All issues > Volume 27(11); 1984

Original Article

J Korean Pediatr Soc. 1984;27(11):1045-1054. Published online November 30, 1984.

A Clinical Study on Morbidity and Mortality in Newborns of Mothers wieh Premature Rupture of Membrane.

Myung Shik Lee¹, Dong Gwan Han¹

¹Department of Pediatrics, College of Medicine，Yonsei University, Seoul, Korea

Abstract

A clinical study was made on 997 newborns of mothers with premature rupture of membrane (study group) and 5,552 newborns of mothers without ruptured membrane (control group) at YUMC from January 1981 to December 1983. The following results were obtained: 1) The incidence of the study group was 15.2% and morbidity incidences were 5.4% due to sepsis, 9.5% due to asphyxia and 0.8% due to RDS. 2) Morbidity was higher in newborn males for both groups in sepsis and RDS and there was no sex preference in the cases of neonatal asphyxia. 3) Each incidence of the study group was higher than the control varying according to the category: 3 times higher due to sepsis, 1.6 times higher due to neonatal asphyxia and 2.3 times higher due to neonatal death. The sole exception was the incidence of RDS (mostly inpremature newborns for both groups) which was 3 times higher than the conrol group. 4) The incidence of sepsis, neonatal asphyxia and neonatal death in the study groups increased proportionally with the duration of the ruptured membrane. A significant difference was observed in the incidence of sepsis, neonatal asphyxia and neonatal death occurring before and after 24 hours following ruptured membrane. The incidence after 24 hours was 3〜4 times greater than the incidence bofore 24 hours. However, the incidence was lower in the cases of RDS. 5) With respect to etiological bacteria, Staphylococci were more frequently observed in full-term newborns while Gram negative bacilli were more frequently among the premature newborns. When the duration of ruptured membrane exceeds 24 hours, the incidence of neonatal sepsis, asphyxia and death increased. Therefore, the appropriate management recommended is initial antibiotic therapy and adequate resuscitation measure to reduce the incidence of neonatal mortality.

Keywords :Premature rupture of membrane; Sepsis; Neonatal asphyxia;RDS; Neonatal death.