后 p =0.939)。(4)结论:PPROM与需要有创通气的风险高出1.48倍有关。
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Does Preterm Prolonged Rupture of Membranes Increase the Risk of Needing Invasive Respiratory Support? A Retrospective Single-Centre Study
(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King’s College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7–35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78–293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM (p < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13–1.92, adjusted p = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33–0.43, adjusted p < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56–0.66, adjusted p < 0.001] and antenatal corticosteroid use (adjusted p = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation.
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