Risk factors for premature rupture of membranes at term

Premature rupture of membranes (PROM) is defined as the rupture of the amniotic sac before the onset of labor and occurs in approximately 8% of pregnancies worldwide. Despite its high prevalence, the etiology of this condition remains unclear. The leading etiological theory currently implicates infection. Risk factors for PROM at full term have been assessed in numerous studies; however, they vary depending on the population studied. This article examines the risk factors for PROM in a population of women living in a large industrial city. Aim. To study risk factors for premature rupture of membranes in women with a gestational age of more than 37 weeks. Materials and Methods. A retrospective case-control study was conducted involving 200 women. The first group consisted of 100 women who gave birth to preterm premature rupture of membranes at 37-41+6 weeks' gestation, while the second group consisted of 100 women who delivered normally and with timely rupture of membranes. The study was conducted using data extracted from birth records and individual patient records. Statistical analysis was performed using StatTech v. 4.10.4 (developed by StatTech LLC, Russia). Differences were considered statistically significant at p < 0.05. Results. The study identified 18 reliable risk factors for premature rupture of membranes. The most significant risk factors for premature rupture of membranes were infectious (acute respiratory viral infections in the first trimester, vaginal infections before 12 weeks, and a history of STIs), anamnestic (infertility, history of intrauterine surgery), and obstetric complications of pregnancy (threatened miscarriage, gestational anemia, gestational diabetes, preeclampsia). Conclusion. The analysis demonstrates that the risk factors identified in the study are characterized by significant heterogeneity and cannot be explained within a single etiopathogenetic framework. Current scientific research predominantly emphasizes the infectious theory in the development of premature rupture of membranes. However, clinical conditions such as gestational anemia, gestational diabetes mellitus, and preeclampsia cannot be fully explained by this theory alone. Therefore, the pathogenesis of premature rupture of membranes remains unclear and requires further comprehensive interdisciplinary research.

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