Abstract:
Premature rupture of membranes is a common occurrence in many pregnancies,
resulting in adverse fetal outcomes that range from mild to irreversible long-term neonatal
complications and even death. However, there is a lack of information concerning adverse fetal
outcomes among women who have experienced premature rupture of membranes in the study
area.
Objective: This study aimed to identify the magnitude of adverse fetal outcomes and the factors
associated with premature rupture of the membrane among women who gave birth at public
hospitals in Harari Region, Eastern Ethiopia, from January 1, 2021, to December 31, 2023.
Methods: A hospital-based cross-sectional study design was conducted from September 1 to
15, 2024. A simple random sampling technique was employed to select 421 charts of women
diagnosed with premature rupture of membranes who gave birth at public hospitals in the Harari
region. Data were collected using a data extraction checklist through Kobo Toolbox software.
The collected data were exported and analyzed using Stata version 17. Descriptive analyses
included percentages, frequency distributions, and measures of central tendency like the mean.
A binary logistic regression model was then utilized to determine the association between
independent and dependent variables. Adjusted odds ratios with 95% confidence intervals were used to measure the strength of the association. A P-value of ≤ 0.05 was used to declare statistical
significance.
Results: The magnitude of adverse fetal outcomes among women who experienced premature
rupture of membranes was 35.9% [95% CI, 31.3 to 40.7]. Factors significantly associated with
adverse fetal outcomes included being rural residents [AOR=1.96, 95% CI (1.14-3.36)], preterm
birth [AOR=6.48, 95% CI (3.45-12.15)], anemia during pregnancy [AOR=2.9, 95% CI (1.69-
4.96)], and a history of adverse fetal outcomes [AOR=4.55, 95% CI (2.40-8.65)]. The magnitude of adverse fetal outcomes in this study was significant. Rural
residents, preterm birth, anemia, and a history of adverse fetal outcomes were significantly
associated with these outcomes. The findings highlighted improvements in maternal healthcare
access, especially in rural areas, early detection of anemia and iron supplementation, and the
optimization of preconception care for mothers with a history of adverse fetal outcomes.
