troduction : Maternal mortality remains a major public health challenge globally and in India. Although India’s maternal mortality ratio (MMR) has declined, high-risk pregnancies (HRP) continue to contribute significantly to adverse maternal and perinatal outcomes. Tamil Nadu has achieved a low MMR through robust maternal death audits; however, systematic assessment of HRP patterns is needed. This study aimed to estimate the prevalence, patterns, and outcomes of HRP in Poonamallee Health Unit District (HUD), Tamil Nadu.
Methods : A descriptive cross-sectional study was conducted using secondary data from the Pregnancy and Infant Cohort Monitoring and Evaluation (PICME) system. All registered HRPs in Poonamallee HUD from April 2024 to March 2025 were included (n = 3,593). Maternal sociodemographic details, antenatal risk factors, and pregnancy outcomes were analyzed using descriptive statistics
RESULTS: Among 9,426 registered pregnancies, 3,593 (38.1%) were high-risk, with higher prevalence in Avadi (urban) (53.0%). Most women were aged 25–29 years (42.6%) and gravida 2 (43.3%). Caesarean section was the predominant mode of delivery (64.5%). Live births accounted for 99.7%, while stillbirths were 0.3%. Low birth weight was observed in 15.6% of neonates. Common risk factors included hypothyroidism (26.1%), previous LSCS (18.4%), gestational diabetes mellitus (10.2%), and pregnancy-induced hypertension (6.7%). Nearly one-third (32.2%) had multiple coexisting risk factors.
CONCLUSION: Over one-third of pregnancies were high-risk, with hypothyroidism, previous LSCS, and gestational diabetes as major contributors. The high caesarean rate and burden of low birth weight underscore the need for strengthened antenatal risk stratification, timely referral, and comprehensive perinatal care to further reduce maternal and neonatal morbidity and mortality.