Antepartum Risk Assessment for Pregnant Women Visiting a Tertiary Care University Teaching Hospital in Southern India.

Abstract

Aim: The study was conducted to assess the prevalence of high-risk pregnancy (HRP) cases among pregnant women visiting the Prabhakar Kore Hospital (PKH) at Belagavi, Karnataka for antenatal care (ANC) and determination of the level of risk in the identified cases.

Materials & methods: Data were collected as a part of a screening procedure of a nutrition supplement clinical trial on pregnant women [Study title: Maternal DHA Supplementation and offspring Neurodevelopment in India (DHANI)]. ANC case records including detailed notes on medical and obstetric history, physical examination, laboratory investigations of pregnant women with ≤ 20 weeks of gestational age were screened for known risk factors.

Results: A total of 11,686 new cases were registered for ANC between June 2016 through August 2017. Of these, 3379 (<20 weeks gestation) were screened out of 428 pregnant women, 12.6% pregnant women were found to be at risk, 40.2% (n=172) fell in the high-risk category. Most commonly reported risk factors were thyroid disorders (27.3%, hypothyroidism 17.3%; hyperthyroidism 10%), gestational diabetes (16.1%), bad obstetric history (12.6%) and anaemia (10.7%).

Conclusion: Early identification of these at-risk mothers through a simple, practical, reliable and customized risk scoring schedule can ensure interventions either to control the risk causing factor or delivery of timely and appropriate care as and when needed.

Clinical significance: Considering the disproportionate burden that high risk pregnancies pose on higher mortality rates and compromised quality of life for the cases which survive, early identification of these high risk cases (12.6% identified in this study) can have a significant impact on maternal and child health. The population negatively affected by at-risk pregnancies is only expected to increase in the near future in light of the rising trend of its known risk factors such as high blood pressure, diabetes, or being HIV-positive.