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 · 2026
A model to predict latency in preterm prelabor rupture of membranes.
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Bromwich Kira A, Zafman Kelly B, Forkpa Markolline, Chittams Jesse, Goba Miatta, Thapa Natasha, Schwartz Nadav, Hamm Rebecca F
Аннотация
BACKGROUND: Unpredictability regarding latency following preterm premature rupture of membranes (PPROM) complicates counseling and contributes significant patient stress and uncertainty.
OBJECTIVE: To develop a predictive model for latency duration in patients presenting with PPROM.
STUDY DESIGN: 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.
RESULTS: 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).
CONCLUSION: 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.
OBJECTIVE: To develop a predictive model for latency duration in patients presenting with PPROM.
STUDY DESIGN: 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.
RESULTS: 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).
CONCLUSION: 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.