High-risk prenatal: the importance of pediatric and obstetric follow-up

Abstract

High-risk prenatal care is specialized monitoring for pregnant women with health conditions or clinical factors that increase the risk of complications during pregnancy, childbirth, or the postpartum period, such as chronic diseases, advanced maternal age, a history of obstetric complications, or multiple pregnancies. The goal is to ensure rigorous and personalized monitoring to prevent or minimize potential harms, ensuring a safer gestational outcome. Globally, while 87% of pregnant women have access to at least one prenatal consultation, fewer than three in five receive the minimum recommended of four consultations. The World Health Organization (WHO) revised its guidelines, recommending a minimum of eight prenatal consultations to reduce perinatal mortality. In Brazil, guidelines recommend a minimum of six consultations. High-risk prenatal care should be comprehensive, integrating shared and complete professional follow-up that focuses on identifying risk factors and warning signs. Prenatal care aims for gestational development, the birth of a healthy newborn, and the absence of adverse maternal health outcomes, incorporating a psychosocial approach and educational activities. Despite advances, maternal mortality remains a public health issue, with gestational complications being the leading causes of death among women of reproductive age. Prenatal care has been emphasized in Brazil, with risk-pregnant women recommended to receive care from a multidisciplinary team. This systematic review highlights the importance of obstetric and pediatric follow-up in high-risk prenatal care, emphasizing that a multidisciplinary and continuous approach improves maternal and infant health outcomes and reduces complications. Studies point to the importance of obstetric and pediatric monitoring in high-risk pregnancies, highlighting the emotional and physiological challenges faced by these pregnant women. Specialized care is crucial for early problem identification and offering appropriate interventions, as prenatal care is vital for building a trusting relationship with healthcare professionals, promoting adherence to recommended care. The family health unit care model has proven effective, facilitating early initiation of prenatal care and continuous and integrated monitoring, while multidisciplinary collaboration is essential to ensure comprehensive care. However, merely increasing the number of consultations is not enough; it is necessary to adopt a qualitative approach that considers the complexity of pregnant women's needs and improves accessibility to health services. Moreover, joint monitoring is essential for preventing congenital infections, which pose significant risks to maternal and infant health, highlighting the urgency of awareness-raising and preventive actions during pregnancy.