MCN: CHAPTER 2 - Lesson 1: IDENTIFYING CLIENTS AT RISK

high-risk pregnancy

is used to describe a situation in which a mother, her fetus, or both are at higher risk for problems during pregnancy or delivery than in a typical pregnancy.

high-risk pregnancy

These pregnancies require specialized monitoring and care to ensure the health and safety of both mother and child.

• maternal age extremes (under 17 or over 35),

• pre-existing health conditions (e.g., diabetes, hypertension, heart disease),

• multiple pregnancies (twins or more),

• and complications from previous pregnancies (e.g., preterm birth, miscarriage, preeclampsia).

High-risk conditions include

Risk Pregnancy

is a pregnancy with a pre-existing or developing condition that threatens the progression of the pregnancy, labor and delivery of a healthy term infant.

Risk factors

are conditions or behaviors that increase the likelihood of disease, complications, or poor health outcomes.

• Medical Risk Factors

• Genetic Risk Factors

• Behavioral Risk Factors

• Environmental Risk Factors

In maternal and child health, risk factors can be categorized as:

Medical Risk Factors

Pre-existing conditions (e.g., hypertension, diabetes, infections).

Genetic Risk Factors

Family history of genetic disorders or congenital abnormalities.

Behavioral Risk Factors

Smoking, alcohol use, poor nutrition, lack of prenatal care.

Environmental Risk Factors

Exposure to pollution, inadequate healthcare access, unsafe living conditions.

at-risk individual

is a person who has a higher probability of developing a disease or experiencing a negative health outcome due to specific genetic, medical, lifestyle, or environmental factors.

• Maternal Age (Below 16 Years and Above 35 Years)

• Birth Interval

• Weight (Less than 100 Pounds or More than 200 Pounds)

• Height Less Than 5 Feet

• Parity (Number of Previous Pregnancies)

Personal-Social Factors;

Pregnancies above 35 years

have a higher chance of gestational diabetes, hypertension, miscarriage, and chromosomal abnormalities (e.g., Down syndrome).

Teenage pregnancies

increase risks of preterm birth, low birth weight, and pregnancy-induced hypertension due to the mother’s incomplete physical development.

Short intervals (less than 18 months) between pregnancies

can lead to preterm birth and low birth weight due to inadequate maternal recovery.

Long intervals (more than 5 years)

may also increase complications like preeclampsia and labor difficulties.

Underweight mothers

are at risk of delivering low birth weight babies, malnutrition, and preterm labor

Overweight or obese mothers

have higher risks of gestational diabetes, hypertension, cesarean delivery, and birth defects.

Height Less Than 5 Feet

Short stature can be linked to a small pelvis, increasing the risk of obstructed labor and cesarean section.

Parity (Number of Previous Pregnancies)

First-time mothers and those with multiple pregnancies (five or more births) are at higher risk of complications such as preeclampsia, postpartum hemorrhage, and preterm labor.

• Poor Diet/Nutritional Deficiencies

• Low Income

• Low Educational Level

Socio-Economic Factors;

Poor Diet/Nutritional Deficiencies

Inadequate intake of essential nutrients like folic acid, iron, and calcium increases risks of neural tube defects, anemia, and poor fetal development.

Low Income

Financial constraints limit access to quality prenatal care, proper nutrition, and medical support, increasing risks of pregnancy-related complications.

Low Educational Level

Lack of knowledge about prenatal care, nutrition, and healthy pregnancy practices can result in poor maternal health behaviors and higher maternal and infant mortality rates.

• Maternal Behaviors

• Smoking

• Use of Drugs

• Use of Alcohol

• Intake of Caffeine

Behavioral Factors;

Smoking

Leads to restricted fetal growth, preterm labor, low birth weight, and an increased risk of sudden infant death syndrome (SIDS).

Illicit drug use (e.g., cocaine, heroin)

can result in preterm birth, birth defects, stillbirth, and neonatal withdrawal syndrome.

Use of Alcohol

Increases the risk of fetal alcohol syndrome (FAS), intellectual disabilities, and developmental delays.

Occupational Factors

• Exposure to hazardous chemicals, prolonged standing, heavy lifting, and stressful work environments can increase risks of preterm labor, miscarriage, and fetal developmental issues.

• Shift work, especially night shifts, can disrupt maternal sleep patterns, leading to hormonal imbalances and pregnancy complications.

Health Care Delivery

• Limited access to prenatal care, skilled birth attendants, and postnatal support increases the risk of undetected pregnancy complications, maternal mortality, and neonatal mortality.

• Inadequate maternal health services in rural or low-income communities contribute to higher rates of preventable maternal and child health complications.