A population-based study of race-specific risk for preterm premature rupture of membranes

Objective: The purpose of this study was to test the hypothesis that race is associated with the risk of preterm birth due to preterm premature rupture of membranes (PPROM) and its recurrence. Study Design: We conducted a population-based cohort study using the Missouri Department of Health's maternally linked birth certificate database (1989-1997) to assess racial effects on the occurrence and recurrence of PPROM, while adjusting for socioeconomic and maternal medical risk factors (n = 644,462). Results: Black mothers were more likely to have PPROM compared to white mothers (aOR, 2.3; 95% CI, 2.0-2.5). The magnitude of risk of PPROM for black mothers compared to white mothers was greatest at < 28 weeks of gestation (aOR 2.8, 95% CI, 2.5-3.2). Black mothers were at significantly higher risk of recurrent PPROM compared to white mothers (aOR 6.4, 95% CI, 3.7-11.0). Conclusion: There is an overrepresentation in the occurrence and recurrence of PPROM in black mothers that persists after adjusting for known risk factors.