Abstract
We revisited risk factors and outcomes related to the preterm premature rupture of membranes (PPROM). A total of 7866 pregnant women were recruited during 5 years at their first prenatal visit to the perinatal clinic of the institution. We compared three groups (women without prematurity, women with spontaneous preterm labor with intact membranes (sPL with IM), women with PPROM) regarding 60 criteria about characteristics, lifestyle, medical, gynecological, obstetrical history of mothers, medication during pregnancy, events at delivery, and complications in neonates. Logistic regression analyses adjusting for potential confounding factors were used. Of the 6968 women selected, 189 (2.8%) presented a PPROM, and 225 (3.2%) an sPL with IM. The specific risk factors for PPROM were body mass index (BMI) <18.5 kg/m2 (adjusted odds ratio, aOR: 2.00 (1.09–3.67)), history of PPROM (aOR: 2.75 (1.19–6.36)), nulliparity (aOR: 2.52 (1.77–3.60)), gestational diabetes (aOR: 1.87 (1.16–2.99)), and low level of education (aOR: 2.39 (1.20–4.78)). The complications associated with PPROM were abruption placentae, cesarean, APGAR 5′ <4, birth weight <2500 g, stillbirth, neonatal jaundice, and hospitalization of mother and neonates. All these complications were also associated with sPL with IM. Our study confirms some of the risk factors of PPROM and highlights a new one: gestational diabetes. Outcomes of PPROM are related to prematurity.
Highlights
Preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 37 weeks of gestation, complicates approximately 2%–4% of all pregnancies and is responsible for 40% of all spontaneous preterm births [1,2], while spontaneous preterm labor with intact membranes represents 60% of spontaneous preterm births [3]
We proposed to revisit the risk factors and outcomes of PPROM, based on a well-characterized large-scale prospective cohort of 7866 pregnant women recruited at their first prenatal visit to the perinatal clinic of the institution
Our study identified a new risk factor of PPROM, gestational diabetes, which resulted in a 1.87-fold increased risk
Summary
Preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 37 weeks of gestation, complicates approximately 2%–4% of all pregnancies and is responsible for 40% of all spontaneous preterm births [1,2], while spontaneous preterm labor with intact membranes (sPL with IM) represents 60% of spontaneous preterm births [3]. Many factors can increase the risk of PPROM, its cause is not fully understood [5]. A history of PPROM, a history of prematurity, or multiple pregnancies are predominant considered risk factors [2,10,11]. Other factors, such as nulliparity, the interval between pregnancies (60 months), cervico-isthmic abnormalities, genital infections, and hydramnios, have been reported [8,10,12,13]. The outcomes associated with PPROM include prematurity, oligohydramnios, abruption placentae, intrauterine infection, and chorioamnionitis [2,14,15]
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