Epidemiological determinants of pregnancy outcome in urban slums of Jammu city-a prospective study

Background: In the backdrop of continuing high child and maternal mortality, eight millennium development goals (MDGs) were spelt out by United Nations in 1990 setting targets for reduction in child mortality (MDG-4) by two-thirds and reduction in maternal mortality ratio (MDG-5) by three-quarter by 2015. Knowledge about the biosocial determinants, place of delivery and presence of complications in the present and past pregnancy are important factors to predict pregnancy outcome. Objectives: To study the epidemiological determinants of pregnancy outcome in the urban slums of Jammu city. Materials and Methods: A prospective study for 1 year was conducted on pregnant women living in urban slums. Expectant mothers who were registered with Anganwadis in slums and were in their third trimester (>28 weeks of gestation) were enrolled and followed until 7 days after delivery. After collecting preliminary sociodemographic information, each woman was evaluated employing Indian council of medical research antenatal risk scoring system and presence or absence of selected epidemiologic determinants. Results: Results revealed multifactorial determinants of pregnancy outcome. Among them, individual factors were literacy status and occupation of pregnant women. Health system determinants of pregnancy outcome were delivery by an untrained birth attendant, home delivery, and obstetric complications in the current pregnancy and unfavorable pregnancy outcomes in previous pregnancies. Conclusion: Our study reiterates the need of combining scoring variables which conventionally include clinical parameters, with epidemiologic determinants to predict the pregnancy outcome so that high-risk pregnancies can be detected and managed accordingly.