Peer-reviewed article
Risk of recurrent preterm premature rupture of membrane in subsequent pregnancy: a systematic review and meta-analysis.
Yehua Min, Qingqing Yao ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examines the risk of recurrent preterm premature rupture of membranes (PPROM) and preterm birth in women who experienced PPROM in a previous pregnancy. The analysis of nine studies found that approximately 18% of women with prior PPROM experience recurrence, and 34% have preterm birth in their next pregnancy. The review provides clinical risk estimates for pregnant women with obstetric history but does not address child well-being outcomes.
Key points
- Recurrent PPROM risk in subsequent pregnancy is 18% (95% CI: 12-25%)
- Preterm birth risk when defined as <37 weeks is 34% (95% CI: 22-59%)
- High inter-study heterogeneity was noted (I2 = 93%)
- Risk varies depending on how preterm birth is defined (<34 weeks: 23%; <28 weeks: 20%)
- Study included nine peer-reviewed publications on recurrence patterns
Limitations
This is a maternal obstetric outcomes study focused on pregnancy recurrence patterns rather than child well-being after birth. The review does not evaluate interventions or assess health outcomes in children themselves.
Abstract
OBJECTIVE: Preterm prelabor rupture of membranes (PPROMs) is associated with high rates of neonatal mortality and morbidity. We aimed to review evidence on the risk of recurrent PPROM and preterm birth (PTB) in women with a history of PPROM in prior pregnancy. METHODS: PubMed, Embase, Scopus, and Web of Science databases were searched up to 26 August 2025, for studies reporting the recurrent risk of PPROM and/or PTB in the subsequent pregnancy. Pooled estimates with 95% confidence intervals (CIs) were calculated in the DerSimonian-Laird random-effects meta-analysis model. RESULTS: Nine studies were included. Pooled analysis showed that the overall risk of recurrent PPROM in women was 18% (95% CI: 12-25%). Inter-study heterogeneity was high (I2 = 93%). On leave-one-out meta-analysis, the recurrence rate varied from 16% (95% CI: 11-22%) to 20% (95% CI: 14-27%). The risk of PTB when defined as <37 weeks was 34% (95% CI: 22-59%), while the risk was 23% (95% CI: 12-39%) and 20% (95% CI: 9-38%) when PTB was defined as <34 and <28 weeks, respectively. Subgroup analysis based on the definition of PPROM and location resulted in varied estimates. CONCLUSIONS: Women with PPROM in the prior pregnancy have a high risk of recurrence of PPROM as well as PTB.