Maternal and Fetal Outcomes of PPROM Using the National Inpatient Sample, 2015–2019 [ID 1200]

INTRODUCTION: The incidence of premature rupture of membranes (PPROM) is rising in the United States. The objective of this study is to describe adverse maternal and fetal outcomes among PPROM patients and to identify those in the United States who are at greater risk for complications associated with PPROM. METHODS: We identified all PPROM patients in the Nationwide Inpatient Sample (NIS), 2015–2019, using ICD-10 codes. Maternal outcomes, including postpartum hemorrhage and maternal infection, were explored. Poor fetal outcomes were defined as poor fetal growth and fetal death (stillbirth and intrauterine death). Analyses include descriptive statistics and multivariable logistic regression. Weighted adjusted odds ratios (aORs) and 95% CIs were reported. RESULTS: Of the 84,410 PPROM patients identified, 7.91% had maternal infection, 3.94% had a postpartum hemorrhage, 3.16% had poor fetal growth, and 3.63% had fetal death outcomes. Compared to White women, Black, Hispanic, and other women had a higher risk of maternal infection (adjusted odds ratio [aOR] 1.64, P <.001; aOR 1.41, P <.001; and aOR 1.54, P <.001, respectively), postpartum hemorrhage (aOR 1.33, P <.001; aOR 1.11, P ≤.05; and aOR 1.12, P ≤.05, respectively), and fetal death (aOR 2.76, P <.001; aOR 1.47, P <.001; and aOR 1.32, P <.001, respectively). Compared to White women, non-Whites had a higher risk of poor fetal growth (aOR 1.35, P <.001; and aOR 1.15, P ≤.05, respectively), whereas Hispanics had a lower risk (aOR 0.90, P =.064). CONCLUSIONS/IMPLICATIONS: Poor maternal and fetal outcomes in PPROM patients, including infection, postpartum hemorrhage, and poor fetal outcomes, are linked to race, with non-White populations having the highest odds.