Outcomes of hypoxic respiratory failure at birth associated with previable rupture of membranes

Objective:to characterize clinical outcomes of infants born after previable rupture of membranes (prom, < 23 weeks gestation and latency period ≥ 2 weeks) in relation to refractory hypoxic respiratory failure (rhrf).study design:prom neonates categorized as rhrf (fio2 > 0.6 for ≥ 2 h) and treated (high frequency ventilation + inhaled nitric oxide) were compared with no rhrf group. primary outcome was survival until discharge. factors associated with rhrf and mortality were identified.result:overall, mortality and disability rates were 28% and 22%, respectively. treated rhrf group (n = 32) had longer period of rom, mortality was (31% vs. 14%; p = 0.20), with similar survival-without-disability (54% vs. 47%; p = 0.67). higher gestational age at birth [1.57 (1.03,2.39)] and cesarean delivery [12.6 (1.22,125)] were associated with increased survival.conclusion:birth after prom is associated with high rates of adverse outcomes, independent of latency period. following treatment, rhrf infants may have similar long-term outcomes as those without rhrf.