The relationship between premature rupture of the membranes and the respiratory distress syndrome.

The records of 212 patients of 36 weeks' gestational age or less were reviewed to study the relationship between premature rupture of the membranes (PRM) and the development of the respiratory distress syndrome (RDS). PRM greater than 16 hours resulted in a statistically significant decrease of RDS in neonates of 32 weeks' gestational age or less but not in the group from 32 to 36 weeks' gestational age. However, survival was significantly improved with PRM greater than 16 hours in the latter group but not in the former. A possible explanation for this observation is offered. Black patients had a higher over-all infant mortality rate than white patients, and, although the incidence of RDS is similar in both races, it may be a more lethal condition in black patients. There was no significant difference noted between female and male infants. Sepsis was responsible for only seven deaths in this series, and three of those cases could not be etiologically related to prolonged PRM.