Periviable Preterm Premature Rupture of Membranes: A Retrospective Study on Determinants of Neonatal Mortality

Abstract

ABSTRACT Purpose: The present study aimed to determine the risk factors for fetal and neonatal mortality in the context of Periviable Preterm Premature Rupture of Membranes (PPROM). Patients and Methods: This was a retrospective cohort study conducted at perinatology department of Zekai Tahir Burak Research and Training Hospital. The study population consisted of patients with PPROM before completing the 23rd gestational week were opted for expectant management. Maternal and Neonatal characteristics were recorded. Multivariate Logistic Regression with backward elimination is performed to investigate the effect of certain parameters on neonatal mortality. Results: In multivariate logistic regression model, gestational age <21 weeks at onset of PPROM (Odds Ratio (95% confidence interval): 8.58 (2.41–30.5), p<0.01) and nulliparity (Odds Ratio (95% confidence interval): 4.47 (1.25–15.9), p: 0.02) were independently associated with stillbirth or delivery before 23rd weeks. According to Cox regression model, the significant determinants of survival were: completed gestational weeks at delivery, sepsis in the first neonatal week and presence of pulmonary hypoplasia. Conclusion: The present data suggest that favorable outcomes can be anticipated in periviable PPROM that has occurred after 22th gestational weeks. Completed gestational weeks at delivery and nulliparity are other important determinants of mortality.