Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.

<h4>Introduction</h4>Ethiopia is one of the countries where persistently high neonatal and maternal mortalities are reported. Preterm prelabor rupture of membrane (PPROM) plays an important contribution to these high mortalities. However, there is a paucity of comprehensive evidence abou...

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Main Authors: Habtamu Geremew, Mohammed Ahmed Ali, Mulat Belay Simegn, Eyasu Bamlaku Golla, Alegntaw Abate, Smegnew Gichew Wondie, Hawi Kumbi, Mitku Mammo Taderegew, Werkneh Melkie Tilahun
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Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0311151
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author Habtamu Geremew
Mohammed Ahmed Ali
Mulat Belay Simegn
Eyasu Bamlaku Golla
Alegntaw Abate
Smegnew Gichew Wondie
Hawi Kumbi
Mitku Mammo Taderegew
Werkneh Melkie Tilahun
author_facet Habtamu Geremew
Mohammed Ahmed Ali
Mulat Belay Simegn
Eyasu Bamlaku Golla
Alegntaw Abate
Smegnew Gichew Wondie
Hawi Kumbi
Mitku Mammo Taderegew
Werkneh Melkie Tilahun
author_sort Habtamu Geremew
collection DOAJ
description <h4>Introduction</h4>Ethiopia is one of the countries where persistently high neonatal and maternal mortalities are reported. Preterm prelabor rupture of membrane (PPROM) plays an important contribution to these high mortalities. However, there is a paucity of comprehensive evidence about the epidemiology of PPROM in Ethiopia. Therefore, this systematic review was conducted to assess the pooled prevalence and determinants of PPROM among pregnant women in Ethiopia.<h4>Methods</h4>A systematic review and meta-analysis were conducted following the PRISMA guideline. Relevant literatures were searched on African Journals Online (AJOL), PubMed, Scopus, Epistemonikos, CINAHL, Cochrane Library and gray literature. All statistical analyses were performed using STATA 17 software. The random effect meta-analysis model was employed to summarize the pooled estimates. Heterogeneity between included studies was evaluated using I2 statistic. Egger's regression test and Begg's correlation test were employed to assess publication bias, in conjunction with funnel plot. Besides, the non-parametric trim-and-fill analysis, sensitivity analysis, subgroup analysis and meta-regression were also performed.<h4>Results</h4>A total of 13 original studies with 24,386 participants were considered in this systematic review. The pooled prevalence of PPROM was 6.58% (95% CI: 5.36, 7.79). Urinary tract infection (OR: 3.44; 95% CI: 1.81, 6.53), abnormal vaginal discharge (OR: 4.78; 95% CI: 2.85, 8.01), vaginal bleeding (OR: 2.04; 95% CI: 1.03, 4.06), history of PROM (OR: 4.64; 95% CI: 2.71, 7.95), history of abortion (OR: 3.06; 95% CI: 1.71, 5.46), malnutrition (OR: 5.24; 95% CI: 2.63, 10.44), anemia (OR: 3.97; 95% CI: 2.01, 7.85) and gestational diabetes (OR: 5.08; 95% CI: 1.93, 13.36) were significantly associated with PPROM.<h4>Conclusion</h4>This meta-analysis found a high prevalence of PPROM in Ethiopia. Urinary tract infection, abnormal vaginal discharge, vaginal bleeding, history of PROM, history of abortion, malnutrition, anemia and gestational diabetes were risk factors for PPROM. Prevention and control of antenatal infections and malnutrition are highly recommended to reduce the magnitude of PPROM in Ethiopia. Additionally, healthcare providers should emphasize the identified risk factors.<h4>Protocol registration number</h4>CRD42024536647.
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spelling doaj-art-4ca7a8d85df3414497db945bc1bd7c5b2024-11-19T05:32:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031115110.1371/journal.pone.0311151Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.Habtamu GeremewMohammed Ahmed AliMulat Belay SimegnEyasu Bamlaku GollaAlegntaw AbateSmegnew Gichew WondieHawi KumbiMitku Mammo TaderegewWerkneh Melkie Tilahun<h4>Introduction</h4>Ethiopia is one of the countries where persistently high neonatal and maternal mortalities are reported. Preterm prelabor rupture of membrane (PPROM) plays an important contribution to these high mortalities. However, there is a paucity of comprehensive evidence about the epidemiology of PPROM in Ethiopia. Therefore, this systematic review was conducted to assess the pooled prevalence and determinants of PPROM among pregnant women in Ethiopia.<h4>Methods</h4>A systematic review and meta-analysis were conducted following the PRISMA guideline. Relevant literatures were searched on African Journals Online (AJOL), PubMed, Scopus, Epistemonikos, CINAHL, Cochrane Library and gray literature. All statistical analyses were performed using STATA 17 software. The random effect meta-analysis model was employed to summarize the pooled estimates. Heterogeneity between included studies was evaluated using I2 statistic. Egger's regression test and Begg's correlation test were employed to assess publication bias, in conjunction with funnel plot. Besides, the non-parametric trim-and-fill analysis, sensitivity analysis, subgroup analysis and meta-regression were also performed.<h4>Results</h4>A total of 13 original studies with 24,386 participants were considered in this systematic review. The pooled prevalence of PPROM was 6.58% (95% CI: 5.36, 7.79). Urinary tract infection (OR: 3.44; 95% CI: 1.81, 6.53), abnormal vaginal discharge (OR: 4.78; 95% CI: 2.85, 8.01), vaginal bleeding (OR: 2.04; 95% CI: 1.03, 4.06), history of PROM (OR: 4.64; 95% CI: 2.71, 7.95), history of abortion (OR: 3.06; 95% CI: 1.71, 5.46), malnutrition (OR: 5.24; 95% CI: 2.63, 10.44), anemia (OR: 3.97; 95% CI: 2.01, 7.85) and gestational diabetes (OR: 5.08; 95% CI: 1.93, 13.36) were significantly associated with PPROM.<h4>Conclusion</h4>This meta-analysis found a high prevalence of PPROM in Ethiopia. Urinary tract infection, abnormal vaginal discharge, vaginal bleeding, history of PROM, history of abortion, malnutrition, anemia and gestational diabetes were risk factors for PPROM. Prevention and control of antenatal infections and malnutrition are highly recommended to reduce the magnitude of PPROM in Ethiopia. Additionally, healthcare providers should emphasize the identified risk factors.<h4>Protocol registration number</h4>CRD42024536647.https://doi.org/10.1371/journal.pone.0311151
spellingShingle Habtamu Geremew
Mohammed Ahmed Ali
Mulat Belay Simegn
Eyasu Bamlaku Golla
Alegntaw Abate
Smegnew Gichew Wondie
Hawi Kumbi
Mitku Mammo Taderegew
Werkneh Melkie Tilahun
Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
PLoS ONE
title Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
title_full Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
title_fullStr Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
title_full_unstemmed Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
title_short Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis.
title_sort determinants of preterm prelabor rupture of fetal membrane among pregnant women in ethiopia a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0311151
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