SOCIO-DEMOGRAPHIC AND OBSTETRIC RISK FACTORS FOR UTERINE RUPTURE: A FIVE-YEAR CASE-CONTROL STUDY IN A NIGERIAN TERTIARY HOSPITAL

ABSTRACT Uterine rupture remains a catastrophic complication in low- and middle-income countries like Nigeria. This study identified risk factors for uterine rupture among 91 cases and 400 controls in a Nigerian tertiary hospital. Increased risks were found for lower socioeconomic status (Odds Ratio [OR] = 3.64, p = 0.015) and unbooked status (OR = 11.3, p < 0.001). Obstetric factors with significant associations included high parity (≥5: OR = 5.7, p < 0.001), previous cesarean section (OR = 2.6, p < 0.001), use of oxytocics (OR = 8.2, p < 0.001), and prolonged obstructed labor (OR = 41.6, p < 0.001). In the multivariable model, previous cesarean section (Adjusted OR [AOR] = 16.6, p < 0.001), use of oxytocics (AOR = 17.6, p < 0.001), and prolonged obstructed labor (AOR = 10.65, p < 0.001) were significant independent risk factors. High parity (≥5: AOR = 5.4, p = 0.021) was also a risk factor, while younger age (≤20 years: AOR = 0.15, p = 0.023) was protective. The study shows the need to improve antenatal care and emergency obstetric services. A key limitation is the retrospective nature of this single-center study, which is susceptible to incomplete data and potential selection bias.