Maternal and Fetal Complications in High-Risk Pregnancies: A Prospective Study to Evaluate and Mitigate Adverse Outcomes Through Pharmacist- Led Counselling

Introduction: High-risk pregnancies continue to account for a major proportion of maternal and neonatal morbidity in developing countries. This study evaluated common maternal and fetal complications and examined the effect of pharmacist-led counselling in mitigating adverse outcomes. Methods: A prospective observational study was conducted over 15 months (February 2024–April 2025) in two tertiary hospitals in Bengaluru. 222 pregnant women enrolled in the study and 185 were identified as high-risk pregnancy. Clinical profiles, complications, and newborn outcomes were documented. Structured pharmacist counselling sessions were provided, and outcomes were compared before and after intervention. Sample size was determined using a single-proportion formula (p = 0.49, d = 0.05), yielding n ≈ 183. Data were analysed using SPSS v27. Results: The individual prevalence of the co morbidities that includes 41.4% of anemia, 3.2% of pregnancy induced hypertension, 3.6% of Gestational diabetes mellitus, 17.6% of hypothyroidism, 31.1% of previous lower segment caesarean section, 2.3% of twin/multiple pregnancy, 34.2% bad obstetric history, 1.4% of young gravida, 4.5% of elderly gravida, 6.8% of Rh incompatibility, 5.9% of low-lying placenta, 0.4% of HCV positive and 0.4% of HbSAg positive. Common fetal outcomes included low birth weight (6.3%), preterm delivery (9%), and neonatal complication. No serious drugrelated adverse events were observed. Conclusion: Pharmacist participation in antenatal care significantly improved awareness and adherence among high-risk mothers, suggesting that multidisciplinary collaboration can enhance pregnancy outcomes in resource-limited settings.