Obstetric High Risk Screening and Prediction of Neonatal Morbidity

Abstract

A retrospective study using an obstetric risk score protocol was applied to a stratified sequential sample of 843 singleton livebirths, occurring in the Royal Hospital for Women, Sydney, over a 12-month period (March, 1985-February, 1986). Data collection included 53 prenatal factors, 41 intrapartum factors and 37 neonatal factors. The study was comprised of 346 women admitted to the hospital birth centre and 497 women admitted to labour ward. In labour ward admitted women there was a significant association between high prenatal scores, high intrapartum scores and high neonatal morbidity scores. Women admitted to the birth centre were subjected to a screening procedure which resulted in low prenatal and relatively low intrapartum risk scores. However, neonatal morbidity scores were similar for both groups. The risk scoring protocol used in this study requires further revision to allow the adequate selection of low risk women delivering infants with a low risk of neonatal morbidity in a low risk obstetric setting.

High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study

“…The Malaysian antenatal risk stratification approach, which screens pregnant women based on antepartum risk factors, was used in the current study. Other risk assessment tools use either antepartum risk factors or intrapartum risk factors, or both [27,[49][50][51]. Some risk assessment tools collect neonatal risk factors, as well [51].…”

“…Other risk assessment tools use either antepartum risk factors or intrapartum risk factors, or both [27,[49][50][51]. Some risk assessment tools collect neonatal risk factors, as well [51]. The Malaysian risk stratification approach has 15 risk factors in the red category, 14 in the yellow category, 32 in the green category, and 9 in the white category.…”

“…In contrast, a simple risk scoring system used in Nepal had 28 antepartum and 16 intrapartum factors [27]. An obstetric risk scoring tool used in Australia had 53 antepartum, 41 intrapartum, and 37 neonatal factors [51].…”

The National Birth Center Study Part III—Intrapartum and immediate postpartum and neonatal complications and transfers, postpartum and neonatal care, outcomes, and client satisfaction

“…The concept of maternal risk screening began in the 1950s, when epidemiologic studies found associations between certain maternal characteristics and a higher‐than‐average incidence of poor pregnancy outcomes (17–19)[Text missing in PDF] This led to increasingly formalized efforts to identify high‐risk pregnant women in order to provide them with the most sophisticated and intensive obstetric and neonatal care. A complementary purpose of such risk assessment is identification of low‐risk women in order to provide them with less expensive, less technologic care, such as that in free‐standing childbirth centers.…”