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  1. Somboonsook B, Wakerman J, Hattch CT, Collison M, Barnes A, Kyi W, et al.
    Med J Malaysia, 1995 Sep;50(3):212-20.
    PMID: 8926897
    This study was the first assessment of a nationwide risk approach system to antenatal management introduced to Malaysia in 1989. Three rapid, record-based surveys on three different study groups were conducted to determine risk factor prevalence, accuracy of risk assignment, action after risk assignment and the relationship of risk level and place of delivery. The most frequent risk factors were short birth interval, high parity and first pregnancy. Accuracy of risk assignment was highest at the lowest levels of risk and poorest at the highest levels. Women at the lowest levels of risk were more likely to be seen by a doctor than women at highest risk. These was a trend to deliver in hospital, rather than at home, as level of risk increased; but many women at high risk still delivered at home. Recommendations are made on modifications to the system prior to future evaluation.
    Matched MeSH terms: Pregnancy, High-Risk*
  2. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    PMID: 34071394 DOI: 10.3390/ijerph18115801
    Maternal and neonatal morbidity and mortality tend to decrease if referral advice during pregnancy is utilized appropriately. This study explores the reasons for nonadherence to referral advice among high-risk pregnant women. A qualitative study was conducted in Morang District, Nepal. A phenomenological inquiry was used. Fourteen participants were interviewed in-depth. High-risk women who did not comply with the referral to have a hospital birth were the study participants. Participants were chosen purposively until data saturation was achieved. The data were generated using thematic analysis. Preference of homebirth, women's diminished autonomy and financial dependence, conditional factors, and sociocultural factors were the four major themes that hindered hospital births. Women used antenatal check-ups to reaffirm normalcy in their current pregnancies to practice homebirth. For newly-wed young women, information barriers such as not knowing where to seek healthcare existed. The poorest segments and marginalized women did not adhere to referral hospital birth advice even when present with high-risk factors in pregnancy. Multiple factors, including socioeconomic and sociocultural factors, affect women's decision to give birth in the referral hospital. Targeted interventions for underprivileged communities and policies to increase facility-based birth rates are recommended.
    Matched MeSH terms: Pregnancy, High-Risk*
  3. Achanna S, Monga D
    Med J Malaysia, 1995 Mar;50(1):37-41.
    PMID: 7752974
    The obstetric performance of 59 elderly primigravidae delivering at the University Hospital, Kelantan, between January 1, 1987 and December 12, 1988 is compared with that of 60 young primigravidae delivering during the same time period. The total number of deliveries during this period was 16,284, and the predominant ethnic group was Malays. Apart from an increased incidence of preeclampsia (23.7% vs. 13.3%), breech presentation (6.78% vs. 3.33%) and Caesarean sections (74.6% vs. 10%) among the study group, there were no other statistically significant obstetric complications. Majority of Caesarean sections were done as emergency procedures, the principal indications being poor progress of labour and foetal distress. The neonatal outcome (in terms of birthweight, gestational age and breastfeeding at discharge) was similar in the two groups. For most women in both groups this was the first marriage, though a higher proportion in the study group had an interval of more than two years between marriage and childbirth.
    Matched MeSH terms: Pregnancy, High-Risk*
  4. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    PLoS One, 2020;15(12):e0244072.
    PMID: 33370361 DOI: 10.1371/journal.pone.0244072
    BACKGROUND: The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death. This study aimed to determine the prevalence of high-risk pregnancies and explore the association between risk stratification and severe maternal morbidity.

    METHODS: This hospital-based prospective cohort study included 346 pregnant women between 28-32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity.

    RESULTS: The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth.

    CONCLUSIONS: Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.

    Matched MeSH terms: Pregnancy, High-Risk*
  5. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    BMC Pregnancy Childbirth, 2021 Aug 04;21(1):539.
    PMID: 34348703 DOI: 10.1186/s12884-021-04018-7
    BACKGROUND: A woman's perception of risk affects her decisions about seeking obstetric care and following prescribed regimens of care. This study explored the perceptions of high-risk pregnancy among women with high-risk factors.

    METHODS: A qualitative study was conducted in the Morang district, Nepal. A phenomenological approach was used. In-depth interviews were conducted with 14 participants. Postpartum women with one risk factor for high-risk pregnancy who non-adhere to referral hospital birth were selected purposively. Thematic analysis was done to generate themes and categories.

    FINDINGS: Two main themes emerged in this study: (i) knowledge and understanding of risk and (ii) normalizing and non-acceptance of risk. The participants had inadequate knowledge of risk in pregnancy and childbirth. Their information source was their personal experiences of risk, witnessing their close relatives, and community incidents. The participants perceived pregnancy as a normal event and did not consider themselves as at risk. They tended to deny risk and perceived that everything was fine with their pregnancy.

    CONCLUSIONS: The findings of this study provide a glimpse into how women perceived risk and the reasons that lead them to deny the risks and gave home birth. In the presence of risk factors in pregnancy, some women were not convinced that they were at risk. An antenatal check-up should be utilized as a platform to educate women, explore their intentions, and encourage safer births.

    Matched MeSH terms: Pregnancy, High-Risk/psychology*
  6. Ahmad Z, Jaafar R, Hassan MH, Awang CW
    World Health Forum, 1998;19(2):133-5.
    PMID: 9652210
    Matched MeSH terms: Pregnancy, High-Risk
  7. Rosliza AM, Muhamad JJ
    MyJurnal
    The maternal health status of Orang Asli women in Malaysia was noted to be lower as compared to other groups of population in the country. This study aimed to determine the level of knowledge, attitude and practice on antenatal care, which is a vital component of maternal health among the Orang Asli women in three Orang Asli villages in Jempol District, Negeri Sembilan. All women aged between 15 to 49 years old who had at least one antenatal experience were interviewed using a structured, pretested questionnaire. A total of 104 women were interviewed. Among them, 92.3% admitted attending antenatal clinic during their previous pregnancies while only 48.1% came early for their first check-up. About 70% of the women had history of home delivery and 44.2% had experienced at least one high risk pregnancy before. Study revealed that 44.2% (95% CI, 34.7 – 53.7%) of the women have good knowledge regarding antenatal care while 53.8% (95% CI, 44.3 – 63.1%) of them noted to have positive attitude regarding antenatal care. However, result showed that the level of knowledge regarding the importance of early antenatal care, screening test and complications of diabetes and hypertension in pregnancy were poor. In conclusion, the rate of home delivery and late antenatal booking was still high among the Orang Asli women and it is significantly associated with their attitude regarding antenatal care. These findings can be used to plan a customized health intervention program aiming to improve the maternal health practices and eventually improve the health status of the Orang Asli women
    Study site: Orang Asli village, Jempol, Negeri Sembilan, Malaysia
    Matched MeSH terms: Pregnancy, High-Risk
  8. Wong HB
    Med J Malaysia, 1985 Sep;40(3):153-64.
    PMID: 3916209
    The different methods of prenatal diagnosis are discussed with special reference to ultrasound scan, amniocentesis for cell culture with processing for chromosome study, biochemical analysis and DNA recombination analysis. Chorionic villi aspiration and fetoscopy are new methods which will enhance considerably the methods for prenatal diagnosis. With regard to chromosome study of amniotic cells, experience with 623 cases is reviewed. 2.7% demonstrated chromosome anomalies and of these Downs anomaly was the commonest. A large proportion of cases requesting for amniocentesis are Caucasians who represent only 2% of the population in Singapore, but 25% of the 440 requests were from Caucasions. The various problems associated with the different methods for prenatal deafness are discussed.
    Matched MeSH terms: Pregnancy, High-Risk
  9. Nordiyanah Hassan
    MyJurnal
    The number of deliveries increased very signdicantly in all hospitals in Terengganu since 1986. It is in line with the promotion of Safe Motherhood Initiative' with the aim to reduce maternal mortality and morbidity in a Terengganu. The aim of the study was to determine the pattern of choice for place of deliveries by local people in Terengganu and also to identdy risk factors related to their place of choice. A total of 9741 deliveries home January 1999 to 30”’ of June 1999 were included in the study. About 46% delivered in Hospital Kuala Terengganu, where 72% of them were high-risk mothers. Whereas deliveries in the district hospitals were 9.9% in Kemaman Hospital, 9.7% in Besut Hospital, 7.2% in Dungun Hospital and 3.4% in Hulu Terengganu Hospital. About 67% of district hospital deliveries were high-risk mothers. Only 12.4% of deliveries were home deliveries, however 49% of them were high-risk mothers. Utilization of alternative birthing centre in health clinics was only 1.7%. The study revealed that mothers’ risk factors are the factors signaicantly influence the place of choice for deliveries. The study jindings call for an urgent need of three essential services, Firstly an urban birthing centre conducted by obstetrician or the medical ojicers to be developed at the vicinity of the present general hospital to cater for the high percentage of highrisk pregnancies in the state. Secondly, all or selected district hospital to be given post for obstetrician, and thirdly it is a need to evaluate the current ‘High Risk Checklist for Antenatal Mothers’ to ensure treatment priority is indeed given to those really in need based on appropriate risk factors.
    Matched MeSH terms: Pregnancy, High-Risk
  10. Ishak SH, Yaacob LH, Ishak A
    Malays J Med Sci, 2021 Apr;28(2):119-127.
    PMID: 33958966 DOI: 10.21315/mjms2021.28.2.11
    Background: Men's involvement in pre-pregnancy care is important to ensure a positive pregnancy outcome. The objective of this study is to determine the level of knowledge of pre-pregnancy care among men and the factors associated with poor knowledge.

    Methods: This work is a cross-sectional study conducted at the outpatient clinics of Hospital Universiti Sains Malaysia involving 235 married men. A self-administered questionnaire was used and it consisted of four sections: socio-demographic data, reproductive characteristics of couples, clinical characteristics and knowledge of pre-pregnancy care.

    Results: More than half of the men (51.9%) had poor knowledge of pre-pregnancy care, mostly on high-risk pregnancy, consequences of poor birth spacing and effect of maternal anaemia on a baby. The mean (SD) knowledge was 11.86 (3.85). Poor knowledge of pre-pregnancy care was significantly associated with age (adjusted odds ratio [AOR] = 0.96; 95% CI: 0.94, 0.99, P = 0.002) and education level (AOR = 2.61; 95% CI: 1.49, 4.57; P = 0.001).

    Conclusion: The men in our study had poor knowledge of pre-pregnancy care. Further health promotion and education are needed to be focused on men to increase their knowledge and share the responsibilities in maternal health.

    Matched MeSH terms: Pregnancy, High-Risk
  11. Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH
    Int J Gynaecol Obstet, 2010 Dec;111(3):220-3.
    PMID: 20800837 DOI: 10.1016/j.ijgo.2010.06.023
    OBJECTIVE: To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia.
    METHODS: We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records.
    RESULTS: The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (P<0.05 for all); being anemic, being unsure of the expected delivery date, and having few antenatal visits and a late delivery booking; and low Apgar scores and perinatal complications.
    CONCLUSION: Adolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications.
    Matched MeSH terms: Pregnancy, High-Risk
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