The unborn and the newborn child. Present obstetric risk grouping fails to predict complicated labour and neonatal morbidity.
An epidemiologic analysis is presented of 4,102 women to a birth cohort in Frederiksborg County. The purpose is to evaluate the predictive value of pregnancy risk groups (R) present before labour for complicated delivery (CD) and neonatal morbidity (NM). The risk factors defining R comply with the Danish National Board of Health Recommendations. R included 56%. By primary risk group (PR) is understood women only with complicating factors at the onset of pregnancy, by secondary risk group (SR) women only with complicating factors occurring during pregnancy. The tertiary risk group (TR), which includes women with a complication which with certainty implies CD, was excluded. PR and SR were significant regression variables evaluated by CD and NM. Primiparae had a higher frequency of CD than multiparae, both in the no-risk group (N-R) and in the R, but not evaluated by NM. Primiparity, thus, was a risk factor for CD. NM correlated with CD in the form of severe risk conditions for both the mother and child during delivery. Evaluated by CD and NM, the predictive value of belonging to R was 46% and 16%, and the predictive value of belonging to N-R was 69% and 93%, which suggests that a re-evaluation of the risk factors is required.
D003718:Denmark; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000401:mortality; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D012306:Risk