NEW YORK (Reuters Health) - Women whose water has broken early may
want to wait at least 18 months before having their next child, new research
shows.
Known by doctors as preterm premature rupture of membranes, this
complication, in which a woman's water breaks before her pregnancy has
reached full term and before labor has begun, occurs in up to 5 percent of
pregnancies, Dr. Darios Getahun of Kaiser Permanente Southern California
Medical Group in Pasadena and colleagues note in their report.
The complication accounts for one in every four premature births, they
report in the American Journal of Obstetrics & Gynecology, and puts mother
and fetus at risk of infection.
While the reasons why some women's water breaks early are "elusive," Getahun
and his team say, there are likely many factors involved. Women who have had
the complication previously, they add, are known to be at greater risk in
subsequent pregnancies. And the risk is also known to be higher for black
women compared to whites.
To investigate whether the length of time between pregnancies might also
influence this risk, the researchers reviewed data from the state of
Missouri on nearly 200,000 women who had two or three children between 1989
and 1997. Around 3 percent of black women and 1 percent of white women's
water broke early during their first or second pregnancies.
Among white women whose water broke early, 6 percent had the complication in
their subsequent pregnancy, compared to 2 percent of women who hadn't
suffered premature membrane rupture.
The rates for black women were 10 percent and 4 percent, respectively. This
translated to a nearly nine-fold increased risk of subsequent early water
breaking for white women, and a seven-fold greater risk for black women.
The risk was even further increased if a woman got pregnant again within 18
months, and was particularly high for African-American women. For example, a
black woman who got pregnant again within three to six months would be
nearly nine times more likely to have the complication than a woman who
waited at least 18 months.
The risk of early water breaking for white women who got pregnant again this
soon was tripled.
This suggests, the researchers say, that the complication may be related to
inflammation, and that a longer interval between pregnancies is needed to
allow for full recovery. "We think that it might be a chronic inflammation
that may persist from one pregnancy to another pregnancy," Getahun told
Reuters Health.
Women whose water has broken early should be watched closely in subsequent
pregnancies, he added, so that if infection does develop they can receive
prompt antibiotic treatment, which could help prevent the complication from
recurring.
SOURCE: American Journal of Obstetrics & Gynecology, online February 4,
2010.
