Prevalence of adverse pregnancy outcomes and maternal risk factors in India: Review from Multi Regional Studies

Abstract

Background: Adverse pregnancy outcomes (APO) such as low birth weight (LBW), preterm birth, abortions, and maternal complications remain major public health challenges in India. Despite improvements in maternal health services, preventable risks persist, particularly in rural and high‑risk populations.

Methods: A review of literature was conducted using PubMed, Google Scholar, (NFHS), and other databases. The studies were based on both community and hospital settings from various states across the country. These studies included cross-sectional surveys, follow-up studies, and hospital record reviews that looked at how women’s social, medical, and obstetric factors were linked to APO.

Results: As per NFHS-5, 17.8% of women reported having experienced an APO, up from 16.5% in NFHS-4 in Delhi, placing it in top five states/UTs with the highest APO prevalence which is higher than the national average of 12.2 %. The prevalence of LBW ranged from 17% to 21% across regions. Key risk factors included maternal undernutrition, anemia, hypertension, inadequate iron–folic acid intake (IFA), and <3 antenatal visits. Advanced maternal age (≥35 years) was strongly associated with gestational diabetes, hypertension, fetal growth restriction, preterm delivery, and higher caesarean rates. In rural Delhi, 47% of women reported abortions, 65% of which were unsafe, reflecting poor contraceptive use and low awareness of legal services. Early registration, balanced diet, and regular IFA intake offered best protection.

Conclusion: In India, pregnancy problems are caused by both health issues in the mother and social conditions like poverty, poor diet, and lack of care. To reduce low‑birth‑weight babies, unsafe abortions, and illness in mothers, it is important to give women advice before pregnancy, improve their nutrition, provide safe abortion and family planning services, and make sure good antenatal care reaches rural and poor areas.

Keywords: Adverse pregnancy outcomes, Maternal health, Reproductive age women, Risk factors, NFHS, India