Association between adverse pregnancy outcomes and preceding risk factors: a cross-sectional study from Nashik District, India

Abstract

Background The preconception phase of women’s life cycle is critical but comparatively ignored. The presence of health risks is judged as hazardous to the wellbeing of women and their offspring. This study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between certain risk factors and adverse outcomes. Methods As a part of a preconception care intervention project, a baseline survey was conducted in four blocks of Nashik District, India. In this population-based cross-sectional analytical study, we compared cases in the study group (randomly selected one tribal and one non-tribal block) with those of the control group (one tribal and one non-tribal block). A comparison was also made between the tribal and non-tribal blocks in each group. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists conducted the survey under the direct supervision of Auxiliary Nurse Midwives and Medical Officers. Multivariate analysis was carried out to find the adjusted prevalence ratio of having a particular adverse outcome because of the prespecified potential risk factors. Results A total of 9307 women participated in the study. The prevalence of adverse pregnancy outcomes was as follows: abortion in 4.1%, stillbirth in 1.7%, preterm birth in 4.1%, low birth weight in 13.2%, and congenital physical defect in 2.8%. Prevalence of parental consanguinity, pre-existing maternal illness at conception, heavy work during the last six months of pregnancy, tobacco consumption, alcohol consumption, direct exposure to pesticides and domestic violence during pregnancy was 18.5, 2.2, 18.7, 5.6, 0.5, 2.3, and 0.8% respectively. Risk factors associated with abortion included pre-existing illness and heavy work in the last six months of the pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of low birth weight were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. Conclusion There is a need to emphasize on maternal behaviour, including tobacco consumption, and heavy work during pregnancy, as well as on parental consanguinity and pre-existing maternal illnesses, in order to achieve the best possible pregnancy outcomes.

Knowledge regarding consanguineous marriage and it effects on pregnancy outcome among the adolescents of village in Bagalakote district

“…[1][2][3][4][5] Genuine reason for consanguineous marriage in the community is primarily social and cultural. 2,3,6 Several social studies indicated that reasons for consanguinity are: Stability in marriage due to high Compatibility between husband, wife, and between couples and Family. Who shares the same social relationship before the marriage and after the marriage, it is considered favorable for Status of women who will have a better relationship with her in-laws, reduces the possibility of a hidden uncertainty in health and financial issues, strengthens the financial ties and provides solidarity.…”

“…5 Girl's parents prefer to have their daughter living near them and to enjoy the presence of their grandchildren, and lastly the family wants to keep their wealth or property within the family. [1][2][3]6 Socially, consanguineous marriages may provide strength to relationships, the economic condition in families. 3,5 But many health-care providers and genetic scientists consider consanguineous marriage as the risk to health.…”

“…[3][4][5][6][7] Due to the expression of Autosomal recessive genetic mutation inherited from common ancestors, the children born by the consanguineous union are at increased risk for the recessive disorder and other congenital disorders like Neural tube defect, congenital heart disease, recessive hearing loss disorder, retrieval dystrophies. 2,3,[6][7][8] However, because of less or no national or state-level data for all genetic disorders makes the derivation of credible prevalence rates virtually impossible. 3 Studies state there is a significant association between consanguineous marriage and cystic fibrosis, Alzheimer's disease1.…”

“…1,3 In the current situation, probably because of urbanization and trending nuclear family patterns, consanguineous marriage in urban areas may be less in numbers. 2,6 However, it remains culturally a major shift in the balance between social and economic benefits associated with the consanguineous marriage and health consequences which can be attributed to the effectiveness of a community education program and increased level of education and awareness among urban population regarding the consequences of consanguinity. 1,3,9 Previous studies conducted to assess the knowledge regarding consanguineous and its effects among youth of Iran 10 and Turkey indicated that youth had very poor knowledge and negative attitude toward consanguineous marriage.…”

“…7,9 It has been demonstrated that this can result in lower maternal age at first childbirth, higher pregnancy-related risk, and higher number of children. [1][2][3][4][5][6] Hence, the aim of present study was to assess the knowledge about consanguineous marriage and its effect on pregnancy outcome and to investigate the effect of structured teaching program on high school students' knowledge.…”