Authors
Kira A Bromwich, Kelly B Zafman, Markolline Forkpa, Jesse Chittams, Miatta Goba, Natasha Thapa, Nadav Schwartz, Rebecca F Hamm
Published in
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. Volume 39. Issue 1. Pages 2708452. Epub Aug 25, 2026.
Abstract
Unpredictability regarding latency following preterm premature rupture of membranes (PPROM) complicates counseling and contributes significant patient stress and uncertainty.
To develop a predictive model for latency duration in patients presenting with PPROM.
We conducted a retrospective cohort study of singleton gestations presenting with PPROM between 24w0d and 32w6d from 2017-2022 at two academic hospitals. Patients with active labor, clinical chorioamnionitis, contraindications to expectant management, or known fetal anomalies were excluded. Primary outcomes were latency ≥2 days and ≥7 days. Data on maternal history, prenatal course, and presentation characteristics-including symptoms, laboratory values, vital signs, and fetal data-were collected via chart review. Multivariable logistic regression was used to generate predictive models.
Among 218 patients presenting with PPROM, 192 (88%) met inclusion criteria; exclusions were primarily due to fetal anomalies or contraindications to expectant management. Mean gestational age (GA) at presentation was 30w2d, and mean GA at delivery was 31w5d. Overall, 71.4% achieved a latency of ≥2 days, while 40.6% achieved a latency of ≥7 days. For latency ≥2 days, GA at presentation (p = 0.02), presence of contractions (p = 0.02), and cervical dilation (p = 0.03) were significantly associated. A model incorporating these variables demonstrated moderate discrimination (AUC 0.72). Parity, obstetric history, maternal vital signs, basic laboratory markers, and fetal heart rate patterns were not significant. For latency ≥7 days, only GA (p = 0.01) and cervical dilation (p = 0.01) were significant, yielding a lower-performing model (AUC 0.68).
A predictive model for latency ≥2 days can be generated for patients presenting with PPROM and may support individualized counseling and expectation-setting. An equally accurate predictive model is not able to be generated for latency ≥7 days.
PMID:
42642332
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.
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