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. 2019 Nov 15;8(11):1987.
doi: 10.3390/jcm8111987.

Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited

Damien Bouvier  1 , Jean-Claude Forest  2 , Loïc Blanchon  3 , Emmanuel Bujold  4 , Bruno Pereira  5 , Nathalie Bernard  6 , Denis Gallot  7 , Vincent Sapin  1 , Yves Giguère  2
Affiliations

Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited

Damien Bouvier et al. J Clin Med. .

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.

Keywords: PPROM; gestational diabetes; outcomes; risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study. BMI: Body mass index, HDP: Hypertensive disorders of pregnancy, ICU: Intensive care unit, IUGR: Intrauterine growth retardation, PPROM: Preterm premature rupture of membranes, sPL with IM: spontaneous preterm labor with intact membranes.
Figure 2
Figure 2
Forest plot showing odds ratios for risk factors of preterm premature rupture of membranes integrated into a multivariable analysis after a bootstrapping process. Horizontal lines represent 95% CIs. CI: confidence interval.
See this image and copyright information in PMC

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