Assessment of Risk Factors for the Development of PROM in a Tertiary Care Hospital

Background: Premature Rupture of Membranes (PROM) is a significant obstetric issue associated with increased rates of perinatal morbidity and mortality. Understanding the risk factors for PROM is essential to develop appropriate preventive policies to improve pregnancy and neonatal outcomes. Objective: This study aimed to assess the risk factors for the development of PROM in a tertiary care hospital and to analyze the associated maternal and neonatal complications. Methods: This descriptive cross-sectional study was conducted at the Gynae Department, Hayatabad Medical Complex, Peshawar, from March 2022 to February 2023. The study included 190 pregnant women diagnosed with PROM. Participants were selected using a non-probability consecutive sampling method. Data were collected using a structured questionnaire and patient medical records. PROM was diagnosed based on clinical examination, positive nitrazine test, and ferning test. In ambiguous cases, additional diagnostics like ultrasound and biochemical markers (PAMG-1 and IGFBP-1) were used. Ethical approval was obtained, and data were analyzed using SPSS Version 25. Descriptive statistics summarized the demographic and clinical characteristics, and associations between risk factors and PROM were evaluated using Chi-square and t-tests, with a p-value <0.05 considered statistically significant. Results: The mean age of participants was 28.5±5.3 years, with 55.3% aged 20-29 years and 58.4% being multiparous. Significant risk factors included lower socioeconomic status (43.7%), history of sexually transmitted infections (21.6%), and previous PROM (34.2%). Obstetric factors such as multiple gestations and polyhydramnios were present in 12.1% and 15.8% of cases, respectively. Complications associated with PROM included intra-amniotic infection (17.9%), preterm labor (42.6%), and neonatal sepsis (9.5%). Conclusion: The study identified significant risk factors for PROM, including lower socioeconomic status, history of sexually transmitted infections, and prior PROM. These findings highlight the need for targeted interventions and management strategies to mitigate complications such as intra-amniotic infection, preterm labor, and neonatal sepsis, thereby improving maternal and neonatal outcomes. productivity.