Objective: To investigate the prevalence of preterm premature rupture of membranes (PPROM) in urban areas in China and examine the associated risk factors. Methods: A population-based, prospective study was undertaken in 14 cities in China between January 1, 2011, and January 31, 2012. Women were recruited at their first prenatal-care visit, when maternal characteristics were recorded. Risk factors were analyzed by one-way analysis of variance. Results: Of 112 439 women included in analyses, 3077 (2.7%) had PPROM. Univariate analysis showed an increased risk of PPROM before 28 weeks of pregnancy in migrant women (odds ratio [OR] 225; 95% confidence interval [Cl] 153-330; P < 0.001), in those with a history of recurrent induced abortions (OR 2.75; 95% CI 1.66-4.56; P < 0.001), and in those with a history of preterm birth (OR 3.90; 95% CI 0.77-19.61; P < 0.001). The associations were maintained in multivariate analysis (P < 0.001). Conclusion: Migration as a result of urbanization, high rates of induced abortion, and preterm birth are potential risk factors for PPROM in Chinese women. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.