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Rupture of membranes and short-term respiratory outcomes in extremely preterm infants: a multicenter retrospective

Gonzalo Solís-García1,2, Alejandro Avila-Alvarez3,4, Fermín García-Muñoz Rodrigo5,6

  • 1Neonatology Department, Hospital Universitario la Paz, Madrid, Spain.

Pediatric Research
|June 1, 2026
PubMed

Insights

Preterm premature rupture of membranes (PPROM) timing impacts survival in extremely preterm infants. Earlier gestational age at rupture of membranes and longer latency to delivery are linked to worse outcomes, affecting survival and respiratory health.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Obstetrics

Background:

  • Preterm premature rupture of membranes (PPROM) affects extremely preterm infants.
  • Understanding the epidemiology and outcomes of PPROM is crucial for this vulnerable population.
  • The timing of rupture of membranes (ROM) is a key factor influencing infant survival and respiratory health.

Purpose of the Study:

  • To describe the epidemiology and outcomes of PPROM in extremely preterm infants.
  • To analyze the impact of ROM timing on survival and short-term respiratory outcomes.
  • To provide data for improved family counseling and perinatal decision-making.

Main Methods:

  • An observational, multi-center cohort study was conducted.
  • Included extremely preterm infants born between 23 weeks 0 days and 27 weeks 6 days gestation.
  • Key exposure variables included gestational age at ROM and the interval from ROM to birth; primary outcome was survival without bronchopulmonary dysplasia (BPD).

Main Results:

  • The study included 4954 infants; median gestational age was 26 weeks.
  • Higher gestational age at ROM correlated with increased survival and survival without BPD, and decreased pneumothorax risk.
  • Longer intervals from ROM to delivery were associated with decreased survival, decreased survival without BPD, and increased pneumothorax risk.

Conclusions:

  • The timing of ROM significantly impacts survival and survival without BPD in extremely preterm infants.
  • Both earlier gestational age at ROM and prolonged latency to delivery are associated with adverse outcomes.
  • These findings underscore the importance of considering ROM timing in counseling families regarding preterm birth risks.
Abstract

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