{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:14:43Z","timestamp":1761808483885,"version":"3.37.3"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n            Objective\u2003We sought to characterize the incidence and risk factors associated with developing maternal morbidity following preterm prelabor rupture of membranes.<\/jats:p><jats:p>\n            Study Design\u2003Retrospective case\u2013control study of patients with preterm prelabor rupture of membranes at a single institution from 2013 to 2019 admitted at \u226523 weeks gestational age. The primary outcome was a composite of maternal morbidity which included: death, sepsis, intensive care unit (ICU) admission, acute kidney injury, postpartum dilation and curettage, postpartum hysterectomy, venous thromboembolism, postpartum hemorrhage, postpartum wound complication, postpartum endometritis, pelvic abscess, postpartum pneumonia, readmission, and\/or need for blood transfusion were compared with patients without above morbidities. Severe morbidity was defined as: death, ICU admission, venous thromboembolism, acute kidney injury, postpartum hysterectomy, sepsis, and\/or transfusion &gt;2 units. Demographics, antenatal, and delivery characteristics were compared between patients with and without maternal morbidity. Bivariate statistics and regression models were used to compare outcomes and calculate adjusted odd ratios.<\/jats:p><jats:p>\n            Results\u2003Of 361 included patients, 64 patients (17.7%) experienced maternal morbidity and nine (2.5%) had severe morbidity. Patients who experienced maternal morbidity were significantly (p\u2009&lt;\u20090.05) more likely to be older, have private insurance, have BMI \u226540, have chorioamnionitis at delivery, and undergo cesarean or operative vaginal delivery when compared with patients who did not experience morbidity. After controlling for confounders, cesarean delivery (aOR 2.38, 95% CI[1.30,4.39]), body mass index \u226540 at admission (aOR 2.54, 95% CI[1.12,5.79]), private insurance (aOR 3.08, 95% CI[1.54,6.16]), and tobacco use (aOR 3.43, 95% CI[1.58,7.48]) were associated with increased odds of maternal morbidity.<\/jats:p><jats:p>\n            Conclusion\u2003In this cohort, maternal morbidity occurred in 17.7% of patients with preterm prelabor rupture of membranes. Private insurance, body mass index \u226540, tobacco use, and cesarean delivery were associated with higher odds of morbidity. These data can be used in counseling and to advocate for smoking cessation.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1740011","type":"journal-article","created":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T23:31:51Z","timestamp":1638142311000},"page":"803-807","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Adverse Maternal Outcomes following Expectantly Managed Preterm Prelabor Rupture of Membranes"],"prefix":"10.1055","volume":"39","author":[{"given":"Alice J.","family":"Darling","sequence":"additional","affiliation":[{"name":"Duke University, School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-3037","authenticated-orcid":false,"given":"Hailey M.","family":"Harris","sequence":"additional","affiliation":[{"name":"Duke University, School of Medicine, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory E.","family":"Zemtsov","sequence":"additional","affiliation":[{"name":"Duke University Hospital, Department of Obstetrics and Gynecology, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Small","sequence":"additional","affiliation":[{"name":"Duke University Hospital, Department of Obstetrics and Gynecology, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Grace","sequence":"additional","affiliation":[{"name":"Vanderbilty University Hospital, Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8384-3721","authenticated-orcid":false,"given":"Sarahn","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Duke University Hospital, Department of Obstetrics and Gynecology, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah K.","family":"Dotters-Katz","sequence":"additional","affiliation":[{"name":"Duke University Hospital, Department of Obstetrics and Gynecology, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/GRF.0b013e318217d4d3","article-title":"Preterm PROM: prediction, prevention, principles","volume":"54","author":"T P Waters","year":"2011","journal-title":"Clin Obstet Gynecol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1053\/j.semperi.2017.07.012","article-title":"Preterm prelabor rupture of the membranes: a disease of the fetal membranes","volume":"41","author":"R Menon","year":"2017","journal-title":"Semin 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Kawakita","year":"2017","journal-title":"Matern Health Neonatol Perinatol"},{"issue":"01","key":"ref10","first-page":"e1","article-title":"ACOG practice bulletin no. 188: prelabor rupture of membranes","volume":"131","author":"Committee on Practice Bulletins-Obstetrics","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref11","first-page":"CD004735","article-title":"Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome","volume":"3","author":"D M Bond","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1007\/s10995-017-2309-9","article-title":"Tobacco use prevalence and outcomes among perinatal patients assessed through an \u201copt-out\u201d cessation and follow-up clinical program","volume":"21","author":"C Buchanan","year":"2017","journal-title":"Matern Child Health J"}],"container-title":["American Journal of 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