Risk Factors and Outcomes of Premature Rupture of Membranes Among Women in the Middle East and North Africa: Mapping Review

Background/Objectives: Term and preterm premature ruptures of membranes (PROM and PPROM) are serious pregnancy complications associated with adverse maternal and neonatal outcomes. Although widely studied in the global literature, data on the risk factors and outcomes of PROM and PPROM in the Middle East and North Africa (MENA) region remain limited. This mapping review aimed to identify and assess existing evidence and highlight gaps in knowledge regarding risk factors for PROM, including preterm PROM, and related maternal and neonatal outcomes among women in the region. Methods: We conducted a comprehensive and systematic search of articles published in English and Arabic between January 2000 and June 2025 across Scopus, Embase, Web of Science, and PubMed/Medline. Eligible studies included observational and interventional studies conducted in MENA countries. Data were extracted and synthesised using thematic mapping. Results: Out of 5359 retrieved records, 136 met the inclusion criteria. The main study design was cross-sectional (51 studies), followed by case–control (41), cohort (26), and 15 randomised controlled trials. The geographic distribution of the evidence varied significantly. Research has mainly focused on PROM and its biological risk factors, such as infections and chronic medical conditions. Psychological and environmental factors have been the least reported. Neonatal and gestational outcomes have frequently been addressed, whereas maternal outcomes have received less attention. Conclusions: The findings reveal significant geographic, thematic, and methodological disparities in research throughout the MENA region. The results underscore the need for further studies on the prevention and identification of women at higher risk of PROM.