Abstract
This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006–2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery ≥72 h vs. immediate delivery <72 h). Data were compared among 345 women (expectant, n = 39; immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p < 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (≥72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM.
Highlights
Preterm premature rupture of membranes (PPROM), defined as the rupture of membranes before 37 weeks of gestation, accounts for one-third of all preterm births [1]
We investigated whether expectant management longer than 72 h improved outcomes in late preterm (LPT) infants with PPROM according to gestational age
The median gestational age at PPROM was shorter in the expectant group
Summary
Preterm premature rupture of membranes (PPROM), defined as the rupture of membranes before 37 weeks of gestation, accounts for one-third of all preterm births [1]. PPROM occurs between 23 + 0 and 34 + 0 weeks of gestation, expectant management in women without evidence of infection is used as the standard form of care, with suggested delivery at 34 + 0 weeks of gestation if labor has not yet ensued. The optimal time for delivery beyond 34 + 0 weeks of gestation with PPROM is still considered controversial. The management of PPROM depends on the balance between the risk of ascending infection and those associated with prematurity. Three trials (PROMEXIL, PROMEXIL 2, and PPROMT) comparing active and expectant management in women with PPROM at 34 + 0 and 36 + 6 weeks of gestation did not show that immediate delivery reduces the rate of early onset neonatal sepsis. Current emerging evidence suggests that LPT infants born at 34
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