Prevalence and Risk Factors of Neisseria Gonorrhoeae and Chlamydia Trachomatis Among Pregnant Women With Preterm Premature Rupture of Membranes at the Kenyatta National Hospital and Pumwani Maternity Hospital

Abstract

Background: Premature rupture of membranes complicates 2% of pregnancies and is associated with 40% of preterm deliveries with resultant significant perinatal morbidity and mortality. Previous studies have shown an association between ascending infection from the lower genital tract and occurrence of preterm premature rupture of membranes (pre-PROM). Global estimates have shown that bacterial vaginosis, candidiasis and Group B streptococcus are a major contributor to microbes in the amniotic fluid leading to neonatal mortality. Among these pathogens, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are commonly reported with a global prevalence among pregnant women reported at 7% and 0.4% respectively. However, these microbial pathogens and their contribution to spontaneous infections associated with pre-PROM remain understudied especially in Kenya. Objective: To determine the prevalence of genital infections (N. gonorrhoea and C. trachomatis) and the associated risk factors among pregnant women presenting with pre-PROM at the Kenyatta National Hospital and Pumwani Maternity hospital Methodology: This study was a cross-sectional study with sub group analysis among women presenting at KNH and Pumwani labour ward for delivery. A total of 248 pregnant women with history suggestive of premature rupture of membranes were recruited into the study. Data was collected through an interviewer administered questionnaire and vaginal swabs collected for Polymerase Chain Reaction (PCR) testing. Descriptive statistics were used to provide a summary of the data and logistic regression models used to investigate the association between genital infections and pre-PROM among women presenting for delivery at KNH and Pumwani Maternity hospital. Significance of the study: The study findings will inform the diagnosis and further management of the commonly isolated pathogens, CT and NG among patients presenting with pre-PROM.