Risk of recurrent preterm premature rupture of membrane in subsequent pregnancy: a systematic review and meta-analysis.
Yehua Min, Qingqing Yao
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In 30 seconds
This systematic review and random-effects meta-analysis assessed recurrent preterm prelabor rupture of membranes (PPROM) and preterm birth (PTB) in subsequent pregnancies among women with prior PPROM. Nine studies were included. The pooled risk of recurrent PPROM was 18% (95% CI: 12-25%), with high between-study heterogeneity (I² = 93%). Pooled PTB risk varied by gestational-age definition: 34% (95% CI: 22-59%) for birth before 37 weeks, 23% (95% CI: 12-39%) before 34 weeks, and 20% (95% CI: 9-38%) before 28 weeks.
Key findings
- Across nine studies, recurrent PPROM risk was 18% (95% CI: 12-25%).
- Heterogeneity in recurrent PPROM estimates was high (I² = 93%).
- PTB risk was 34% (95% CI: 22-59%) before 37 weeks, 23% (95% CI: 12-39%) before 34 weeks, and 20% (95% CI: 9-38%) before 28 weeks.
- Recurrence estimates varied in subgroup analyses by PPROM definition and study location.
Why it matters
These pooled estimates quantify the substantial risk of recurrent PPROM and preterm birth after a prior PPROM pregnancy. They can inform discussions of subsequent-pregnancy risk, while the marked heterogeneity and variation across definitions and locations indicate that the pooled figures may not apply uniformly to every population.
What to keep in mind
The review included nine studies and found high heterogeneity in recurrent PPROM estimates; subgroup estimates also varied by definition and location.