Introduction

Presenting findings from a recent comprehensive study conducted by researchers at the ICMR’s National Institute for Research in Reproductive and Child Health (NIRRCH) in Mumbai.
Utilizing data extracted from the National Family Health Survey-5 (2019-2021), the study offers a nuanced understanding of the prevalence and determinants of high-risk pregnancies among Indian women.

Pregnancy Issues: Key Statistics

The study encompasses data from nearly 24,000 pregnant women across India.
Prevalence of high-risk pregnancies stands at a staggering 49.4%.
Northeastern states, including Meghalaya (67.8%), Manipur (66.7%), and Mizoram (62.5%), alongside Telangana (60.3%), exhibit the highest prevalence rates.
Meghalaya records the highest frequency of multiple high-risk factors at 33%.
Regional disparities in risk factors underscore the imperative for tailored interventions to address local challenges effectively.

Data Analysis Approach: Employing unit-level data sourced from the Demographic Health Surveys (DHS) program, the study meticulously scrutinizes the prevalence of high-risk pregnancies among women aged 15-49.
Primary Risk Factors: The study identifies short birth spacing, adverse birth outcomes, and caesarean deliveries as primary contributors to the incidence of high-risk pregnancies.

Maternal Risks: Critical maternal factors such as age, height, body mass index (BMI), and gestational weight gain emerge as pivotal determinants of pregnancy-related risks.
Lifestyle and Birth Outcome Risks: Lifestyle choices including tobacco use, alcohol consumption, along with previous birth outcomes significantly influence the likelihood of high-risk pregnancies.
Educational Disparities: Pregnant women with limited formal education are disproportionately affected, exhibiting heightened prevalence rates of multiple high-risk factors compared to their educated counterparts.
Temporal Patterns: Notably, high-risk factors tend to escalate during the third trimester, emphasizing the critical need for vigilant monitoring and timely interventions.

Janani Shishu Suraksha Karyakram (JSSK) (2011): Provides free delivery, including Cesarean section, and essential healthcare services to pregnant women in public health institutions.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) (2016): Ensures quality antenatal care and high-risk pregnancy detection on the 9th of every month.
LaQshya Initiative (2011): Aims to improve the quality of care in labor rooms and maternity operation theatres, promoting Respectful Maternity Care.
Pradhan Mantri Matru Vandana Yojana (PMMVY) (2016): The program aims to provide assured, comprehensive and quality antenatal care, free of cost, universally to all pregnant women on the 9th of every month.
Surakshit Matritva Aashwasan (SUMAN): Aims to provide assured, dignified, and quality healthcare at no cost for every woman and newborn visiting public health facilities.
Anaemia Mukt Bharat (2018): Launched with a 6x6x6 strategy to reduce anaemia prevalence among children, adolescents, and women in the reproductive age group.

Tailored Interventions: Develop region-specific interventions targeting areas with high prevalence rates, addressing local challenges effectively.
Strengthened Antenatal Care: Ensure access to quality antenatal care services, particularly for women at risk, through initiatives like the Pradhan Mantri Surakshit Matritva Abhiyan.
Capacity Building: Invest in training healthcare professionals to identify and manage high-risk pregnancies effectively, improving maternal and child health outcomes.
Integration of Initiatives: Foster coordination and integration among existing government initiatives like Janani Shishu Suraksha Karyakram, Pradhan Mantri Matru Vandana Yojana, and Anaemia Mukt Bharat for holistic maternal care.

The study advocates for a comprehensive approach aimed at mitigating the prevalence of high-risk pregnancies, safeguarding maternal and child health, and promoting equitable access to healthcare across diverse socio-economic strata.