Risk of recurrent preterm premature rupture of membrane in subsequent pregnancy: a systematic review and meta-analysis

Preterm prelabor rupture of membranes (PPROMs) is associated with high rates of neonatal mortality and morbidity. We aimed to review evidence on the risk of recurrent PPROM and preterm birth (PTB) in women with a history of PPROM in prior pregnancy.
PubMed, Embase, Scopus, and Web of Science databases were searched up to 26 August 2025, for studies reporting the recurrent risk of PPROM and/or PTB in the subsequent pregnancy. Pooled estimates with 95% confidence intervals (CIs) were calculated in the DerSimonian–Laird random-effects meta-analysis model.
Nine studies were included. Pooled analysis showed that the overall risk of recurrent PPROM in women was 18% (95% CI: 12–25%). Inter-study heterogeneity was high (I2 = 93%). On leave-one-out meta-analysis, the recurrence rate varied from 16% (95% CI: 11–22%) to 20% (95% CI: 14–27%). The risk of PTB when defined as <37 weeks was 34% (95% CI: 22–59%), while the risk was 23% (95% CI: 12–39%) and 20% (95% CI: 9–38%) when PTB was defined as <34 and <28 weeks, respectively. Subgroup analysis based on the definition of PPROM and location resulted in varied estimates.
Women with PPROM in the prior pregnancy have a high risk of recurrence of PPROM as well as PTB.

早产胎膜早破（preterm prelabor rupture of membranes, PPROM）与较高的新生儿死亡率及发病率显著相关。本研究旨在回顾既往妊娠有早产胎膜早破病史女性的复发性早产胎膜早破及早产（preterm birth, PTB）风险相关证据。
研究检索了截至2025年8月26日的PubMed、Embase、Scopus及Web of Science数据库，筛选报道后续妊娠中早产胎膜早破和/或早产复发风险的研究。采用德西蒙-莱尔德（DerSimonian–Laird）随机效应荟萃分析模型，计算合并效应值及95%置信区间（confidence intervals, CI）。
最终纳入9项研究。合并分析结果显示，该类女性复发性早产胎膜早破的总体风险为18%（95% CI：12%~25%）。研究间异质性较高（I²=93%）。留一法荟萃分析结果显示，复发率波动范围为16%（95% CI：11%~22%）至20%（95% CI：14%~27%）。当早产定义为妊娠孕周<37周时，其发生风险为34%（95% CI：22%~59%）；若将早产分别定义为孕周<34周及<28周，则对应发生风险分别为23%（95% CI：12%~39%）与20%（95% CI：9%~38%）。基于早产胎膜早破定义及研究地域的亚组分析得到了不同的效应估计值。
既往妊娠发生过早产胎膜早破的女性，其复发性早产胎膜早破及早产的风险均较高。