Association Between Maternal Anemia and Premature Rupture of Membranes: A Literature Review

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