RISK ASSESSMENT & MIDWIFERY Introduction This

Risk status assessment is an important part of the primary prevention of disease or negative outcome. Negative outcomes are avoided by reducing or altering susceptibility of risks. Secondary prevention of outcomes includes early detection and treatment, also through risk assessment. Tertiary prevention includes the alleviation of problems with the promotion of health, as much as possible within the disease state. Thus risk assessment is an important part of educating and caring for the patient (Murphy, p. 67).

Formal assessment tools are developed, based on risk factors that are known. For example, lack of a high school education is a risk factor that has been associated with an adverse outcome. Risk factors associated with negative outcomes for pregnant women, include lack of education, race, age, marital status, and levels of prenatal care. Black women that are 40 years of older are six times more likely to die from pregnancy than the same age white woman. The screening technique used with pregnant women is designed to assess for these and other risk factors (Danel, Berg, & Atrash, 1998, p. 20; Murphy, p. 67).

Although risk assessment is important, there are also neg

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rse outcomes, however, examples of high risk variables are known (PHSEP, p. 14). Medical risk factors include genetic, nutritional and anthropometric, medical disorders, reproductive history, and specific pregnancy hazards. Chromosomal abnormalities are a cause of reproductive loss. Low maternal prepregnant weight is a risk of low birth weight. Disorders such as hypertension, anemia, diabetes, or psychiatric disorders may complicate pregnancy. Prior preterm delivery is the best predictor of preterm birth and reproductive difficulties are found to cluster in the same women. Preeclampsia in the third trimester is a risk that is currently avoided by adequate prenatal care. Diabetes mellitus, blood group incompatibilities, multiple gestations, maternal phenylketonuria and sickle cell anemia, abnormalities of the placenta, infections such as HIV, syphilis, chickenpox, hepatitis, and toxic or teratogenic agents are all pregnancy risk factors (PHSEP, pp. 15-18). Psychosocial risk factors include social and economic disadvantages, a lack of formal education, poverty, age, parity, and interpregnancy interval. Psychological risks include a lack of support network, high stress levels, emotional disorders, and negative beliefs
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