A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India

Almost 15% of all pregnant women can develop potentially life‑threatening complications. As a result, identification of high‑risk pregnancy at earliest stage will be useful in directing appropriate intervention. Hence, the current study was done to determine the prevalence and outcome of high‑risk pregnancy among antenatal women in rural Puducherry.

A record‑based longitudinal study was done during March 2018 among 569 antenatal women who have attended rural health center of tertiary care institute. High‑risk pregnancy was classified based on the guidelines from Pradhan Mantri Surakshit Matritva Abhiyan and outcome assessment based on the obstetric and neonatal outcomes.

Among 569 antenatal case record reviewed, 315 (55.3%) were in the age group of 20–25 years and majority (463, 81.4%) belonged to below poverty line families; 410 (74.3%) registered their current pregnancy within the first trimester. The prevalence of high‑risk pregnancy among study participants was 18.3% (95% confidence interval: 15.3%–21.7%). Majority (81.9%) had term delivery. Regarding obstetric and neonatal outcomes, majority had spontaneous vaginal delivery (73.9%); about 10.4% gave birth to low‑birth weight baby, and only 1.7% had stillbirth. Parity, socioeconomic status, and unfavorable outcomes such as low‑birth weight, preterm, and postterm delivery were associated with high‑risk pregnancy.

The current study found that almost one‑fifth of the pregnant women in rural area have high‑risk pregnancy. Unfavorable obstetric and neonatal outcomes were common among high‑risk cases. Hence, early detection of high‑risk pregnancy needs to be done at primary health‑care level to improve the maternal, obstetric, and neonatal outcomes.