Maternal and Neonatal Outcomes of High-Risk Pregnancies Identified through PMSMA in Rural West Bengal: A Longitudinal Study

Background: High-risk pregnancies (HRPs) contribute significantly to maternal and neonatal morbidity and mortality. The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) and its extended version aim to identify and manage HRPs through structured antenatal care, especially in underserved areas. Thus, present study was conducted to assess the clinico-social profile and evaluate maternal and neonatal outcomes among high-risk pregnant women registered under PMSMA in Budge-Budge II block, West Bengal. Materials & Methods: A longitudinal observational study was conducted from January 2025 to July 2025, including 305 HRPs registered at PMSMA clinics. Participants were followed through delivery up to the 8th postnatal day. Data on socio-demographic, clinical risk factors, and outcomes were collected using a structured schedule. Coopland’s high-risk pregnancy scoring system was used to categorize risk levels. Data were analysed using descriptive statistics and binary logistic regression. Results: Teenage pregnancy (28.9%), early primigravida status (27.5%), and previous caesarean section (27.2%) were common risk factors. Severe-risk pregnancies (score ≥7) constituted 28% of cases. Poor neonatal outcomes were observed in 22.6%, and poor maternal outcomes in 21.6% of participants. Caesarean section rate was 84.9%, and live births occurred in 97.7% of cases. Severe-risk pregnancies showed a significant association with poor neonatal outcomes (OR: 7.01, 95% CI: 3.77–12.01) and poor maternal outcomes (OR: 3.92, 95% CI: 1.91–8.02). Conclusion: Strengthening Extended PMSMA visits and referral linkages is essential to improve maternal and neonatal outcomes in rural settings. Key words: Pregnancy, High-Risk, Maternal Health Services, Pregnancy Outcome, India, Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)