{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:48:05Z","timestamp":1766738885950,"version":"3.37.3"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"name":"The Research Council of Uppsala-\u00d6rebro County Council"},{"name":"ALF funding from Uppsala University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Preterm birth (PTB, birth before 37 gestational weeks) is the leading cause of neonatal death and a major challenge for obstetric and neonatal care. About two-thirds of PTBs are spontaneous PTB (sPTB), of which approximately 30% start with preterm premature rupture of membranes (PPROM). The aim of the study was to investigate risk factors and maternal and perinatal outcomes in sPTB with and without PPROM.<\/jats:p><jats:p>\n            Study Design\u2003This is a national population-based cohort study including all singleton pregnancies in nulliparous women with spontaneous onset of labor and vaginal births (n\u2009=\u2009266,968) registered in the Swedish Medical Birth Register 2005 to 2014. sPTB with PPROM (sPTB-PPROM) and sPTB without PPROM were compared regarding risk factors and maternal and perinatal outcomes. Logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, body mass index, country of birth, smoking, chronic hypertension, pregestational and gestational diabetes, and gestational length.<\/jats:p><jats:p>\n            Results\u2003sPTB-PPROM (n\u2009=\u20095,037), compared with sPTB without PPROM (n\u2009=\u20098,426), was more common in women with previous spontaneous abortions, prepregnancy urinary tract infections, chronic hypertension, and gestational diabetes and had a higher risk of postpartum endometritis (aOR: 2.78, 95% CI: 1.55\u20135.00). Infants born to women with sPTB-PPROM had a lower risk of birth asphyxia (aOR: 0.60, 95% CI: 0.43\u20130.83), respiratory distress syndrome (aOR: 0.86, 95% CI: 0.70\u20131.00), retinopathy of prematurity (aOR: 0.93, 95% CI: 0.92\u20130.94), necrotizing enterocolitis (aOR: 0.95, 95% CI: 0.94\u20130.96), and higher risk of hypoglycemia (aOR: 1.14, 95% CI: 1.01\u20131.28), and hyperbilirubinemia (aOR: 1.28, 95% CI: 1.19\u20131.38) compared with infants born to sPTB without PPROM.<\/jats:p><jats:p>\n            Conclusion\u2003Our findings of risk factors and distinct differences in adverse outcomes after sPTB-PPROM compared with sPTB without PPROM are of vital importance and might serve as a basis when elaborating programs for the prevention and management of PPROM.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1973-7482","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:22:41Z","timestamp":1667953361000},"page":"e958-e967","source":"Crossref","is-referenced-by-count":5,"special_numbering":"S","title":["Maternal and Perinatal Outcomes in Singleton Nulliparous Spontaneous Preterm Birth with and without Preterm Premature Rupture of Membranes\u2014A National Population-Based Cohort Study"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-8140","authenticated-orcid":false,"given":"Tansim","family":"Akhter","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Hesselman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"},{"name":"Department of Clinical Research, Falun; Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Lindstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ove","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"},{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden and Centre for Clinical Research, S\u00f6rmland, Uppsala University, Eskilstuna, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inger Sundstr\u00f6m","family":"Poromaa","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000365798","article-title":"Global incidence of preterm birth","volume":"81","author":"J M Tielsch","year":"2015","journal-title":"Nestle Nutr Inst Workshop Ser"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications","volume":"379","author":"H 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