Pregnancies at Risk: Identifying Factors that Effect Maternal Outcomes

Monday, 30 July 2012

Lucy R. Van Otterloo, RN, BS, MSN
School of Nursing, California State University, Long Beach, Long Beach, CA
Cynthia D. Connelly, PhD, RN, FAAN
1. University of San Diego Hahn School of Nursing, 2. Child and Adolescent Services Research Center -Rady Children's Hospital, San Diego, CA

Learning Objective 1: identify what risk factors are present in women with adverse outcomes including admission to ICU, mechanical ventilation, hemorrhage, and increased length of stay.

Learning Objective 2: describe the relationship between demographic and obstetric/medical risk factors and adverse maternal outcomes.

Purpose: Antenatal risk assessment is a key strategy to the successful provision of risk-appropriate care and prevention of maternal mortality and/or morbidity.  Complications can often be prevented when healthcare providers are appropriately educated to meet the unique needs of patients they serve and when patients have rapid access to the appropriate healthcare. Although several studies have been conducted on the effect of maternal factors related to newborn outcomes few have focused on the effect these risk factors have on the mother's outcome.  Therefore, the purpose of this study is to identify maternal factors that have predictive value in determining adverse maternal outcomes in order to support the development of maternal risk-appropriate care. 

Methods: A descriptive, correlational design employing linked secondary data sets from the California Office of Statewide Health Planning and Office of Vital Statistics will be used.  The statistical analysis includes descriptive and inferential statistics.  The statistical tests include univariate analysis, Chi-square, bivariate analysis, and logistic regression.  These analyses allow examination of the associations between risk factors and adverse outcomes while controlling for confounding factors.

Results: In progress

Conclusion: Nurses are being challenged to use their knowledge and skills to identify potential factors that may cause injury or harm to the patient.  The earlier these factors are recognized the sooner the nurse can initiate the decision making process to mitigate the risk.  Information is needed about potentially modifiable versus non-modifiable factors.  Modifiable factors could be reduced through primary and secondary prevention strategies.  Women with non-modifiable factors would potentially benefit from increased vigilance and care to minimize adverse outcomes and decrease cost.  This study's results will contribute information regarding what pregnancy related complications increase the risk for poor maternal outcomes.  Information gained will inform practice standards and improve the recognition of risk and subsequent requirements for care to mitigate the potential for adverse outcomes.