Pre-term pre-labour rupture of membranes (PPROM) occurs in approximately 3% of all pregnancies but is implicated in 30-40% of preterm births. Current guidance in the United Kingdom is to aim to continue the pregnancy until 37 completed weeks, unless birth is indicated sooner, or the woman goes into spontaneous labour. Maternal biomarkers in the context of PPROM have previously been reviewed in the context of predicting latency between membrane rupture and birth, but not neonatal outcome. Although neonatal outcome is closely associated with gestational age at birth, preterm infants with neonatal sepsis have a worse prognosis than their counterparts born at a similar gestational age without sepsis. Timing of birth in PPROM is thus a balancing act between maximizing gestational age at birth and initiating delivery prior to significant adverse outcome. Identification of predictors of adverse outcome at birth may help to guide timing of birth.
Buchan et al. (Sat,) studied this question.