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