Publication:

Obstetric and neonatal outcomes among high-risk pregnancy in Bengaluru

Background High-risk pregnancy (HRP) significantly contributes to adverse maternal and neonatal outcomes. Early identification and appropriate management through antenatal care (ANC) services, including initiatives such as Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), are crucial in reducing morbidity and mortality. This study aimed to determine the obstetric and neonatal outcomes among high-risk pregnancies in a rural area of Bengaluru, South India.

Methods A retrospective cohort study was conducted in the rural field practice area of a Tertiary care hospital and Medical College. High-risk pregnant women registered at a Primary Health Centre between January 2022 and July 2023 were included. Descriptive statistics were expressed as proportions with 95% confidence intervals. Chi-square test was used to assess associations between variables.

Results A total of 94 high-risk pregnant women were included (mean age 26.7±4.1 years). Most participants (97.9%) had more than four ANC visits, while 89.4% did not utilize PMSMA services. Referral to higher centres was made in 36.2% cases. Common high-risk conditions included previous lower segment cesarean section (31.9%), previous bad obstetric history (19.1%), hypothyroidism (11.7%), gestational diabetes (5.3%) and pregnancy-induced hypertension (5.3%). Term deliveries accounted for 87.2% and the cesarean section rate was 73.4%. Postpartum hemorrhage occurred in 14.9% cases. Live births constituted 92.6%, with 3.2% stillbirths and 4.3% neonatal deaths. Low birth weight was observed in 19.1% newborns. A statistically significant association was found between number of ANC visits and newborn status (χ²=45.97, p<0.01).

Conclusions High-risk pregnancies were associated with considerable obstetric and neonatal complications, including high cesarean section rates and low birth weight. Although ANC coverage was satisfactory, utilization of PMSMA services was low. Strengthening early risk identification, improving program awareness and ensuring timely referral and comprehensive management are essential to improve maternal and neonatal outcomes.