ADEQUACY OF PRENATAL-CARE AND RISK OF PRE TERM RUPTURE OF AMNIOTIC SAC MEMBRANES

Premature rupture of amniotic membranes (PROM) is associated with perinatal morbidity and mortality. A matched case-control study was undertaken to determine whether adequacy of prenatal care was associated with increased risk for PROM. Three study groups were defined, consisting of women delivering pre term with PROM, full term with PROM, and pre term without PROM. Cases were singly matched by race, age, and parity with women having full term deliveries without PROM. Data were collected by face-to-face structured interviews with eligible subjects and by medical records abstraction. Conditional multiple logistic regression indicated that among women with inadequate levels of prenatal care during pregnancy the risk for pre term PROM was 3.11 (CI = 1. 10-8.78) and for pre term without PROM 2.18 (CI = 1.05-4.53) times higher than for their matched controls, even when adjusted for other sociodemographic, behavioral, index pregnancy, and medical history factors. We conclude that inadequate prenatal care may be a marker for less healthy behaviors, lifestyles, and environmental factors among women at increased risk for pre term delivery.