Determinants of premature membrane rupture among mothers receiving labor care at different public hospitals in Northeast Ethiopia: An unmatched case control study

Abstract

Background: Premature rupture of membranes is a painless gush of amniotic fluid resulting from the rupture of membranes through the vaginal canal before the onset of uterine contractions and is responsible for increased perinatal mortality and neonatal morbidity. Therefore, identifying the determining factors is essential for minimizing its adverse impact. Despite the existence of this problem in the study area, there is a gap in identifying the factors affecting its occurrence. Objectives: To assess the determinants of prematuremembrane rupture among mothers who attendedlabor at public hospitals in theNorth Wollo Zone, 2022/23. Methods: An unmatched case‒controlstudy was conducted from December 1, 2022, to March 30, 2023. Three public hospitals were selected through a lottery method, and by proportional allocation, a total of 353 participants (118 cases and 235 controls) receiving labor were recruited. Cases were selected through convenience sampling, while controls were recruited through systematic random sampling. The datawere collected using a structured questionnaire and card review, entered into EpiData 4.6 and analyzed using STATA version 17. Logistic regression was employed to identify determinants, and a P value < 0.05 in multivariable logistic regression was considered to indicate statistical significance. Results: Previous caesarian section (AOR: 2.11; 95% CI: 1.05–4.23), history of abortion (AOR: 3.68; 95% CI: 1.70–7.94), history of premature membrane rupture (AOR: 3.89; 95% CI: 1.73–8.71), chronic cough (AOR: 4.23; 95% CI: 1.47–12.18), mid-upper arm circumference <23 cm (AOR: 3.47; 95% CI: 1.53–7.84), suspected sepsis (AOR: 2.99; 95% CI: 1.25–1.99), and presence of urinary tract infection (AOR: 3.14; 95% CI: 1.50–6.60) were determinants of premature membrane rupture. Conclusions: This study indicated that the aforementioned factors are determinants of premature membrane rupture. Therefore, hospitals need to increasethe proportion of vaginal deliveriesand provide strong advice regarding the complications of abortion. Moreover, early screening, diagnosis, and treatment should be applied for malnutrition, chronic cough, sepsis, and urinary tract infections.