evidence: Women who had expectant management after PPROM at 16+0-17+6 weeks’ gestation and gave birth after 23 weeks' gestation had comparable live births and perinatal morbidity rates with those who had PPROM at 22+0-22+6 weeks’ gestation. This finding could be a result of lack of statistical power because only seven babies survived to discharge after PPROM at 16+0- 17+6 weeks' gestation. Also, when PPROM occurred earlier in pregnancy, possibly more pregnancies with less favourable characteristics had a termination of pregnancy for medical reasons, negating any negative effect of gestational age of PPROM on perinatal morbidity. A study from the Netherlands, however, with a rate of termination of only 2%, also found no difference in perinatal morbidity after PPROM at ≥13-<20 weeks' gestation (n=21) compared with ≥20-<24 weeks' gestation (n=41).34 We suggest that the effect of gestation on perinatal morbidity after PPROM needs further evaluation. [...] The incidence of PPROM between 16+0 and 22+6 weeks’ gestation of 0.04% was likely underestimated because of under-reporting, particularly during the covid-19 pandemic. We have no evidence of biased reporting, however, which might influence the generalisability of the results. A recent analysis of hospital episode statistics for the whole of France found a prevalence of 0.2% of PPROM at 14+0-24+6 weeks' gestation, which was considered to be likely underestimated because to fully validate the diagnosis with coded data is not possible.27 Within our study the incidence of PPROM was lowest between July and December 2020, possibly because of staffing pressures or potentially a lower rate of PPROM secondary to public health control measures, such as lockdowns.