The Incidence Of High-risk Pregnancy And Its Relationship With Pregnancy Outcome In Qiandeng Town

Objective:To study occurrence of the high-risk pregnancy and adverse pregnancy outcomes, and to explore impact of high-risk pregnancy on pregnancy outcome (including maternal, fetal and neonatal outcome), and to guide the management of maternal and child health work.Methods:1. Subjective:A retrospective cohort study was used to enroll women who were living in Qiandeng Town, and carried a prenatal examination and delivery in three hospitals in Qiandeng, Kunshan City, Jiangsu Province, from January 2011 to December 2013.2. Research methods:Participants’demographic characteristics including age, education, hukou, times of prenatal examination, pregnancy history and mode of delivery were collected. Risk factors of high-risk pregnancy including history of abortion, uterine scar, accessories operation, fetal breech of more than 32, twins, more than 28 placenta previa, maternal height or weight, history of perinatal mortality and complicated disease of pregnancy (hyperthyroidism, diabetes, primary hypertension, tuberculosis, heart disease, et al) were extracted from records of maternal care, test results of HTV, HBV and syphilis, pregnancy outcomes including maternal and fetal outcomes were investigated.3. Statistical analysis:The rate and proportion were used to describe morbidity of the high-risk pregnancy and distribution of risk factors of the high-risk pregnancy, respectively. Chi-square test or Fish’s exact probability method was used to compare the incidence of high-risk pregnancy differences among different age, education, history of pregnancy groups. And non-conditional logistic regression analysis was used to analyze association of high-risk pregnancy, high-risk factors scores and other factors with adverse pregnancy outcomes.Results:1. Morbidity of high-risk pregnancy and distribution of high risk factorsFrom 2011-2013,947 maternal cases were collected,284(29.99%) of them were high-risk pregnancy. The top 3 of the risk factors of high-risk pregnancy were:abortion history, accounting for 39.13% of high-risk pregnancy women; the scar uterus, accounted for 38.41%; younger (<18 years) or older (>35 years old), accounting for 15.94%.2. Influencing factors of high risk pregnancyThe incidence rate of high risk pregnant women with Junior high school and below was 38.20%, which was higher than that in maternal women with high school education (20.31%), or those with college degree and above education (25.24%). The Maternal with rural hukou had higher incidence of high-risk pregnancy than those with urban hukou (43.37% vs 25.47%, P<0.001). Women with a history of previous pregnancy, experiencing <8 of prenatal examination during the pregnancy had higher morbidity of the high-risk pregnancy than those without history of pregnancy, or experiencing≥8 times prenatal examination.3. Association of high-risk pregnancy and other factors with adverse outcomesThe maternal women with high-risk pregnancy had higher risk of adverse pregnancy outcomes, with OR of 3.95995%CI=2.929-5.351), compared to those were not high-risk pregnancy, moreover, the risk of adverse pregnancy outcomes increased with the increase of the risk factors scores. And maternal women with older age, rural hukou, lower education, pregnancy more than 4 times, and experiencing<8 of prenatal examination during pregnancy had higher risk of adverse outcomes.Conclusion:1. Differences in the incidence of high-risk pregnancy between Qiandeng area within three hospitals and Kunshan city was not statistically significant.2. High-risk pregnancy risk factors were age, pregnancy history, the number of prenatal monitoring, maternal education level, household and other. To strengthen the maternal perinatal health education, raise awareness levels, help to reduce the incidence of high-risk pregnancy.3. High-risk pregnancy increases maternal adverse pregnancy outcomes, leading to a series of fetal diseases. The management of maternal health should be strengthened, to prevent and reduce the occurrence of high risk pregnancy, and to reduce maternal and neonatal complications and death.