A cross-sectional study was carried out on a sample of 900 pregnant women attending MCH centers in Alexandria to determine the incidence of high risk pregnancy and to demonstrate the common risk factors among them. The simplified scoring system developed by Morrison and Olsen (1979) was used. Mothers with scores 0-2 were considered at low risk those with score 3 and more were categorised as high risk. Results revealed that high risk women constituted 27.78% of the sample. Twenty three risk factors were identified among all pregnant women screened. The most frequently encountered were anaemia (37.33%), age 35+ (15.66%), parity 5+ (16.66%), previous gynecological surgery (8.88%) and history of previous stillbirth or neonatal death (6.11%). The mean number of risk factors in the low risk group was 0.95 compared to 3.03 in the high risk group. Stepwise regression analysis indicated that the reproductive history score was the best one variable predictor of total risk score explaining about 74% of the variation in the total score while the present history score explained a further 16% of the variation and the associated conditions score explained 9% only of the variation. The use of scoring technique is recommended to be used in identification of high risk pregnant women in MCH centers.
PIP: Data on 900 pregnant women attending 4 maternal and child health (MCH) centers in Alexandria, Egypt between June-August 1989 were analyzed to screen for high risk pregnancies and identify common risk factors among these pregnancies. The Morrison and Olsen scoring system revealed high or extreme risk pregnancy in 27.78% of the women. Women in the low risk group had a mean of 0.95 risk factors. Women in the high risk group had a mode of 2 risk factors and a mean of 3.03. The most frequent combination of 3 risk factors were maternal age of at least 35, parity =or 5, and anemia. Total scores ranged form 0 to 14. Among women of the high risk group, 49.6% received scores of 3-4, 28% of 5-6, and 22.3% of =or 7. The mean total risk score for the low risk group was 1.03 compared with 5.25 for the high risk group. The most common risk factors in order of frequency were anemia (37.33%), parity =or 5 (16.66%), maternal age of at least 35 (15.66%), previous gynecologic surgery (8.88%), and history of stillbirth or neonatal mortality (6.11%). All of these risk factors except anemia occurred significantly more often in the high risk group than in the low risk group. Reproductive history accounted for 74% of the variation in the total risk score. Present pregnancy score and associated conditions accounted for 16% and 9% respectively. It is suggested that health workers use a scoring system to screen pregnant women attending antenatal clinics. They should also learn how to identify and manage high risk pregnancies. Trained personnel should design and distribute uniform records for assessment of high risk pregnancy to all primary health care units with antenatal services. Each MCH center should register perinatal deaths so health workers can use the data to make antenatal diagnoses and determine care.