Elevated risk for neonatal outcome following denial of pregnancy: results of a one-year prospective study compared with control groups

Abstract Aims: Newborns following denied pregnancies are delivered after either late onset or total absence of antenatal care, with a presumed subsequently increased risk for neonatal outcome. For this specific group, several characteristic outcome parameter are investigated. Methods: During the period July 1, 1995 to June 30, 1996, a prospective case sampling was performed for denied pregnancies in Berlin. Besides determination of the parameters' frequency, comparison with two control groups is performed: a normal group (BBR, all Berlin deliveries in 1995) and a high risk group (VIR, all deliveries at a perinatal center in 1996). Results: Altogether 69 neonates occurred. For gestational age < 37 weeks, birth weight < 2500 g, small for gestational age, transferal rate of newborns to neonatal unit and surgical delivery, a statistically significant worse outcome is demonstrated for denied pregnancies versus BBR and VIR (p-level < 0.05). Neonatal mortality is 5.8% in all cases, the corrected rate is 1.5% (excluding three non-viable cases of 21st and 23rd week of gestation). Conclusions: The data underline the elevated fetal outcome risk for newborns after denial of pregnancy. In this group, total absence or late onset of antenatal care results in a manifestation of pregnancy dependent risks. Preterm births and small for gestational age newborns, together with deaths, may be classified as at least potentially avoidable.