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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 2

Category: Prematurity

Poster Session 2

(581) Shorter Latency After Previable PPROM Is Associated With Increased Risk of Subsequent Preterm Birth

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Marissa A. Hand, MD

    Resident
    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Cleveland, Ohio, United States

    • Coauthor(s)

  • HS

    Hannah Sinks, MD

    Hofstra Northwell School of Medicine
    Hofstra Northwell School of Medicine, New York, United States

  • AD

    Amrit Dhanushkoti, BS

    University of Newcastle
    University of Newcastle, New South Wales, Australia

  • CC

    Christine Chien, MD

    Resident
    Carle Foundation Hospital
    Urbana, Illinois, United States

  • CP

    Caroline Pennacchio, MD

    Resident
    University of Pittsburgh Medical Center
    University of Pittsburgh Medical Center, Pennsylvania, United States

  • CK

    Catherine Klammer, MD

    Fellow
    University of Pennsylvania
    University of Pennsylvania, Pennsylvania, United States

  • AH

    Adriana Huelmo, BS

    University of Newcastle
    University of Newcastle, New South Wales, Australia

  • MY

    Meng Yao, MS

    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Ohio, United States

  • CW

    Carol Wang, BSc

    University of Newcastle
    University of Newcastle, New South Wales, Australia

  • LG

    Lisa Gray, BS, MD

    Associate Medical Director of Maternal-Fetal Medicine
    Carle Foundation Hospital
    Carle Foundation Hospital, Illinois, United States

  • DG

    Dzhamala Gilmandyar, MD

    Associate Director, Division of Maternal-Fetal Medicine
    Hofstra Northwell School of Medicine
    Hofstra Northwell School of Medicine, New York, United States

  • AA

    Ahmed Ahmed, MD, MSc, RDMS

    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Ohio, United States

  • AM

    Amol Malshe, MD

    MFM
    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Ohio, United States

  • Craig Pennell, MBBS, PhD (he/him/his)

    Chair in Obstetrics and Gynaecology, Professor of Maternal Fetal Medicine
    University of Newcastle
    University of Newcastle, New South Wales, Australia

Objective:
Women who experience previable preterm premature rupture of membranes (PPROM) are at increased risk for recurrent preterm birth (PTB) in subsequent pregnancies. However, limited data exist regarding factors that may influence this recurrence risk. One potential factor is the time to onset of labor after membrane rupture during the index pregnancy, reflecting underlying inflammatory or structural abnormalities. Length of latency following previable PPROM may help guide counseling and risk stratification for future pregnancies.

Study Design:
A multinational, retrospective cohort study of pregnancies complicated by previable PPROM (14w0d–23w6d) in the U.S. and Australia from 2010–2023, and subsequent pregnancy outcomes beyond 14 weeks were included. Patients were grouped by latency duration in the index pregnancy: labor onset < 24 hours (idiopathic preterm birth) vs. > 24 hours. Cases with IUFD preceding PPROM or artificial rupture were excluded. Outcomes in the index pregnancy were stratified as early mid-trimester loss (MTL) (14w0d–19w6d), late MTL (20w0d–23w6d), and PTB (24w0d–36w6d).

Results:
Of 111 patients with previable PPROM, 35 spontaneously labored within 24 hours and 76 after 24 hours. No significant differences were observed in aspirin or progesterone use, or hypertensive disorders in the index pregnancy. Patients who experienced idiopathic PTB < 24 weeks in the index pregnancy had an increased risk of MTL (11.4% vs. 7.9%, p = 0.073) and significantly higher rates of PTB (34.3% vs 17.1%, p < 0.001) in the subsequent pregnancy compared to those with ruptured for greater than 24 hours (Table 1).

Conclusion:
Among patients with previable PPROM, those who labored within 24 hours of membrane rupture were at increased risk of mid-trimester loss and significantly more likely to experience preterm birth in a subsequent pregnancy. These findings suggest that latency duration may serve as a clinically meaningful marker of underlying biological risk and inform surveillance strategies in future pregnancies.