Prevalence of term prelabor rupture of membranes and factors associated with a longer interval of rupture: data from the 2021 French national perinatal survey

Abstract

Objectives

Term prelabor rupture of membranes (term PROM) increases maternal and neonatal morbidity, but its current prevalence is unknown. This study aimed to estimate the prevalence of term PROM and to identify factors associated with a longer interval of rupture of membranes using recent national population-based data.

Study design

Women with singleton pregnancies and term deliveries from the 2021 French National Perinatal Survey were selected. The prevalence of term PROM, defined as the rupture of membranes from 37 weeks before spontaneous labor, and its 95 % confidence interval (CI) were estimated. The median interval of rupture, defined as the time between the rupture of membranes and the onset of spontaneous labor, induction or prelabor caesarean (whichever occurred first) was calculated. Sociodemographic and pregnancy factors related to a longer interval of rupture of membranes were analyzed using a survival analysis, adjusting for competitive risks of a spontaneous labor: induction of labor and prelabor cesarean. Adjusted Hazard Ratios (aHR) were calculated using multivariate analysis.

Results

Among 10,810 eligible women, 3,052 had a term PROM, yielding a prevalence of 28.2 % (95 %CI 27.4–29.1). The median interval of rupture was 8.3 h (Interquartile 25–75[3.5–21.3]). Within the first 24 h following PROM, 90 % of women with a spontaneous labor were in labor. Factors associated with a longer interval of rupture included maternal age ≥35 (aHR = 0.82 95 %CI 0.72–0.93), primiparity (aHR = 0.73 95 %CI 0.66–0.81), Body-mass Index ≥25 (aHR = 0.87 95 %CI 0.77–0.97) or ≥30 (aHR = 0.73 95 %CI 0.62–0.85), being single (aHR = 0.66 95 %CI 0.48–0.90) and lower education (aHR = 0.82 95 %CI 0.69–0.97).

Conclusions

Term PROM affects more than one in four women. Sociodemographic factors and parity are associated with a longer interval of rupture.