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.