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Preterm prelabour rupture of membranes: a retrospective cohort study of association with adverse outcome in subsequent pregnancy.
BJOG. 2017 Oct; 124(11):1698-1707.BJOG

Abstract

OBJECTIVE

To assess the association of first pregnancy preterm prelabour rupture of membranes (PPROM) with adverse maternal and perinatal outcomes in the next pregnancy.

DESIGN

Retrospective cohort study.

SETTING

Grampian, Scotland, UK.

POPULATION

Women with first deliveries recorded in the Aberdeen Maternity Neonatal Databank, 1986-2005.

METHODS

Women identified from the AMND database (n = 37 776) were classified into exposed (PPROM in first pregnancy; n = 1979) and unexposed (no PPROM in first pregnancy; n = 35 797) cohorts. Each cohort (exposed n = 1174; unexposed n = 20 860) was followed up until December 2012 for next singleton pregnancy.

MAIN OUTCOME MEASURES

Second pregnancy, miscarriage, pregnancy-induced hypertension (PIH), pre-eclampsia (PE), antepartum haemorrhage (APH) and postpartum haemorrhage, repeat PPROM, type of labour, mode of delivery, preterm delivery, low birth weight (LBW), admission to neonatal unit, neonatal infections and death.

RESULTS

PPROM in the first singleton pregnancy was associated with an equal likelihood of second pregnancy but with a significantly increased risk of adverse outcomes in the next singleton pregnancy: PPROM [odds ratio (OR) (95% confidence interval (CI)): 6.6 (5.4-7.9)], PE [2.4 (1.7-3.5)], instrumental [2.2 (1.7-2.8)] and caesarean delivery [1.8 (1.5-2.3)], PIH [1.5 (1.2-1.9)] and APH [1.3 (1.1-1.6)] in the mother, and neonatal infection [5.4 (1.4-20.3)], death [2.6 (1.0-6.7)], admission to neonatal unit [2.4 (2.0-2.9)], preterm delivery [2.3 (1.8-2.9)] and LBW [1.44 (1.1-1.9)]. Even in women without a recurrent PPROM, there was still a significant increase in PIH [1.4 (1.1-1.8)], PE [2.3 (1.6-3.5)], instrumental [2.2 (1.7-2.9)] and caesarean delivery [1.9 (1.5-2.4)], and neonatal unit admission [1.6 (1.3-2.0)].

CONCLUSIONS

PPROM in the first pregnancy is associated with significant adverse maternal and perinatal outcomes in the next pregnancy, but not reduced likelihood of second pregnancy.

TWEETABLE ABSTRACT

PPROM in the first singleton pregnancy increases risk of adverse maternal and perinatal outcomes in the next singleton pregnancy.

Authors+Show Affiliations

Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.Obstetric Epidemiology, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28029224

Citation

Aris, I M., et al. "Preterm Prelabour Rupture of Membranes: a Retrospective Cohort Study of Association With Adverse Outcome in Subsequent Pregnancy." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 124, no. 11, 2017, pp. 1698-1707.
Aris IM, Logan S, Lim C, et al. Preterm prelabour rupture of membranes: a retrospective cohort study of association with adverse outcome in subsequent pregnancy. BJOG. 2017;124(11):1698-1707.
Aris, I. M., Logan, S., Lim, C., Choolani, M., Biswas, A., & Bhattacharya, S. (2017). Preterm prelabour rupture of membranes: a retrospective cohort study of association with adverse outcome in subsequent pregnancy. BJOG : an International Journal of Obstetrics and Gynaecology, 124(11), 1698-1707. https://doi.org/10.1111/1471-0528.14462
Aris IM, et al. Preterm Prelabour Rupture of Membranes: a Retrospective Cohort Study of Association With Adverse Outcome in Subsequent Pregnancy. BJOG. 2017;124(11):1698-1707. PubMed PMID: 28029224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preterm prelabour rupture of membranes: a retrospective cohort study of association with adverse outcome in subsequent pregnancy. AU - Aris,I M, AU - Logan,S, AU - Lim,C, AU - Choolani,M, AU - Biswas,A, AU - Bhattacharya,S, Y1 - 2016/12/28/ PY - 2016/10/25/accepted PY - 2016/12/29/pubmed PY - 2018/12/14/medline PY - 2016/12/29/entrez KW - Cohort KW - neonatal outcome KW - obstetric outcome KW - preterm delivery KW - preterm prelabour rupture of membranes KW - recurrence KW - subsequent pregnancy SP - 1698 EP - 1707 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 124 IS - 11 N2 - OBJECTIVE: To assess the association of first pregnancy preterm prelabour rupture of membranes (PPROM) with adverse maternal and perinatal outcomes in the next pregnancy. DESIGN: Retrospective cohort study. SETTING: Grampian, Scotland, UK. POPULATION: Women with first deliveries recorded in the Aberdeen Maternity Neonatal Databank, 1986-2005. METHODS: Women identified from the AMND database (n = 37 776) were classified into exposed (PPROM in first pregnancy; n = 1979) and unexposed (no PPROM in first pregnancy; n = 35 797) cohorts. Each cohort (exposed n = 1174; unexposed n = 20 860) was followed up until December 2012 for next singleton pregnancy. MAIN OUTCOME MEASURES: Second pregnancy, miscarriage, pregnancy-induced hypertension (PIH), pre-eclampsia (PE), antepartum haemorrhage (APH) and postpartum haemorrhage, repeat PPROM, type of labour, mode of delivery, preterm delivery, low birth weight (LBW), admission to neonatal unit, neonatal infections and death. RESULTS: PPROM in the first singleton pregnancy was associated with an equal likelihood of second pregnancy but with a significantly increased risk of adverse outcomes in the next singleton pregnancy: PPROM [odds ratio (OR) (95% confidence interval (CI)): 6.6 (5.4-7.9)], PE [2.4 (1.7-3.5)], instrumental [2.2 (1.7-2.8)] and caesarean delivery [1.8 (1.5-2.3)], PIH [1.5 (1.2-1.9)] and APH [1.3 (1.1-1.6)] in the mother, and neonatal infection [5.4 (1.4-20.3)], death [2.6 (1.0-6.7)], admission to neonatal unit [2.4 (2.0-2.9)], preterm delivery [2.3 (1.8-2.9)] and LBW [1.44 (1.1-1.9)]. Even in women without a recurrent PPROM, there was still a significant increase in PIH [1.4 (1.1-1.8)], PE [2.3 (1.6-3.5)], instrumental [2.2 (1.7-2.9)] and caesarean delivery [1.9 (1.5-2.4)], and neonatal unit admission [1.6 (1.3-2.0)]. CONCLUSIONS: PPROM in the first pregnancy is associated with significant adverse maternal and perinatal outcomes in the next pregnancy, but not reduced likelihood of second pregnancy. TWEETABLE ABSTRACT: PPROM in the first singleton pregnancy increases risk of adverse maternal and perinatal outcomes in the next singleton pregnancy. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/28029224/Preterm_prelabour_rupture_of_membranes:_a_retrospective_cohort_study_of_association_with_adverse_outcome_in_subsequent_pregnancy_ L2 - https://doi.org/10.1111/1471-0528.14462 DB - PRIME DP - Unbound Medicine ER -