STUDY OF ASSOCIATION OF RISK FACTORS WITH FETOMATERNAL OUTCOME

Abstract

Introduction: Preterm Birth and low birth weight are most important factors affecting life of neonate. Labour itself is considered re-birth for Mother. Many factors during labour affect life of mother like operative delivery, PPH, etc. We are dealing with two lives- Mother and the baby. If we know what are preventable and or treatable risk factors causing these complications, we can reduce the unfavorable outcomes. Teenage, adequate Antenatal care, anemia, thyroid disorder, gestational diabetes mellitus, PIH are some of these risk factors. Teenage pregnancy is known to have unfavorable/ bad outcomes⁵. They are more likely to experience complications like pregnancy-induced hypertension (PIH) and early labour onset. Premature birth and low birth weight (LBW) were more common in teenage mothers along with maternal anemia.⁴ Adequate antenatal care is found to reduce risk in pregnancy. It can reduce the risk of stillbirths and pregnancy complications and give women a positive pregnancy experience.⁶ Maternal anemia contributes to preterm birth and low birth weight and increases the risk of maternal mortality.⁷ Adverse maternal health outcomes pertaining to maternal anemia were Fetal growth restriction, need for cesarean delivery, diabetes, hypertension and increased risk for maternal mortality. Hence, with this background, the present study is conducted in MGM MCHA, We have studied association of risk factors like teenage pregnancy, anemia, antenatal care, gestational diabetes mellitus, hypothyroidism and PIH with Preterm birth, low birth weight, PPH, operative delivery, maternal death, and stillbirth. Method: We enrolled 104 pregnant women when they came for labour room admission at MGM MCHA. Risk factors like teenage pregnancy, whether or not she has received adequate antenatal care, maternal anemia, hypothyroidism, GDM, PIH were noted. Pregnancy outcomes like, preterm labour, low birth weight, operative delivery, PPH, still birth and maternal death were studied. The association of risk factors with pregnancy outcomes with help of odds ratio was measured. Result: Positive correlation is noted with preterm birth, operative delivery and maternal death with teenage pregnancy. Positive correlation noted with PPH and operative delivery in patients who received Inadequate antenatal care. Patients who had anemia were more likely to have preterm births and PPH. No correlation noted with hypothyroidism with any of the feto-maternal outcomes. GDM has positive correlation with PPH and still birth. PIH has positive correlation with low birth weight and operative delivery. Conclusion: Preterm birth is associated with teenage pregnancy and maternal anemia. Low birth weight associated with PIH. PPH is associated with Inadequate antenatal care, maternal anemia and GDM. Operative delivery is associated with teenage pregnancy, Inadequate antenatal care and PIH. Maternal death can be associated with risk factor like early age of pregnancy i.e. teenage pregnancy. Still birth is associated with Gestational diabetes mellitus.

Keywords: Teenage Pregnancy, Feto-maternal Outcome, GDM, Anemia, PIH, LBW, PPH, Operative delivery and preterm births.