Telayneh Animut Takele, Ketema Daniel Bekele, Mengist Belayneh, Yismaw Lieltework, Bazezew Yibelu, Birhanu Molla Yigzaw, Habtegiorgis Samuel Derbie
Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia.
PLOS Glob Public Health. 2023 Mar 8;3(3):e0001702. doi: 10.1371/journal.pgph.0001702. eCollection 2023.
Pre-labor rupture of membranes (PROM) is the rupture of fetal membranes before the onset of labor. PROM is found in 3-15% of all pregnancies and 30-40% of preterm labor worldwide. The most serious complications are neonatal and prenatal mortality, which is higher in Africa, including Ethiopia. Despite a paucity of evidence on the magnitude and factors affecting PROM after 28 weeks of gestation but before the onset of labor (including both term and preterm PROM). Hence, the purpose of this study was to determine the magnitude and identify associated factors of the pre-labor rupture of membranes. An institutional-based cross-sectional study was conducted among 315 pregnant women from April 10, 2019 to June 30, 2019 at Debre Markos Referral Hospital. The samples were chosen using a systematic random sampling method among admitted pregnant women. The data were entered using EpiData entry version 4.2 and cleaned and analyzed using Stata/SE version 14.0. In binary logistic regressions, variables with a p-value <0.20 are selected for multivariable analysis. A multivariable logistic regression model with a 95% confidence interval and a p-value <0.05 was used to identify associated factors. In this study, the magnitude of PROM was 19%. Maternal monthly income ≤1000 birr [AOR: 3.33 (95%CI: 1.33, 8.33)], gestational age <37weeks [AOR: 3. 28 (95%CI: 1.53, 7.02)], multiple pregnancy [AOR: 4.14 (95%CI: 1.78, 9.62)], polyhydramnios [AOR: 5.06 (95%CI: 2.28, 11.23)] and history of abnormal vaginal discharge [AOR: 6.65 (95%CI: 2.62, 16.72)] were found significant associated factors. In conclusion, the magnitude of the pre-labor rapture of the membranes was higher than in previous studies. Hence, health professionals should strengthen counseling, early diagnosis, and treatment of infections, as well as focus on women with pregnancy-related risks, to reduce pre-labor rupture of membranes and improve fetal and perinatal health.
胎膜早破（PROM）是指在临产前胎膜破裂。全球范围内，胎膜早破在所有妊娠中占3%-15%，在早产中占30%-40%。最严重的并发症是新生儿和产前死亡，在包括埃塞俄比亚在内的非洲地区这一比例更高。尽管关于妊娠28周后但临产前（包括足月和早产胎膜早破）胎膜早破的严重程度和影响因素的证据不足。因此，本研究的目的是确定胎膜早破的严重程度并识别相关因素。2019年4月10日至2019年6月30日，在德布雷马科斯转诊医院对315名孕妇进行了一项基于机构的横断面研究。样本是在入院孕妇中采用系统随机抽样方法选取的。数据使用EpiData录入版本4.2录入，并使用Stata/SE版本14.0进行清理和分析。在二元逻辑回归中，p值<0.20的变量被选入多变量分析。使用具有95%置信区间且p值<0.05的多变量逻辑回归模型来识别相关因素。在本研究中，胎膜早破的发生率为19%。产妇月收入≤1000比尔[调整后比值比（AOR）：3.33（95%置信区间：1.33，8.33）]、孕周<37周[AOR：3.28（95%置信区间：1.53，7.02）]、多胎妊娠[AOR：4.14（95%置信区间：1.78，9.62）]、羊水过多[AOR：5.06（95%置信区间：2.28，11.23）]以及异常白带病史[AOR：6.65（95%置信区间：2.62，16.72）]被发现是显著的相关因素。总之，临产前胎膜破裂的发生率高于先前的研究。因此，卫生专业人员应加强咨询、早期诊断和感染治疗，并关注有妊娠相关风险的女性，以减少临产前胎膜破裂并改善胎儿和围产期健康。
