Early Onset Neonatal Infection in Pregnancies with Prelabour Rupture of Membranes in Kosova: A Major Challenge

Objective: Prelabour rupture of membranes (PROM) is a common event in obstetrics that has major impact in pregnancy outcome. This condition is linked to a number of pregnancy and birth complications with early onset neonatal infection (EONI) being one of the major threats.
This study was undertaken to determine the rate of neonatal infection in newborn infants with a maternal history of prelabour rupture of membranes and to evaluate the association of risk factors with neonatal infection following PROM.
Material and Methods: A cross-sectional descriptive design was used to analyze a population of 200 pregnant women presenting to the Obstetrics and Gynecology Tertiary Center in Kosova (during 2013-2015) with prelabour rupture of membranes who gave birth to single newborns. Data including demographic characteristics, neonatal outcome, and risk factors for infectious neonatal morbidity were recorded and analyzed.
Results: The study included 200 pregnant women with prelabour rupture of membranes and their newborns (N=200). Participant demographics include: the majority were young, between 20-29 years old (67%), primiparous (67.5%), unemployed (92%), completed secondary level of education (83%) and with middle socioeconomic status (86%).
Overall, 13% of the newborns had an early onset neonatal infection, and sepsis was proven in 5% of cases. Newborns of mothers with risk factors such as preterm <37 weeks PROM, low gestational weight at birth, prolonged rupture of membranes, maternal colonization, and low Apgar Score at birth, had higher rate of infection in comparison with newborns of mother without these risk factors.
Conclusion: The rate of EONI in pregnancies complicated with PROM continues to be a global challenge in Perinatology and as this study reports, also a major challenge for Kosova. Future research, revision and improvement on prenatal care utilization and practices, timing of delivery, medical treatment, and prophylactic use of antibiotics in PROM are needed to reduce rates.