International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
Maternal infection in the context of actively managed prelabor rupture of membranes at term: An observational study.
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Martins Inês, Gomes Brou Inês, Macedo Miguel, Pinto Luísa
Аннотация
OBJECTIVE: To assess maternal infection following prelabor rupture of membranes (PROM) at term in a setting where active management is recommended, and to identify associated risk factors.
METHODS: A retrospective cohort study was conducted including pregnant women admitted to a Portuguese tertiary care center where immediate induction of labor is recommended following term PROM. Women with singleton term pregnancies complicated by PROM, who delivered between January 2020 and July 2023, were included. The primary outcome was intrauterine maternal infection, defined as clinical chorioamnionitis and/or endometritis. A comparative analysis was conducted between groups, based on latency to delivery (≤12 h vs. >12 h). A multivariable logistic regression model was used to evaluate the influence of confounding factors on the association between latency and the primary outcome.
RESULTS: A total of 759 patients with singleton term pregnancies complicated by PROM were included, corresponding to a prevalence of 9.7%. Chorioamnionitis and/or endometritis occurred in 40 patients (5.3%), with significantly different rates between the up to 12 h and the more than 12 h latency groups (0.9% vs. 7.3%, P < 0.001). Latency of more than 12 h was independently associated with maternal infection (odds ratio 9.0; 95% confidence interval 2.1-39.2). Group B streptococcus colonization status was not associated with increased maternal infection risk. Neonatal outcomes were similar between groups.
CONCLUSION: This study demonstrates the increased risk of maternal infection when latency exceeds 12 h following term PROM, supporting the rationale for active management strategies and highlighting the need to evaluate additional prophylactic measures.
METHODS: A retrospective cohort study was conducted including pregnant women admitted to a Portuguese tertiary care center where immediate induction of labor is recommended following term PROM. Women with singleton term pregnancies complicated by PROM, who delivered between January 2020 and July 2023, were included. The primary outcome was intrauterine maternal infection, defined as clinical chorioamnionitis and/or endometritis. A comparative analysis was conducted between groups, based on latency to delivery (≤12 h vs. >12 h). A multivariable logistic regression model was used to evaluate the influence of confounding factors on the association between latency and the primary outcome.
RESULTS: A total of 759 patients with singleton term pregnancies complicated by PROM were included, corresponding to a prevalence of 9.7%. Chorioamnionitis and/or endometritis occurred in 40 patients (5.3%), with significantly different rates between the up to 12 h and the more than 12 h latency groups (0.9% vs. 7.3%, P < 0.001). Latency of more than 12 h was independently associated with maternal infection (odds ratio 9.0; 95% confidence interval 2.1-39.2). Group B streptococcus colonization status was not associated with increased maternal infection risk. Neonatal outcomes were similar between groups.
CONCLUSION: This study demonstrates the increased risk of maternal infection when latency exceeds 12 h following term PROM, supporting the rationale for active management strategies and highlighting the need to evaluate additional prophylactic measures.