Risk Factors for Preterm Premature Rupture of the Fetal Membranes

Abstract

Preterm premature rupture of the membranes (PPROM) is a significant cause of prematurity, accounting for approximately one third of preterm births in the United States. PPROM occurs in approximately 0.7-2% of all pregnancies nationally, and has a reported recurrence rate of 21%. The elucidation of potential risk factors for PPROM could contribute to a better understanding of its etiology. To study the contributions of 20 potential risk factors, we undertook a case-control study in our clinic population, which has a 5-6% incidence of PPROM. One hundred and thirty-three patients experiencing PPROM were matched for race, age, parity and gestational age with undelivered patients. Studies performed included ultrasonographic examinations, blood levels of ascorbic acid and zinc, microbiologic assays, patient questionnaires, and chart reviews. After stratification of both groups into subgroups based on matching criteria, summary tests of significance and Mantel-Haenszel tests of odds ratios were performed. On univariate analysis the following factors achieved significance at the p less than 0.05 level with 95% confidence intervals: 1) previous history of PPROM 2) smoking (dose related) 3) fundal location of the placenta in the present pregnancy. 4) a prior history of cerclage. After regression analysis, we concluded that smoking and history of previous PPROM were found to be risk factors for PPROM in our inner city black population.

To study second trimester placental location as a predictor of adverse pregnancy outcome

“…Our finding consistent with another study done by Shulman et al that shows significant association of posterior placenta and preterm labour. 8 Similar results are found in study by Hadley et al 1 In our study, the association between lateral location of placenta with IUGR was statistically significant (p value <0.0018). This result is accordance with Kalaniti et al who studied that in IUGR babies chances to find lateral placenta are more than 3.8 times than normal babies.…”

“…Placental location has been implicated in preterm birth, in fetal mal-position and malpresentation, small for gestational age, low Apgar score and in development of pre-eclampsia. [1][2][3][4] The significance of placental location in the uterine cavity has been studied extensively. Placental location has been found to correlate with fetal position and presentation, length of gestation, course of labour, presence of pre-eclampsia.…”

Association of Placental Localization at 16-24 Week and Pregnancy Outcome

“…This was found to be inconsistent with a study done by Shulman et al 9 that shows significant association of posterior placenta and preterm labour. Similar results are found in study by Hadley et al 10 …”

Influence of previous pregnancy outcomes and continued smoking on subsequent pregnancy outcomes: an exploratory study in Australia

“…[23][24][25][26] Smoking also reduces the level of type III collagen, which may increase the risk of preterm rupture of the membranes. 27,28 It is also well established that infants of mothers who smoke are weaker and less likely to survive. [29][30][31] These might be possible reasons of how SIP work as causal pathway for adverse pregnancy outcomes.…”