1.Risk factors for women attending pre-pregnancy screening in selected clinics in Selangor
Nik Mazlina M ; Ruziaton H ; Nuraini DB ; Izan Hairani I ; Norizzati BIB ; Isa MR ; Mimi O
Malaysian Family Physician 2014;9(3):20-26
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.