Risk factors for women attending pre-pregnancy screening in selected clinics in Selangor

BACKGROUND: The Ministry of Health is committed to achieve Millenium Development Goal (MDG) MDG 4 and 5 by 2015 and include pre-pregnancy care as a strategy. This study evaluates the risk factors detected during the pre-pregnancy screening at selected public primary care clinics in Selangor.
OBJECTIVES: The objectives of this study were to determine the proportion of women with risk factors receiving pre-pregnancy care in selected clinics in Selangor, their socio demographic features, the types of risk factors detected and their significance.
METHODS: A retrospective review using secondary data was carried out from the month of March until June 2013 in four public primary care clinics in Klang and Petaling districts of Selangor. Data were obtained through non-probability sampling, using the pre-pregnancy screening form utilised in 2012, which is a standard questionnaire to determine the presence of risk factors. Women with at least one defined risk factor were considered as being at risk of an adverse obstetric outcome. Data were analysed using SPSS version 16.
RESULTS: A total of 840 pre-pregnancy screening forms were collected. However only 614 (73.1%) were analysed and studied. The proportion of women with at least one risk factor was 68.8% (95% CI: 65.1, 72.5). The majority was Malays who had tertiary education and earned more than RM 1000. Most were in the reproductive age group of 18-35 years old (350, 82.9%). The mean age was 28.68 + 5.78 years. Most of the women were parous (259, 65.1%) and did not practice any form of contraception (308, 80.8%) despite having risks. The percentage of those not receiving any form of immunisation was small i.e. 9.8% but it was of importance and needed to be addressed prior to the conception. This study did not reveal any person with mental disorder or those who endured domestic abuse. Additionally, 3% (12) of them had unhealthy lifestyle habits, which include smoking, alcohol and substance abuse. Approximately one-third (212, 35.2%) of the women screened were overweight and obese, putting them at risk of developing gestational diabetes mellitus, pregnancy induced hypertension or deep vein thrombosis. The mean body mass index (BMI) for those at risk was 25.36 + 5.94 compared to 21.06 ± 1.46 for those with no risk. This study also found a small percentage of women with raised blood pressure (3.9%), abnormal physical examination (1.5%) and anaemia (14.4%), which need to be investigated and treated prior to conception.
CONCLUSION: More than half of the women who attended the pre-pregnancy screening were found to have at least one risk factor.