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Predictors of Short-Term and Long-Term Latency After Preterm Premature Rupture of Membranes: A Retrospective Cohort
Shokoh Abotorabi1, Maryam Rafiei1, Solmaz Chamanara1
1Department of Obstetrics and Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran, qums.ac.ir.
Background:
Preterm premature rupture of the membranes (PPROM) is the spontaneous rupture of fetal membranes before the 37th gestational week. Despite the importance of the duration of the latency period (time duration between occurrence of PPROM and childbirth), the knowledge regarding its predictive factors is limited and inconsistent.
Aim:
The present study is aimed at identifying the predictive factors of short-term and long-term latency among PPROM cases.
Methods:
A retrospective cohort study was conducted using hospital-based data from a single academic tertiary care hospital between January 2018 and December 2022. Demographic and clinical characteristics of 200 participants admitted due to PPROM were collected. Latency duration was categorized into three categories: less than 48 h; 48 h-7 days (considered as short-term latency); and more than 7 days (considered as long-term latency). In order to investigate the predictors of short-term and long-term latency among PPROM cases, univariable (using ꭓ2, Exact F statistic, and analysis of variance) and multivariable models (multivariable multinomial logistic regression model) were used.
Results:
The only significant predictor of latency duration between 48 h and 7 days, compared with latency duration of < 48 h, was lower gestational age at admission (4% decrease with each day increasing in gestational age at admission, p = 0.02). The significant predictors of latency duration of > 7 days compared with latency duration of < 48 h were lower gestational age at admission (8% decrease with each day increasing in gestational age at admission, p < 0.001), normal glucose tolerance status (7.95 times increased chance, p = 0.003), cervical dilation of <2 cm vs. ≥ 2 cm dilatation at admission (3.27 times increased chance, p = 0.013), and pregnancy termination due to reaching 34 weeks of gestation (36.63 times increased chance, p < 0.001) compared with termination due to labor pain. These variables explained 42.3% of variance for latency duration.
Conclusion:
Obstetricians can expect longer latency period when PPROM cases are admitted at lower gestational age, having normal glucose tolerance status, and cervical dilation of <2 cm vs. ≥ 2 cm dilatation at admission.
