Background: High-risk pregnancies are associated with adverse perinatal and maternal
outcomes. Aim: To know the overall perinatal outcome in high-risk pregnancies.
Methods: Present observational study was conducted in the Obstetrics and Gynecology department
of a rural tertiary center of Northern India over eight months (February-October 2018) on 3,085
antenatal women at gestation ≥ 28 weeks with 1,309 high-risk cases and 1,776 normal pregnancy
cases after Institutional ethical committee approval and informed written consent from the participants.
The demographic features including age, gravidity, parity, gestation, high-risk factors, the
onset of labor, mode of delivery of all the selected antenatal women at gestation ≥ 28 weeks were
recorded on a preformed datasheet by trained staff. All the participants were observed till delivery
and the perinatal outcome was recorded. Statistical analysis was done using software SPSS 22.0
version and a p-value <0.05 was considered statistically significant.
Results: Of total 1,309 high-risk pregnancies, 365(27.9%) were preterm, 936(71.5%) term and eight
(0.6%) post-term cases. Of 1,309 neonates delivered, 66(5.04%) were intra-uterine dead fetuses,
1,243 live fetuses, of which nine (0.7%) had intrapartum still-birth, 278(22.4%) required neonatal
intensive care unit admission, 70(5.6%) intubated, 238(19.1%) needed oxygen support, 343(27.6%)
developed complications, while 11(0.9%) had early neonatal deaths. The average birth weight of
neonates delivered to high-risk mothers was 2.47±0.571 Kg with 271(20.7%) neonates having low
birth weight (<2.5 Kg). Of all high-risk factor Hypertensive disorders of pregnancy, Antepartum
hemorrhage, Anemia, Gestational diabetes mellitus, Intra-uterine growth restriction, oligohydramnios
was significantly associated with adverse perinatal outcomes (p<0.05). High-risk pregnancy was
associated with preterm births, low birth weight, NICU admission, intubation, complications, neonatal
deaths, still-births as compared to normal pregnancy. Most common neonatal complication was the
low birth weight (20.7%) followed by Respiratory distress syndrome (17.6%), prematurity (13.1%).
Conclusion: High-risk pregnancy was associated with an adverse overall perinatal outcome with
increased risk of perinatal morbidities and mortalities.