Classification and Management of High-Risk Pregnancies and the Influence of Antenatal and Nutritional Interventions on Pregnancy and Delivery Outcomes in 1097 Pregnant Women on the MICHD program in Lagos State, Nigeria

Abstract

This study was carried out to monitor 1097 women on the MICHD project. This was an independent monitoring and evaluation study on indigent women in Lagos State. The study was to evaluate the impact of antenatal visits and nutritional interventions on the Mother, Infants and Child and their pregnancy journey; while accessing the impact of the interventions on the High risk pregnancies and their outcome. The cohorts were divided into 2 major groups. The MICHD Plus group with 502 pregnant women (they attended weekly antenatal incentivized by weekly food Packs and Iron supplements for 12 weeks) and the MICHD control group with 595 pregnant (they attend regular antenatal for the same duration without the intervention). The antenatal visits reports were electronically automated and data of all pregnant women on the project collected and transcribed into a Gerocare MICHD application. Statistical analysis of antenatal variable and essential elements of a focused approach to Antenatal Care especially for the high-risk women were analyzed. Stability check reports of the antenatal visits monitored on the application at week 1, week 16 and week 20 showed the percentage of stable women at 56%, 71% and 93% respectively. Report shows that the MICHD cohorts’ attendance records estimates that 85% of the women attended antenatal between 4 - 13 times during the research period. The Highrisk pregnancies were identified and classified; there were 21 women below age 17, 13 had Hepatitis B, 36 had High Blood Pressure, 191 were Obese, 189 had Overweight BMI, 23 had Underweight BMI, and 14 women were above the age of 40. A total of 437 women were identified as High Risk and 610 women were No Risk. 78.3% of the 437 women had vaginal deliveries with no complications, while 87.7% of the no risk had vaginal deliveries. This shows that the interventions were able to improve pregnancy outcomes in 381 High risk women. Of the MICHD Plus intervention group 51% were high risk at takeoff but at delivery 84.2% of the women delivered with no complication and vaginally. An even higher percentage compared to the MICHD control that had less high risk women at takeoff. The results shows that focused approach to antenatal care and enhanced nutrition can improve pregnancy outcomes and reduce the chances of Caesarian surgery in high-risk pregnancies.