Clinical Profile, Risk Factor Stratification and Outcomes of the Fernandez Birth Cohort from India: A Decade of Experience.

Objective: To describe the clinical profile, risk factor stratification and outcomes of 102,683 successive births at a perinatal tertiary referral network in India. Design: Cross-sectional hospital-based study. Setting: Tertiary Perinatal Referral Center Network in India. Sample: 102,683 Births. Methods: This cross-sectional hospital-based study included 102,683 babies birthed by 99,467 women between Jan 2013 and Dec 2023 (11-year period). Women who birthed singletons, twins, triplets or quadruplets were included as cases. The data was collected using an electronic medical record system. Main Outcome Measures: Mode of Birth, Postpartum Haemorrhage, Maternal Deaths, Live Birth Rate, Pre-Term Births, Small for Gestational Age. Results: Overall, 102,683 babies were birthed during the study period. The mean age of the women was 28.3 ± 4.17 years. About half of them (46.6%) were presented during the first trimester. Most of the women had a spontaneous conception (89.14%). One third of the women at presentation were categorized as high risk (34.95%) which increased significantly during pregnancy and birth (75.18%). The most associated co-morbidities were diabetes mellitus (26.4%), thyroid disorders (26.01%) and hypertension (13.27%). The mode of birth included lower segment caesarean Sect. (50%), spontaneous vaginal birth (39.68%) and assisted vaginal birth (9.88%). Post-partum hemorrhage was seen in 7,357 (7.16%) births and atonic (6.16%) was the commonest etiology. The outcomes analyzed were live birth rate (98.86%), pre-term birth rate (16.78%) and small for gestational age (10.84%). Conclusion: High risk pregnancy is a common occurrence in India. It is important to understand the risk factors and monitor the antenatal and postnatal care to ensure good outcomes for the mother and baby.