Chances of Adverse Neonatal Outcome in High-Risk and Low-Risk Obstetrical Patients

Objective: To analyze and compare occurrence of adverse immediate neonatal outcomes in high and low-risk obstetrical population. Methods: Retrospective cohort study of 2370 pregnant women. The odds of adverse outcomes (i.e. low Apgar score (1–4 points) and intermediate Apgar score (5–8 points) at 1 and 5 minutes of life, birth to a small-for-gestational-age neonate (below 90th percentile of birth weight), and requirement for advanced level II-III nursery care) as well as odds of primary cesarean delivery—were analyzed using logistic regression analysis. Results: All of the studied outcomes were seen more often among the high-risk patients. When the outcomes were analyzed within a given group some interesting observations were made. The highest odds of abnormal Apgar scores (when compared to the low risk population) were seen in patients with preeclampsia—6.06 (95 % CI 3.28; 11.22) and twin pregnancies—odds ratio of 6.63 (95 % CI 2.24; 19.67). Among Small-for-Gestational-Age newborns the most frequently identifi ed maternal condition was preeclampsia (21.57%), out of all fetal conditions twin gestation (26.67%) was number one identifi ed scenario. The highest proportion of patients requiring advanced level nursery care (level II and III) was observed in those with twin gestation, pregnancies complicated by hypertension with and without diabetes