[Is previable rupture of membranes an independent neonatal prognostic factor from the gestational age at birth?]
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Updated: May 22, 2025
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Published on: November 20, 2015
Mélodie Luk1, Lola Loussert2, Karim Daou3
1Maternité Port Royal, hôpital Cochin, AP-HP, Paris, France.
Objective:
Compare, at the same gestational age at birth, survival without severe neonatal morbidity among live-born infants after previable premature rupture of membranes (PROM) occurring before 22weeks of gestation (WG) versus at or after 22weeks.
Methods:
Retrospective study conducted in a tertiary care referral center between 2016 and 2021, including live births between 23 and 36weeks+6days after PROM. Only live-born infants with neonatal resuscitation care were included. Each infant from the group PROM<22weeks was matched for gestational age at birth with the next two infants born after PROM≥22weeks. Maternal characteristics, obstetric outcomes, and neonatal outcomes were compared between the two groups. The primary outcome was survival without severe neonatal morbidity at discharge.
Results:
In total, 35 infants were included in the PROM<22weeks group and 70 in the PROM≥22weeks group. The median gestational age at birth was 28,4weeks (IQR [25,3-31,2]). The rate of survival without severe neonatal morbidity was significantly lower in the PROM<22weeks group compared to the PROM≥22weeks group (15/35 [42,9%] vs. 58/70 [82,9%], P<0.01). The number of deaths in the neonatal intensive care unit before 36weeks corrected age was higher in the PROM<22 weeks group (6 [17,1%] versus 3 [4,3%], P=0,03).
Conclusion:
Previable PROM is associated with a survival rate without severe neonatal morbidity that is twice lower than infants born at the same gestational age after PROM≥22weeks.
