MAGNITUDE OF ADVERSE FETAL OUTCOMES AND ASSOCIATED FACTORS AMONG WOMEN WITH PREMATURE RUPTURE OF MEMBRANE WHO GAVE BIRTH AT PUBLIC HOSPITALS IN HARARI REGION, EASTERN ETHIOPIA

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.