TOPLINE:

Among pregnancies complicated by previable preterm premature rupture of membranes (PPROM) before 24 weeks of gestation, two thirds resulted in live births; of these, most infants survived to discharge, and nearly three quarters were discharged without severe comorbidities.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to evaluate neonatal and pregnancy outcomes following previable PPROM before 24 weeks of gestation, to identify factors associated with adverse outcomes, and to describe the condition of infants who survived.
• They included 130 foetuses affected by PPROM before 24 weeks of gestation (mean gestational age at PPROM, 19.3 weeks) who were monitored and delivered at a hospital in France between 2014 and 2019.
• PPROM was diagnosed on the basis of reported leakage of amniotic fluid or findings on clinical examination and confirmed by an immunochromatographic test when needed.
• Maternal and neonatal data were collected from electronic medical records, including daily clinical charts for infants admitted to the NICU.

TAKEAWAY:

• A total of 85 infants were born alive at a mean gestational age of 31.9 weeks, following a median latency period of 92 days. Spontaneous preterm labour accounted for 56.5% of deliveries, medically induced labour accounted for 43.5%, and planned preterm caesarean sections accounted for 5.8%; overall, 26.7% of deliveries needed emergency caesarean sections.
• Among live-born infants, 39% were admitted to the maternity ward without respiratory failure, 76% were preterm, 62% had immediate respiratory distress, 28% developed pulmonary arterial hypertension, 61% were admitted to the NICU, and 48% needed intubation during hospital stay.
• During hospitalisation, 8% of live-born infants died, whereas 92% survived to hospital discharge, and 75% were discharged without severe comorbidities.
• Preterm delivery and short latency after PPROM were independently associated with approximately threefold and eightfold higher risks for death or severe comorbidities, respectively.

IN PRACTICE:

"Parental counseling should be individualized, considering the evolving outcomes and the uncertain trajectory of pregnancies complicated by PPROM before 24 WG [weeks of gestation]. This counseling must be tailored to each specific case," the authors wrote.

"Moreover, extending pregnancy through vigilant monitoring and adherence to current neonatal management guidelines is crucial, as it can reduce the risk of adverse outcomes and enhance the likelihood of a healthier outcome for both mother and infant," they added.

SOURCE:

This study was led by Audrey Cossart, CHU Lille, Jeanne de Flandre Hospital, Lille, France. It was published online on January 30, 2026, in the European Journal of Pediatrics.

LIMITATIONS:

This study did not report any specific limitations explicitly.

DISCLOSURES:

This study did not report any specific funding source. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.