Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

High-risk Pregnancy and Perinatal Outcome: An Observational Study

Author(s): Naina Kumar* and Ashu Yadav

Volume 16, Issue 4, 2020

Page: [318 - 326] Pages: 9

DOI: 10.2174/1573404816999200421100553

Price: $65

Abstract

Background: High-risk pregnancies are associated with adverse perinatal and maternal outcomes. Aim: To know the overall perinatal outcome in high-risk pregnancies.

Methods: Present observational study was conducted in the Obstetrics and Gynecology department of a rural tertiary center of Northern India over eight months (February-October 2018) on 3,085 antenatal women at gestation ≥ 28 weeks with 1,309 high-risk cases and 1,776 normal pregnancy cases after Institutional ethical committee approval and informed written consent from the participants. The demographic features including age, gravidity, parity, gestation, high-risk factors, the onset of labor, mode of delivery of all the selected antenatal women at gestation ≥ 28 weeks were recorded on a preformed datasheet by trained staff. All the participants were observed till delivery and the perinatal outcome was recorded. Statistical analysis was done using software SPSS 22.0 version and a p-value <0.05 was considered statistically significant.

Results: Of total 1,309 high-risk pregnancies, 365(27.9%) were preterm, 936(71.5%) term and eight (0.6%) post-term cases. Of 1,309 neonates delivered, 66(5.04%) were intra-uterine dead fetuses, 1,243 live fetuses, of which nine (0.7%) had intrapartum still-birth, 278(22.4%) required neonatal intensive care unit admission, 70(5.6%) intubated, 238(19.1%) needed oxygen support, 343(27.6%) developed complications, while 11(0.9%) had early neonatal deaths. The average birth weight of neonates delivered to high-risk mothers was 2.47±0.571 Kg with 271(20.7%) neonates having low birth weight (<2.5 Kg). Of all high-risk factor Hypertensive disorders of pregnancy, Antepartum hemorrhage, Anemia, Gestational diabetes mellitus, Intra-uterine growth restriction, oligohydramnios was significantly associated with adverse perinatal outcomes (p<0.05). High-risk pregnancy was associated with preterm births, low birth weight, NICU admission, intubation, complications, neonatal deaths, still-births as compared to normal pregnancy. Most common neonatal complication was the low birth weight (20.7%) followed by Respiratory distress syndrome (17.6%), prematurity (13.1%).

Conclusion: High-risk pregnancy was associated with an adverse overall perinatal outcome with increased risk of perinatal morbidities and mortalities.

Keywords: Birth weight, gestation, high-risk pregnancy, neonate, perinatal, respiratory distress syndrome.

Graphical Abstract

[1]
Jain S, Anand S, Aherwar R. High risk scoring for prediction of pregnancy outcome: a prospective study. Int J Reprod Contracept Obstet Gynecol 2014; 3: 516-22.
[http://dx.doi.org/10.5455/2320-1770.ijrcog20140910]
[2]
Alkema L, Chou D, Hogan D, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet 2016; 387(10017): 462-74.
[http://dx.doi.org/10.1016/S0140-6736(15)00838-7] [PMID: 26584737]
[3]
Indian Maternal mortality rate. Available from: https://niti.gov.in/content/maternal-mortality-ratio-mmr-100000-live-births [Accessed on: Feb 15, 2020]
[4]
Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis Lancet 2015; 385(9966)430-40. [doi: 10.1016/S0140-6736(14)61698-6. Epub 2014 Sep 30. Erratum in: Lancet 2016; 387(10037): 2506. Erratum in: Lancet 2015; 385(9966): 420 PMID: 25280870.
[http://dx.doi.org/10.1016/S0140-6736(14)61698-6] [PMID: 25280870]
[5]
Registrar General of India. Sample registration system (SRS) statistical report 2016. New Delhi: 2016. Available from: www.mospi.gov.in [Accessed on: Feb 15, 2020]
[6]
Jadhao AR, Gawade MD, Ughade SN. Outcome of pregnancy among high risk pregnancies in rural area of Nagpur, Maharashtra, Central India. Int J Commun Med Public Health 2017; 4: 628-33.
[http://dx.doi.org/10.18203/2394-6040.ijcmph20170443]
[7]
Jnaneswari K, Dash M. Perinatal outcome in high risk pregnancies. Int Res J Med Sci 2016; 4(4): 1-4.
[8]
World Health Organization. World Health Organization 10 Facts on Maternal Health. Available from: http://www.who.int/features/factfiles/maternal_health/en/ [Accessed on: Apr 24: 2018]
[9]
Good clinical practice recommendations for iron deficiency anemia in pregnancy (IDA) in pregnancy in India. J Obstet Gynaecol India 2011; 61(5): 569-71.
[http://dx.doi.org/10.1007/s13224-011-0097-5]
[10]
Beune IM, Bloomfield FH, Ganzevoort W, et al. Consensus based definition of growth restriction in the newborn. J Pediatr 2018; 196: 71-76.e1.
[http://dx.doi.org/10.1016/j.jpeds.2017.12.059] [PMID: 29499988]
[11]
World Health Organization. World Health Organization; Geneva: 2006. Neonatal and perinatal mortality country, regional and global estimates. Available from: http://whqlibdoc.who.int/publications/2006/9241563206_eng.pdf [Accessed on: Apr 24: 2018]
[12]
Barfield WD. Committee on Fetus and Newborn. Standard terminology for fetal, infant, and perinatal deaths. Pediatrics 2016; 137(5)pii: e20160551
[http://dx.doi.org/10.1542/peds.2016-0551] [PMID: 27244834]
[13]
Majella MG, Sarveswaran G, Krishnamoorthy Y, Sivaranjini K, Arikrishnan K, Kumar SG. A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India. J Educ Health Promot 2019; 8: 12.
[PMCID: PMC6378831] [http://dx.doi.org/10.4103/jehp.jehp_144_18.] [PMID: 30815483]
[14]
Shapla NR, Islam MA, Shahida SM, Parveen Z, Lipe YS. Maternal and foetal outcome of 206 high risk pregnancy cases in border guard hospital, Dhaka. Mymensingh Med J 2015; 24(2): 366-72.
[PMID: 26007267]
[15]
Zareen N, Naqvi S, Majid N, Fatima H. Perinatal outcome in high risk pregnancies. J Coll Physicians Surg Pak 2009; 19(7): 432-5.
[http://dx.doi.org/07.2009/JCPSP.432435.] [PMID: 19576151.]
[16]
Sun L, Yue H, Sun B, et al. Estimation of high risk pregnancy contributing to perinatal morbidity and mortality from a birth population-based regional survey in 2010 in China. BMC Pregnancy Childbirth 2014; 14: 338.
[http://dx.doi.org/10.1186/1471-2393-14-338] [PMID: 25267564]
[17]
Bansal P, Verma D, Bansal A, Verma A. Prenatal risk score in high risk pregnancy cases and perinatal outcome: a study from South India. Int J Reprod Contracept Obstet Gynecol 2016; 5: 3889-92.
[http://dx.doi.org/10.18203/2320-1770.ijrcog20163859]
[18]
Dieb AS, Ibrahim A, Nabil H. Neonatal outcomes in high risk pregnancies in an Egyptian Tertiary Health Care Center. Med J Cairo Univ 2018; 86(3): 1751-8.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy