Premature birth is one of the major concerns for families experiencing PPROM.

A baby born before 37 completed weeks of pregnancy is considered preterm or premature.

In the United States, approximately 1 in 10 babies is born prematurely.

PPROM is an important cause of preterm birth. When the membranes rupture early, some pregnancies continue for days or weeks, while others are followed by delivery much sooner.

Every PPROM journey is different.

Prematurity After PPROM

Babies born prematurely may face challenges because organs and body systems that normally continue developing during the final weeks and months of pregnancy must begin functioning outside the uterus.

The type and severity of complications depend on many factors, including:

• gestational age at birth

• birth weight and growth

• lung development

• infection or inflammation

• circumstances surrounding delivery

• other pregnancy or medical complications

• individual development

• the neonatal care available

Some babies have relatively short hospital stays and few long-term complications. Others may require prolonged intensive care and ongoing medical or developmental support.

It is not possible to predict an individual baby's course based on gestational age alone.

Understanding Viability

Families experiencing very early PPROM often hear the word viability. There is no single gestational age or birth weight at which every baby becomes viable.

Outcomes vary based on gestational age, fetal development, individual circumstances, hospital practices, and the level of neonatal care available.

Hospitals may also differ in when neonatal resuscitation and intensive care are offered. Different states have different laws dictating maternal care. 

For families experiencing very early PPROM, consultation with Maternal-Fetal Medicine and Neonatology can help provide information based on the individual pregnancy and the hospital where delivery may occur.

Understanding Outcome Statistics

Statistics about extremely premature birth can be helpful, but they need context.

Studies and outcome tools may include different groups of babies and may be based on care provided during different time periods.

When discussing outcomes, consider asking:

• How recent are these data?

• Are these outcomes from this hospital?

• Do they include babies who received active neonatal treatment?

• How does our baby's situation compare with the infants included in these statistics?

Population statistics cannot predict exactly what will happen to an individual baby.

Preparing for a Possible Premature Birth

For families undergoing Expectant Management, premature delivery may occur with little warning.

Preparing for the possibility of a NICU stay does not mean giving up hope that pregnancy will continue. It means helping your family understand what may happen next.

Meet With Neonatology

If premature delivery is possible, ask whether you can meet with a neonatologist before birth.

A prenatal Neonatology consultation may include:

• what to expect at delivery

• whether neonatal resuscitation would be offered

• expected care based on gestational age

• respiratory support

• feeding and nutrition

• common complications of prematurity

• how parents can participate in their baby's care

• expected NICU routines

• outcomes at that particular hospital

Bring questions and take notes if that is helpful. You may hear a great deal of unfamiliar information at once.

Learn About Your NICU

If possible, learn what level of neonatal care is available where you are receiving pregnancy care.

Questions you may want to ask include:

• What level NICU does this hospital have?

• Does this NICU regularly care for babies born at the gestational age we are discussing?

• Is a neonatologist available at delivery?

• Would my baby ever need to be transferred to another hospital?

• If higher-level care may be needed, could transfer occur before delivery?

• What resources are available for parents and siblings?

• Are parents able to stay with or near their baby?

• What lactation and feeding support is available?

• What mental-health or peer-support resources are available to NICU families?

When possible, maternal transfer before delivery allows the baby to be born at the hospital equipped to provide the needed level of neonatal care.

Take a NICU Tour

If your hospital offers prenatal NICU tours and your medical circumstances allow it, seeing the unit before delivery may help make the environment feel more familiar.

A tour may help you learn about:

• NICU rooms and equipment

• visiting policies

• parent participation in care

• pumping and breast milk storage

• skin-to-skin care when medically appropriate

• rounds and communication with the medical team

• sibling and family policies

• parking, meals, lodging, and practical resources

Virtual tours may also be available.

Common Challenges of Premature Birth

Premature infants may experience complications involving different body systems.

These can include:

Breathing and Lung Development

Premature lungs may not yet be ready to function independently.

Some babies need supplemental oxygen or respiratory support. Babies born after very early PPROM may also have additional respiratory concerns related to prolonged low amniotic fluid or pulmonary hypoplasia.

Feeding and Growth

Premature babies may initially have difficulty coordinating sucking, swallowing, and breathing.

Some require feeding tubes or intravenous nutrition while these skills develop.

Infection

Premature infants may be more vulnerable to infection because their immune systems are still developing.

Brain and Neurologic Development

Extremely premature infants are monitored for complications including bleeding in the brain and other neurologic concerns.

Temperature Regulation

Premature babies often need help maintaining body temperature and may spend time in an incubator or warmer.

Eyes and Hearing

Some premature infants require specialized screening of vision and hearing.

Intestinal Complications

Very premature infants are monitored for gastrointestinal complications, including necrotizing enterocolitis.

Long-Term Development

Some children born prematurely have ongoing medical, developmental, learning, movement, hearing, vision, or behavioral needs.

Others develop without significant long-term impairment.

Developmental follow-up helps identify children who may benefit from early intervention or additional support.

The NICU Journey

A NICU stay can be overwhelming.

Parents may suddenly find themselves learning unfamiliar medical terminology, making decisions, pumping milk, traveling between home and the hospital, caring for other children, returning to work, or recovering physically while their baby remains hospitalized.

Parents are important members of the NICU care team.

Ask your baby's medical team how you can participate in care.

Depending on your baby's condition, this may include:

• talking, reading, or singing to your baby

• providing breast milk or participating in feeding

• skin-to-skin care

• diaper changes

• temperature checks

• comforting and positioning

• participating in medical rounds

• asking questions and sharing observations

What parents can do will change as the baby grows and becomes more stable.

From NICU to Home—and Beyond

Leaving the NICU is another major transition.

Some babies go home without special medical needs. Others may require medication, oxygen, feeding support, equipment, therapies, specialty care, or developmental monitoring.

Families may also continue processing the emotional effects of PPROM, premature birth, and the NICU long after discharge.

Support does not have to end when the baby comes home.

Prematurity & NICU Resources

The following organizations provide information and support for families experiencing premature birth and NICU hospitalization.

Hand to Hold

A national nonprofit providing emotional support, educational resources, peer support, and community for NICU families before, during, and after a NICU stay.

Visit Hand to Hold

Graham's Foundation

Provides resources specifically for parents of premature babies, including peer mentors, educational materials, care packages, and support through the NICU and beyond.

Visit Graham's Foundation

Project Sweet Peas

A national nonprofit providing support to families of premature or critically ill infants and families affected by pregnancy and infant loss. Resources include NICU support, peer support, care packages, and some practical assistance programs.

Visit Project Sweet Peas

March of Dimes

Provides education about prematurity, NICU care, infant health, and current U.S. preterm birth statistics.

Visit March of Dimes

NICU Parent Network

A network supporting organizations and parent leaders working with NICU families.

Visit NICU Parent Network

Current Statistics & Information

U.S. Premature Birth Statistics

March of Dimes PeriStats provides current national and state-level information about premature birth in the United States.

View Current U.S. Premature Birth Statistics

Extremely Preterm Birth Outcomes

NICHD maintains an Extremely Preterm Birth Outcomes Tool that describes outcomes among groups of extremely premature infants.

The tool is based primarily on infants cared for at participating centers between 2006 and 2012, so families should not assume that its estimates represent current outcomes at every hospital.

Ask your Neonatology team whether more current hospital-specific or regional outcome information is available.

NICHD Extremely Preterm Birth Outcomes Tool

Current PPROM Guidance

SMFM Consult Series #71: Management of Previable and Periviable PPROM

Current professional guidance regarding counseling and management of PPROM occurring at very early gestational ages.

Information reviewed: August 2026