The effect of rupture of membranes in two passive and active stages of labor on maternal and neonatal outcomes: A population-based prospective cohort study

Document Type : Original Article

Authors

1 Associate Professor, Department of Midwifery, Social Determinants of Health Research Center, Non-Communicable Diseases Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.

2 Instructor, Department of Midwifery, Social Determinants of Health Research Center, Non-Communicable Diseases Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.

3 Assistant Professor, Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, Research Institute for Prevention of Non -communicable Disease, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.

10.22038/ijogi.2025.81382.6145

Abstract

Introduction: Rupture of membrane (ROM) may occur before or after the onset of labor pains at any gestational age and cause maternal and neonatal consequences. The present study was conducted with aim to investigate the effect of the time of rupture of membranes on the short-and long-term outcomes of the mother and neonate.
Methods: This cohort study was conducted in 2017-2020 on 775 pregnant women with a gestational age of ≥37 weeks who met the inclusion criteria and had referred to Kosar Hospital in Qazvin for delivery. The researcher-made checklist included demographic, obstetrics, labor and delivery course, and maternal and neonatal complications, which was completed during labor, during delivery, immediately after delivery, 24 hours, 1 month, 1 year, and 2 years after delivery. Data analysis was performed using SPSS software (version 25) and logistic regression and risk ratio tests. P<0.05 was considered sttistically significant.
Results: Mothers with ROM in the latent phase compared to the active phase had higher morbidity in the first month after delivery (CI: 0.32-0.76; HR=0.49, P=0.001). Neonatal complications in the first 24 hours (CI: 0.20-0.84; HR=0.41, P=0.015) and in the first month after delivery (CI: 0.04-0.71; HR=0.17, P=0.016) was higher in the ROM group in the latent phase than in the active phase. With ROM in the latent phase, the rate of cesarean delivery and episiotomy was 0.18 higher.
Conclusion: With increase in the duration of ROM, the possibility of complications increases. Therefore, shortening the duration of delivery in term pregnancies is better than expectant management in preventing complications.

Keywords

Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 1
March 2025
Pages 12-23

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