Recommended Citation
Danen C, Adefisoye JO, Kram JJF, Forgie M. Latency after Preterm Pre-labor Rupture of Membranes (PPROM) and Outcomes at a Single Community Hospital. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Preterm pre-labor rupture of membranes (PPROM, membrane rupture <37 weeks>gestation) is associated with increased morbidity/mortality. Guidelines recommend inpatient management until the risks of pregnancy outweigh the risks of neonatal prematurity under 34 weeks’ gestation. Latency, time from PPROM to delivery, varies from days to weeks secondary to potential maternal/fetal complications. ACOG cites that most people deliver within 7.0 days with latency inversely correlating with gestational age at the time of PPROM. However, this is based on an older study out of Israel that may not be generalizable in the US. Updated studies can improve counseling for estimated gestational age at birth, which correlates with neonatal outcomes, and inform patients on anticipated length of inpatient stay.
Purpose:
To determine latency with inpatient PPROM management, and secondarily the relationship between latency and gestational age or other maternal/fetal factors.
Methods:
We retrospectively reviewed encounters with a singleton pregnancy diagnosed with PPROM between 23w0d–34w0d gestation at an urban, teaching hospital from 10/2012 – 10/2024. PPROM was identified using ICD-9 and ICD-10 codes. Encounters were excluded if patient did not receive standard management (7-day course of antibiotics, corticosteroids, and magnesium sulfate if <32w0d). For the latency period, we estimated the median (interquartile ranges [IQR]) and generalized linear models (GLM) with Tweedie distribution and a log link. Two-sided p < 0.05 were considered statistically significant.
Results:
Overall, 343 pregnancy encounters were identified. Following exclusions, 242 unique encounters were included. Primary reasons for delivery were spontaneous delivery (59.1%), induction at 34w0d (19.8%), and placental abruption (9.1%). Latency from inpatient management to delivery was 7.0 (IQR 3.0, 13.0) days. Patients diagnosed before 24w0d had the longest latency (14.5 days; IQR 7.0, 34.5), and patients diagnosed after 32w0d had the shortest latency (4.0 days; IQR 2.0, 8.0). Gestational age at time of PPROM diagnosis (adjusted Mean Ratio (aMR) 0.98, 95% Confidence Interval [CI] 0.97-0.99; p < 0.01) and spontaneous delivery (aMR 0.65, 95%CI 0.44-0.96; p < 0.03) were associated with latency time in multivariable GLM models.
Conclusion:
Our study reinforces previously available evidence with median latency time of 7.0 days and shorter latency periods with later PPROM diagnosis.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Latency after Preterm Pre-labor Rupture of Membranes (PPROM) and Outcomes at a Single Community Hospital
Background/Significance:
Preterm pre-labor rupture of membranes (PPROM, membrane rupture <37 weeks>gestation) is associated with increased morbidity/mortality. Guidelines recommend inpatient management until the risks of pregnancy outweigh the risks of neonatal prematurity under 34 weeks’ gestation. Latency, time from PPROM to delivery, varies from days to weeks secondary to potential maternal/fetal complications. ACOG cites that most people deliver within 7.0 days with latency inversely correlating with gestational age at the time of PPROM. However, this is based on an older study out of Israel that may not be generalizable in the US. Updated studies can improve counseling for estimated gestational age at birth, which correlates with neonatal outcomes, and inform patients on anticipated length of inpatient stay.
Purpose:
To determine latency with inpatient PPROM management, and secondarily the relationship between latency and gestational age or other maternal/fetal factors.
Methods:
We retrospectively reviewed encounters with a singleton pregnancy diagnosed with PPROM between 23w0d–34w0d gestation at an urban, teaching hospital from 10/2012 – 10/2024. PPROM was identified using ICD-9 and ICD-10 codes. Encounters were excluded if patient did not receive standard management (7-day course of antibiotics, corticosteroids, and magnesium sulfate if <32w0d). For the latency period, we estimated the median (interquartile ranges [IQR]) and generalized linear models (GLM) with Tweedie distribution and a log link. Two-sided p < 0.05 were considered statistically significant.
Results:
Overall, 343 pregnancy encounters were identified. Following exclusions, 242 unique encounters were included. Primary reasons for delivery were spontaneous delivery (59.1%), induction at 34w0d (19.8%), and placental abruption (9.1%). Latency from inpatient management to delivery was 7.0 (IQR 3.0, 13.0) days. Patients diagnosed before 24w0d had the longest latency (14.5 days; IQR 7.0, 34.5), and patients diagnosed after 32w0d had the shortest latency (4.0 days; IQR 2.0, 8.0). Gestational age at time of PPROM diagnosis (adjusted Mean Ratio (aMR) 0.98, 95% Confidence Interval [CI] 0.97-0.99; p < 0.01) and spontaneous delivery (aMR 0.65, 95%CI 0.44-0.96; p < 0.03) were associated with latency time in multivariable GLM models.
Conclusion:
Our study reinforces previously available evidence with median latency time of 7.0 days and shorter latency periods with later PPROM diagnosis.
Affiliations
Aurora Sinai Medical Center, Aurora UW Medical Group