Determinants for premature rupture of membranes: a prospective cohort study

This prospective cohort study underscores the importance of parity, considered as a confounder when analyzing determinants for PROM and PPROM in future research. We also found that in nulliparous women, presence of uterine fibroids increased the risk of PPROM while regular exercise reduced the risk; in multiparous women, presence of uterine fibroids was not correlated while regular exercise increased the risk. While occupational stress exhibited preliminary associations, refined exposure metrics are needed to clarify its role. Future research should integrate biological mediators, objective measures and diverse cohorts to confirm the associations and optimize prevention strategies.