Evaluation of Maternal Risk Factors, Delivery, and Neonatal Outcomes of Premature Rupture of Membrane: A Systematic Review Study

Context: Premature rupture of membrane is a serious complication in pregnancy and responsible for one third of preterm labors associated with the neonatal and delivery outcomes. The current study aimed at investigating the risk factors of premature rupture of membrane on delivery and neonatal implications. Data Sources: The articles on the databases, including PubMed, Cochrane Library, ISI and Google Scholar up to 2017 were searched to conduct the current study. The keywords used were “premature rupture of membrane”, “neonatal,” “risk factors”, “maternal”, and “delivery”. Study Selection: The inclusion criteria were articles on the relationship between maternal risk factors and Premature Rupture of Membrane (PROM), neonatal outcomes of PROM, the delivery outcomes of PROM, the study of mothers and infants, English and Persian language articles, and sufficient information on the PROM. The articles investigating amniotomy or the ones that only their abstracts were available were excluded from the study. Data Extraction: The data extracted from the above mentioned databases were fed with the following titles in the Excel software: Authors’ names and surnames, year of study, type of study, place of study, case group, control group, maternal risk factors, delivery outcomes, neonatal outcomes of PROM, and the results of the study. Out of 90 articles, 15 articles were finalized including one prospective study, five cross-sectional papers, six retrospective articles, and three historical cohort studies. Maternal risk factors included age; parity; education; occupation; diabetes; blood pressure; cervical length along with abortion history; history of infection, upper urinary tract infection, and sexually transmitted diseases. Moreover, delivery complications were cesarean section, oligohydramnios, chorioamnionitis, and placental abruption. Neonatal complications included prematurity, respiratory distress syndrome, asphyxia, infection, meningitis, sepsis, pneumonia, perinatal mortality, patent arterial duct, necrotizing enterocolitis, IVH, pulmonary hypoplasia, hyperbilirubinemia, and antibiotic intake. Based on the results of the current study, the most important risk factors for PROM were diabetes and maternal hypertension associated with neonatal and maternal complications. Infection was the most important maternal and neonatal complication.