Association Between Maternal Anemia and Premature Rupture of Membranes: A Literature Review
Otti Chidibere Joel
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku -Ozalla, Enugu State, Nigeria.
Forwah Jacques Ndeh *
Department of Hematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Emem Samuel Edung
Department of Emergency Medicine, Basildon & Thurrock University Hospital. Mid & South Essex NHS TRUST, United Kingdom.
Shemarah Lindo
Department of Obstetrics and Gynecology-HPV Consortium University of Ibadan- University College Hospital, Oyo State, Nigeria.
Islamiyat Ajibola Lawal
Department of Obstetrics and Gynaecology, Doncaster and Bassetlaw NHS Foundation Trust, United Kingdom.
Asogwa Augustine Oluchukwu
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Ekwuazi Kingsley Emeka
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Medinat Enimire Abubakar
Department of Obstetrics and Gynaecology, South West Acute Hospital, Northern Ireland.
Ifezuoke Tochukwu Dickson
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Duru Chinazom Victor
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Chidike Onyedikachi Ezegwui
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Eke-Otuka Uzochukwu
Department of Obstetrics and Gynaecology, Federal Medical Centre Asaba, Delta State, Nigeria.
Orakwe Chukwudumebi Somto
Department of Obstetrics and Gynaecology, Federal Medical Centre Asaba, Delta State, Nigeria.
Catherine Samuel Edung
Department of Microbiology, Cerba Lancet Nigeria, Nigeria.
Euna Kenechi Onyia
Department of Obstetrics and Gynaecology, Enugu State University of Science and Technology, Enugu State, Nigeria.
Idayat Adejumoke Salami-Folami
Department of Obstetrics and Gynaecology, Bolton NHS Foundation Trust, United Kingdom.
Funke Basirat Sangodara
Department of Obstetrics and Gynecology, General Hospital Harvey Road, Yaba Lagos State, Nigeria.
Inyangmme Iniabasi Ime
General Out Patient Department Green Pasture Hospital, Lagos, Lagos State, Nigeria.
Ewa Anthony Obi
Department of Family Medicine, University of Calabar Teaching hospital Calabar, Cross River State, Nigeria.
Ngha James Ngah
Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Etukemo Ubong Amos
Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Ekpe Okpala Aribo
Department of Physiology University of Calabar, Calabar, Cross Rivers State, Nigeria.
Ofor Joshua Obase-Otumoyi
Department of Public Health National Open University, Lagos State, Nigeria.
Idiege Idiege Omang
Department of Surgery, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Ofonime Benjamin Essien
Department of Hematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Akunna Noral Ugaliegbulam
Aneurin Bevan University Health Board Wales, United Kingdom.
Chuba Emmanuel Ifedigbo
Aneurin Bevan University Health Board Wales, United Kingdom.
Edeani Bobby David
Department of Radiation, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Ushie Godwin Abua
Department of Hematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Immaculate Ihuoma Ekeagba
Worcaccce Union Group Integrated Healthcare Sciences, Technological Development and Training and Innovative Research Foundation (WUGIHSTTAIRF), P.O Box 45 Bamenda, North West Region, Cameroon.
Kingsley Akabat O
Department of Hematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
James kolawole Ogah
Obstetrics and Gynaecology, 161 Nigeria Air Force hospital Markurdi, Benue State, Nigeria.
Abeshi Sylvester Etenikang
Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Premature rupture of fetal membranes (PROM) is a significant obstetric complication affecting 2-4% of pregnancies, according to the World Health Organization (WHO, 2025) reports and others recent studies.
Objective: This review examines the link between maternal anemia and PROM, focusing on prevalence, epidemiology, risk factors, and management. A detailed examination of the current prevalence of anemia among women with PROM, the epidemiological characteristics of affected populations, and the principal risk factors were reviewed. The pathophysiological pathways linking anemia to membrane weakening—including oxidative stress, impaired collagen synthesis, and heightened inflammatory activity—are discussed. Maternal and fetal complications such as chorioamnionitis, postpartum hemorrhage, respiratory distress syndrome, and neonatal sepsis are outlined. Diagnostic modalities (clinical assessment, biochemical markers, ultrasonography) and contemporary management strategies (antibiotic prophylaxis, corticosteroids, and individualized delivery planning) are evaluated. Finally, preventive measures are considered.
Methodology: A systematic search of ten search engines including PubMed, ScienceDirect, and Cochrane Library and others (2020-2026) yielded 590 articles. Using search terms "premature rupture of fetal membranes", "anemia", "pregnancy complications", "risk factors", and "management", 450 articles were included after screening.
Results: Anemia contributes to PROM through oxidative stress, impaired collagen synthesis, and inflammation, increasing risks of chorioamnionitis, postpartum hemorrhage, and neonatal complications. Key findings show anemia prevalence among PROM cases is significant, while key risk factors include anemia, infection, and lifestyle factors. Diagnostic approaches include clinical assessment, biomarkers, and ultrasonography. Management involves antibiotic prophylaxis, corticosteroids, and tailored delivery planning.
Conclusion: This review provides a comprehensive overview of the current prevalence, risk factors, clinical presentation, pathophysiological mechanisms, maternal and fetal complications, diagnostic approaches, management strategies, and prevention measures related to PROM. The findings highlight the importance of prompt diagnosis and management of PROM to prevent maternal and fetal complications. Healthcare providers should be aware of the risk factors, clinical presentation, and diagnostic approaches to diagnose and manage PROM promptly
Keywords: PROM, maternal anemia, epidemiology, risk factors, pathophysiology, complications, diagnosis, management, prevention and systematic review