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

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is one of the leading identifiable cause of preterm deliveries, and an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine the prevalence of PPROM, to identify its associated factors and to evaluate the early outcome (within 72 hrs after delivery) following PPROM at the Bamenda Regional Hospital (BRH). Methods: A cross-sectional study was conducted in March and April 2020. Three hundred and eighty-seven women who delivered at the labour room of the BRH were included in this study. Interviewer-administered questionnaires were used to obtain data. The cases of PPROM were women who had lost amniotic fluid continuously before hospitalisation and whose gestational age was between 28 weeks + 0 days and 36 weeks + 6 days. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value <0.05. Results: Among the 387 participants included in the study, 19 had PPROM giving a prevalence of 4.91%. Of 57 preterm deliveries, PPROM accounted for 33.33% (n = 19). The statistically significant independent factors associated with lower odds of PPROM were the age groups 20 - 29 years (aOR = 0.07, 95% CI: 0.01 - 0.42, p = 0.003) and ≥30 years (aOR = 0.01, 95% CI: 0.001 - 0.14, p = 0.001), and attending ANC ≥ 4 times (aOR = 0.23, 95% CI: 0.06 - 0.84, p = 0.026). Whereas, having a multiple pregnancy (aOR = 39.72, 95% CI: 7.19 - 219.33, p < 0.001), urinary tract infection during pregnancy (aOR = 104.86, 95% CI: 12.25 - 897.90, p < 0.001), genital tract infections during pregnancy (aOR = 17.34, 95% CI: 2.67 - 112.56, p = 0.003), and having a history of preterm delivery (aOR = 27.65, 95% CI: 1.76 - 434.15, p = 0.018) were associated with a higher likelihood of PPROM. The study revealed that 10.53% (n = 2) of women who had PPROM had an unfavourable outcome. Babies born by mothers who had PPROM were more likely to have an unfavourable outcome (OR = 14.44, 95% CI: 5.42 - 38.48, p < 0.001). Conclusion: Preterm premature rupture of membranes considerably causes perinatal morbidity and mortality, and thus optimum obstetric and medical care is essential for the reduction of the complications related to it.