Objective: To show that infants delivered prematurely because of preterm 
premature rupture of the membranes (PPROM) show a tendency for asymmetric 
intrauterine growth retardation (IUGR). At the same time, to demonstrate that 
these pregnancies exhibit nutritional deprivation by the presence of 
correspondingly smaller placentas, as demonstrated by the placental-fetal 
ratio.Study Design: A prospective study was performed over 2 years comparing the 
tendency for IUGR in infants born of pregnancies with PPROM (N = 86), as 
compared to normal term controls (N = 351). The tendency for growth restriction 
in the neonate was determined using the ponderal index at birth. Exclusion 
criteria included pregnancies complicated by diabetes, hypertension, 
preeclampsia, multiple gestations, genetic, and other recognized causes of IUGR. 
Four controls were selected for each study patient who delivered the same day. 
The mean ponderal index (PI(m)) was compared, as were the mean placental-fetal 
weight ratios (PWt/PI)(m), for both groups. A comparison of the PI(m) and 
(PWt/PI)(m) for infants delivered prematurely with and without rupture of 
membranes was also noted. Analysis was by the paired Student's t test and chi(2) 
test.Results: The newborn PI was found to be independent of maternal age, 
gravidy, and parity. The number of male and female infants were not 
significantly different in the control and study groups. The PI(m) for the PPROM 
group (PI(m) = 2.33, SD = 0.29) was significantly smaller than that for the 
controls (PI(m) = 2.52, SD = 0.23) (P <.0005). Similarly the (PWt/PI)(m) for the 
PPROM group (mean = 194.8, SD = 49.9) was significantly smaller than that for 
the control group (mean = 273.4, SD = 54.2) (P <.0005). Mean values of PI and 
PWt/PI for preterm deliveries with, as compared to without rupture of membranes, 
showed no significant differences.Conclusions: Using the ponderal index to 
detect IUGR, a significant association of IUGR is noted in infants delivered 
subsequent to PPROM. This growth impairment is accompanied by significantly 
smaller placentas.