Impact of High-risk Pregnancy on Maternal and Child Health Outcomes - Evidence from Rural Ballabgarh.

BACKGROUND

High-risk pregnancies have been found to be associated with various adverse maternal or neonatal outcomes such as having a low-birth-weight (LBW) newborn, stillbirth and pre-term delivery, cesarean section (CS), stillbirths, and infant deaths.

OBJECTIVES

To estimate the burden of high-risk pregnancy and its association with pregnancy and birth outcomes.

MATERIALS AND

METHODS

Retrospective cohort study conducted in rural Haryana among pregnant women registered in health management information system from January 2020 to December 2022, i.e., 3 years. The calculated sample size was 6928. There were two groups of pregnant women, one without high-risk factors (nonexposed) and another with high-risk factors during the course of the pregnancy (exposed). They were followed up till termination of pregnancy or childbirth and their outcomes were recorded.

RESULTS

We included 6402 participants in the study. The mean (standard deviation) age of the pregnant women was 27.5 years (4.2 years). The prevalence of high-risk pregnancy was 37.0%. History of (H/o) abortion was significantly associated with stillbirth (odds ratio [OR]-3.89, 95% confidence interval [CI]-1.19-12.75). H/o CS was significantly associated with having LBW newborn (OR-1.42, 95% CI-1.08-1.87), preterm delivery (OR-1.78, 95% CI-1.41-2.25), and CS (OR-15.78, 95% CI-12.40-20.09). Twins/multiple gestation was significantly associated with having LBW newborn (OR-5.72, 95% CI-2.36-13.91), preterm birth (OR-6.61, 95% CI-2.68-16.26), and CS (OR-3.56, 95% CI-1.45-8.75).

CONCLUSION

More focused intervention targeting maternal nutrition is needed at all the levels of health care. Uniform criteria for classifying high-risk pregnancies are need of the hour, which can be assisted by this study.