Cause and effect of preterm prelabor rupture of membranes during pregnancy: An observational cohort study

Background . Preterm prelabor rupture of membranes constitutes a pregnancy complication that accompanies preterm labor. Since this complication increases neonatal and maternal morbidity and mortality, it is relevant to conduct studies on the effect that the length of the latency period in preterm prelabor rupture of membranes has on the health status of the mother and child. Objective . To identify risk factors for preterm prelabor rupture of membranes in order to predict complications in subsequent pregnancies (possibly with the use of artificial intelligence). Methods . We conducted an observational cohort study examining the medical records of 82 pregnant women aged 18 to 43 years at 25–36 weeks of gestation diagnosed with preterm prelabor rupture of membranes (medical histories of pregnant women, labor records, and medical records of newborns). The study was conducted at the Perinatal Center of the Children’s Regional Clinical Hospital of the Ministry of Health of Krasnodar Krai. The medical records of pregnant women and newborns delivered in 2022–2023 were examined. A total of 1675 labor records were analyzed, of which 82 (4.9%) were selected as consistent with the “diagnosis of preterm prelabor rupture of membranes” (i.e., breaking of waters before 37 weeks). Depending on the length of the latency period, all subjects were divided into three groups: Group 1 (n = 35) with the latency period lasting from 12 to 24 hours; Group 2 (n = 8) with the latency period lasting from 24 to 48 hours; Group 3 (n = 39) with the latency period lasting from 48 hours and more. The study examined the anthropometric data of pregnant women and newborns, reproductive history, the course of current pregnancies, their outcomes, laboratory data, and the health status of newborns according to medical records. The statistical analysis was performed using Statistica 13.3 (Tibco, USA). The generally accepted level of statistical significance p = 0.05 was adopted. Results . The most significant differences between the groups of patients with preterm prelabor rupture of membranes were observed in the number of smoking fathers, pregnancy duration, and endometrial echo on ultrasound after delivery. Such information provides a means to predict the course of subsequent pregnancies and can identify a group of patients in need of obstetric rehabilitation. Conclusion . The analysis of somatic and reproductive history and the course of current pregnancies, as well as the assessment of neonatal health, served as the basis for developing a program for patients with a history of preterm prelabor rupture of membranes and in need of obstetric rehabilitation.