Eur J Obstet Gynecol Reprod Biol X. 2025 May 1;26:100393. doi: 10.1016/j.eurox.2025.100393. eCollection 2025 Jun.
ABSTRACT
OBJECTIVE: Expectant management is an option for preterm prelabor rupture of the membrane (PPROM) between 34 0/7 and 36 6/7 weeks of gestation. Even though expectant delivery in PPROM is justified, there is limited data on predictors of PPROM delivered > 48 hrs in a real-world setting. Therefore, this study aimed to find clinical predictors for delivery > 48 hrs in women with PPROM as well as clinical outcomes in clinical practice.
MATERIALS AND METHODS: This was a retrospective cohort study conducted at two tertiary care hospitals. The inclusion criteria were a singleton pregnancy with PPROM and planned expectant management. Clinical data were retrieved from the hospitals’ databases. Eligible pregnant women were categorized into two groups: PPROM delivered < 48 hrs or PPROM delivered > 48 hrs. The primary outcome was factors predictive of PPROM delivered > 48 hrs.
RESULTS: During the study period, 519 pregnant women met the study criteria. Of those, 90 pregnant women (17.34 %) had PPROM delivered > 48 hrs. Factors independently associated with PPROM delivered > 48 hrs were maternal age ≥ 19 years (adjusted odds ratio [aOR] 0.95, 95 % CI [0.91, 0.99]) and oligohydramnios (aOR 2.41, 95 % CI [1.45, 4.00]). Regarding maternal and neonatal outcomes, the PPROM delivered > 48 hrs group had lower neonatal birth weights (2245 g vs. 2490 g; p < 0.001) than the PPROM delivered < 48 hrs group. However, neonatal outcomes, including respiratory distress, sepsis, neonatal intensive care unit admission, early jaundice, hypoglycemia, positive pressure ventilation, and early respiratory support, were not different.
CONCLUSIONS: Clinical predictors for PPROM delivered > 48 hrs in a real-world setting were maternal age and presence of oligohydramnios. Maternal and neonatal outcomes in the PPROM delivered > 48 hrs were almost comparable with the PPROM delivered < 48 hrs. PPROM delivered > 48 hrs may be safe and can be a treatment option for PPROM. However, further studies may be required in terms of generalizability as this study was conducted retrospectively in tertiary care hospitals in Thailand.
PMID:40458601 | PMC:PMC12127862 | DOI:10.1016/j.eurox.2025.100393
