Clinical Outcomes of Neonates Born to Mothers with Premature Rupture of Membranes: A Prospective Observational Study

Background: Premature rupture of membranes (PROM) is defined as rupture of fetal membranes before the onset of labor and is one of the most common obstetric complications associated with significant maternal and neonatal morbidity. Neonates born following PROM are at increased risk of prematurity, neonatal sepsis, respiratory distress syndrome, birth asphyxia, and prolonged hospitalization. Aim: To study the clinical outcomes of neonates born to mothers with premature rupture of membranes. Materials and Methods: This hospital-based prospective observational study was conducted in the Neonatal Intensive Care Unit (NICU) and maternity ward of a tertiary care teaching hospital over a period of 24 months from March 2024 to March 2026. A total of 120 neonates born to mothers with confirmed PROM after 28 weeks of gestation were included in the study. Maternal demographic details, obstetric history, duration of PROM, mode of delivery, neonatal clinical profile, laboratory investigations, and neonatal outcomes were recorded and analyzed. Neonates were categorized according to duration of PROM into four groups: 0–12 hours, 12–24 hours, 24–36 hours, and >36 hours. Results: The majority of mothers belonged to the age group of 21–25 years (46.7%), and primigravida mothers constituted 55.0% of the study population. Normal vaginal delivery was observed in 67.5% cases. The most common maternal risk factors were urinary tract infection (26.7%) and anemia (23.3%). Low birth weight was observed in 60.0% neonates, while 60.0% were delivered before 37 weeks gestation. Neonatal sepsis (23.3%) was the most common morbidity followed by respiratory distress syndrome (18.3%), hyperbilirubinemia (15.0%), and birth asphyxia (10.0%). NICU admission was required in 33.3% neonates. The incidence of neonatal complications increased significantly with prolonged duration of membrane rupture, especially beyond 24 hours. Blood culture positivity was observed in 10.0% neonates, with Staphylococcus species being the most commonly isolated organism. Neonatal mortality was observed in 4.2% cases and was predominantly associated with extreme prematurity and severe sepsis. Conclusion: PROM is associated with substantial neonatal morbidity, particularly among preterm and low birth weight neonates. Prolonged duration of membrane rupture significantly increases the risk of neonatal sepsis, respiratory distress syndrome, and NICU admission. Early diagnosis, timely administration of antenatal antibiotics, close maternal-fetal monitoring, and prompt neonatal management are essential to improve neonatal outcomes.