Preterm Premature Rupture of Membranes, Intrauterine Infection, and Oligohydramnios: Risk Factors for Placental Abruption
Abstract
OBJECTIVE: To examine whether preterm premature rupture of membranes (PROM), intrauterine infection, and oligohydramnios are risk factors for placental abruption. METHODS: Data for this retrospective cohort study were derived from the 1988 National Maternal and Infant Health Survey (N = 11,777). Association between abruption and these clinical risk factors was expressed as relative risk (RR) and 95% confidence interval (CI), with multivariate adjustment for potential confounders. RESULTS: The overall incidence of abruption was 0.87%. The risk of abruption was 3.58-fold higher (95% CI 1.74-7.39) among women with preterm PROM (2.29%) compared with women with intact membranes (0.86%). The rates of abruption among women with and without intrauterine infection were 4.81% and 0.83%, respectively (RR 9.71, 95% CI 3.23-29.17). However, oligohydramnios was not associated with abruption (1.46% compared with 0.87%; RR 2.09, 95% CI 0.92-5.31). Compared with women with intact membranes, the RR for abruption among preterm PROM and whose membranes were ruptured for 24-47 hours and 48 hours or more before delivery, respectively, were 2.37 (95% CI 0.99-9.09), and 9.87 (95% CI 3.57-27.82). When preterm PROM was accompanied by intrauterine infections, the RR for abruption was 9.03 (95% CI 2.80-29.15) compared with women with intact membranes and no infections. Similarly, preterm PROM accompanied by oligohydramnios conferred over a 7.17-fold risk (95% CI 1.35-38.10) for abruption compared with women with neither of these 2 conditions. CONCLUSION: Women presenting with preterm PROM are at increased risk of developing abruption, with the risk being higher either in the presence of intrauterine infections or oligohydramnios. Physicians managing patients with preterm PROM should be aware that these patients are at increased risk of developing abruption after 24 hours following preterm PROM.
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Oligohydramnios is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [32]
Pregestational and gestational diabetes are clinical risk factors for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [32]
Chorioamnionitis is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [32]
Preterm prelabor rupture of membranes is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [32]
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- Authors
- Ananth, C. V., Oyelese, Y., Srinivas, N., Yeo, L., & Vintzileos, A. M.
- Affiliations
- Robert Wood Johnson University Hospital (US)
- Corresponding author
- Ananth, Cande V.
- Venue
- Obstetrics & Gynecology
- Published
- 2004-07
- Volume
- 104
- Issue
- 1
- Pages
- 71-77
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W1975092616
- Cited by
- 208
- References
- 24
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 12 · 2021: 4 · 2020: 13 · 2019: 13 · 2018: 11 · 2017: 13 · 2016: 12 · 2015: 9 · 2014: 9 · 2013: 14 · 2012: 9
- FWCI
- 7.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD038902)
- Topics
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- preterm premature rupture of membranes, placental abruption, intrauterine infection, oligohydramnios, risk factors, preterm labor, National Maternal and Infant Health Survey
- MeSH terms
- Abruptio Placentae, Adult, Female, Premature Rupture of Fetal Membranes, Humans, Pregnancy, Pregnancy Complications, Infectious, Risk Factors, Confidence Intervals, Oligohydramnios
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