Predictors of Premature Rupture of Membranes among Pregnant Women in Rural Uganda: A Cross-Sectional Study at a Tertiary Teaching Hospital
Simon Byonanuwe, Emmanuel Nzabandora, Baltazar Nyongozi, Theophilus Pius, David Ayebare, Collins Atuheire, Wilson Mugizi, Martin Nduwimana, Maxwell Okello, Yarine Fajardo, Robinson Ssebuufu
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 (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mtext>aOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>0.5</mml:mn></mml:math>, 95% CI: 0.22-0.69, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.038</mml:mn></mml:math>) and gestational age of 37 weeks or more (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mtext>aOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>0.3</mml:mn></mml:math>, 95% CI: 0.14-0.71, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.01</mml:mn></mml:math>) while history of 3 or more abortions (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mtext>aOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>13.1</mml:mn></mml:math>, 95% CI: 1.12-153.62, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.05</mml:mn></mml:math>) 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.