Prevalence of Preterm Premature Rupture of Membrane and Associated Factors among Pregnant Women Admitted in Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia

Abstract

Background: Preterm premature rupture of membrane (PPROM) affects approximately 3% of all pregnancies and is responsible for one-third of all preterm births. Despite its contribution to maternal and neonatal mortality and morbidity, evidence on the burden of PPROM and its associated factors in the study area is scarce. Therefore, this study was aimed to assess the prevalence of PPROM and its associated factors among pregnant women at University Hospital, Eastern Ethiopia from August 01 to 31, 2021.

Methods: A hospital-based cross-sectional study was conducted among 449 randomly selected preterm pregnancies admitted to the labor ward of Hiwot Fana Comprehensive Specialized University Hospital. Data related to socio-demographic variables, obstetric and reproductive health conditions, and labor and related pregnancy outcomes were extracted from their medical records using a structured checklist. After checking for completeness, the data were entered into Epidata 3.1 and analyzed using SPSS 25. Factors associated with PPROM were identified using bivariable and multivariable logistic regression. Association was described using an adjusted odds ratio (AOR) along with 95% confidence interval (CI). P-value <0.05 in the final model was considered as statistically significant.

Results: Of 449 preterm pregnant women included in the study, 64 (14.3%; 95% CI:11.1% -17.5%) had PPROM. Preterm PROM was significantly associated with urinary tract infections (AOR=6.33; 95% CI:3.26-12.29), vaginal bleeding (AOR=2.62; 95% CI:1.23-5.57), history of abortion (AOR= 3.07; 95% CI:1.33-7.06) and mid upper arm circumference <23 (AOR=7.06; 95% CI: 4.02-12.43). A total of 3 (4.3%) stillbirth and 16 (22.9%) early neonatal deaths occurred corresponding with a gross perinatal mortality rate of 271 per 1000 births.

Conclusion:  One in seven preterm pregnancies in eastern Ethiopia had PPROM. Urinary tract infection, vaginal bleeding, previous history of abortion, and undernutrition were associated with PPROM. Early screening and treatment of urinary tract infections and vaginal bleeding are essential to reduce the risk of PPROM.