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Meta-Analysis
. 2024 Nov 8;19(11):e0311151.
doi: 10.1371/journal.pone.0311151. eCollection 2024.

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

Habtamu Geremew  1 , Mohammed Ahmed Ali  2 , Mulat Belay Simegn  3 , Eyasu Bamlaku Golla  1 , Alegntaw Abate  4 , Smegnew Gichew Wondie  5 , Hawi Kumbi  6 , Mitku Mammo Taderegew  7 , Werkneh Melkie Tilahun  3
Affiliations
Meta-Analysis

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

Habtamu Geremew et al. PLoS One. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Protocol registration number: CRD42024536647.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart for studies identified, screened and included.
Fig 2
Fig 2. Pooled prevalence of PPROM in Ethiopia.
Fig 3
Fig 3. Sub-group analysis of prevalence of PPROM by study design.
Fig 4
Fig 4. Sub-group analysis of prevalence of PPROM by sample size.
Fig 5
Fig 5. Sensitivity analysis for prevalence of PPROM in Ethiopia.
Fig 6
Fig 6. Funnel plot, evaluating publication bias for prevalence of PPROM in Ethiopia.
Fig 7
Fig 7. Funnel plop, after the trim-and-fill analysis for prevalence of PPROM in Ethiopia.
See this image and copyright information in PMC

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