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ASSESSMENT OF DETERMINANTS OF MISCARRIAGE IN PRIMI GRAVIDA VISITING GYNAECOLOGY OUT PATIENT DEPARTMENT

Dr Hafiza Maria Arshad, Dr Maksalmina Reshtin, Dr Ghulam Mujtaba

Abstract: Introduction: Neonatal, prenatal and infant mortality rates are still high in developing countries despite national and international efforts to redress this problem. This study was conducted to investigate maternal knowledge and attitudes regarding the risk factors that adversely affect pregnancy outcomes and miscarriages in DHQ Gujranwala. A longitudinal study was conducted among 50 pregnant women attending antenatal clinics from start of their pregnancy to 22 weeks of gestation. Socio-economic, demographic, anthropometric, biomedical and obstetric information was collected. Results showed that, majority of the pregnant women (> 70%, n = 70) were aware of the risk factors that could adversely affect the pregnancy outcomes, however, they did not know the exact mechanisms by which the risk factors acted to cause the adverse effects. Occurrence of risk factors among pregnant women was severe anaemia - smoking, passive smoking, alcohol consumption, unmarried, under-age (< 20 years), over-age (> 35 years), history of stillbirth, history of caesarean section and history of miscarriage. A larger study should also be conducted to ascertain the association of the other risk factors with pregnancy outcomes, starting with pregnant women in their first trimester. Materials and Methods: A longitudinal study was conducted from January 2017 to June 2017 to assess the “Determinants of miscarriages in primigravida visiting gynaecology outpatient department, DHQ hospital, Gujranwala. In this regard a comprehensive questionnaire was prepared to collect data from respondents. Results: The potentially modifiable pre-pregnant risk factors associated with increased miscarriage risk were: age of 30 years or more at conception, underweight, and obesity. During pregnancy, the modifiable risk factors were: alcohol consumption, lifting of >20 kg daily, and night work. We estimated that miscarriages might be prevented by reduction of all these risk factors to low risk levels. Maternal age at conception and alcohol consumption were the most important risk factors. Conclusion: Miscarriage risk is increased by multiple potentially modifiable risk factor and thus considerable proportion of miscarriages may be preventable Key Words: Neonatal, miscarriages, primigravida, modifiable

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