Predictors of Premature Rupture of Membranes among Pregnant Women in Rural Uganda: A Cross-Sectional Study at a Tertiary Teaching Hospital

Abstract

Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0:5, 95% CI: 0.22-0.69, p = 0:038) and gestational age of 37 weeks or more (aOR = 0:3, 95% CI: 0.14-0.71, p = 0:01) while history of 3 or more abortions (aOR = 13:1, 95% CI: 1.12-153.62, p = 0:05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

Prevalence, Risk Factors and Outcome of Preterm Premature Rupture of Membranes at the Bamenda Regional Hospital

“…The incidence of PROM ranges from about five to ten percent of all deliveries [2]. The magnitude of PROM varies from country to country with a prevalence of 6.3% in Nigeria [3], 13.8% in Uganda [4] and 7.4% in Cameroon [5]. Preterm PROM occurs in approximately 3% of all pregnancies and causes about one third of preterm births [2].…”

“…Preterm PROM occurs in approximately 3% of all pregnancies and causes about one third of preterm births [2]. The prevalence of PPROM ranges from 2.2% -4% in India [6] [7], 2.8% in Canada [8], 3.1% in Brazil [9], 3.3% in Nigeria [10], to 4.1% in Egypt [11].…”

Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study

“…It affects 3-4.5% of pregnancies globally [3,4]. Evidences also discovered that PPROM accounts 3.1% in Brazil [5], 2.2 % in Manipur, India [4], 19.2% in China [3], 5.3% in Egypt [6], 3.3% in Nigeria [7], and 7.5 % in Uganda [8]. However, the magnitude is unknown in Ethiopia.…”

Pre-pregnancy and prenatal care risk factors for spontaneous premature delivery in Western Uganda: a hospital based unmatched case-control study

“…23,24 Urinary tract infections have been noted to be a potential reservoir for bacteria that ascend via the pregnant woman's lower genital tract to access the fetal membranes where they release a number of proteolytic enzymes such as collagenases and gelatinases with subsequent inflammation and weakening of the involved membranes. 25 In some cases therefore, occult contractions ensue with resultant spontaneous premature labor and delivery. 17,25 Women with prior history of cervical procedures showed a significant association with spontaneous premature delivery at this hospital.…”

“…25 In some cases therefore, occult contractions ensue with resultant spontaneous premature labor and delivery. 17,25 Women with prior history of cervical procedures showed a significant association with spontaneous premature delivery at this hospital. The odds of prior cervical procedures were 4.37 times greater in the women who had spontaneous premature delivery compared to those who delivered at term (CI: 1.42-9.97, p<0.0001).…”