Clinical significance of the ‘Socio-Demographic Factors’ has been covered in a previous article: this post explores the clinical components of ANC history.
Significance of menstrual history
Gives an idea of the woman’s reproductive health and the
• Reliability of the last menstrual period (LMP) as a marker for estimating the expected date of delivery (EDD).
o Regular menstrual cycles suggest a dependable LMP,
o Irregular cycles may necessitate early ultrasonography for accurate dating.
• A history of menorrhagia can indicate
o Possibility of anemia or
o Underlying endocrine disorders such as hypothyroidism,
Both of the above require evaluation and management during pregnancy.
Significance of marital history
Marital history helps identify genetic risks and fertility-related factors. Consanguinity increases the likelihood of congenital malformations and autosomal recessive disorders in the offspring. The degree of consanguinity is classified as follows:
• First degree (incest): Parent–child, sibling–sibling
• Second degree: Uncle–niece, aunt–nephew
• Third degree: First cousins (or half-uncle–niece, half-aunt–nephew)
Additionally, knowing the interval between marriage and conception offers clues about fecundity:
• High fecundity refers to conception soon after marriage, whereas
• Low fecundity suggests possible subfertility or treated infertility
Knowing fecundity patterns can alert healthcare providers to possible underlying issues such as reproductive system disorders, age-related decline in fecundity, or chronic health conditions impacting pregnancy
Importance of past obstetric history
A detailed obstetric history is critical in guiding clinical decisions in the current pregnancy. The significance of past obstetric history lies primarily in its role to categorize the current pregnancy as potentially high-risk by evaluating the woman’s previous experiences with conception, pregnancy outcomes, and childbirth.
This categorization guides clinicians in tailoring monitoring and interventions to optimize maternal and fetal health outcomes.
• For instance, a previous lower segment cesarean section (LSCS) increase the risk of uterine rupture and therefore determines the mode of delivery—trial of labor versus elective repeat cesarean.
• Recurrent pregnancy loss may indicate causes such as cervical incompetence, warranting cervical cerclage in subsequent pregnancies.
• Certain aspects of a patient’s history carry a risk of recurrence, thereby necessitating early surveillance and timely intervention to ensure optimal outcomes, E.g. A history of
o Preeclampsia or eclampsia
o Gestational diabetes mellitus (GDM),
o Anemia, or
o Preterm labor increases the recurrence risk and requires early surveillance and intervention.
Significance of past medical and surgical history
Past medical and surgical histories help classify pregnancies as low-risk or high-risk and anticipate complications.
• Some conditions may worsen in pregnancy (e.g., cardiac disease, diabetes mellitus),
• Others remain stable (e.g., bronchial asthma), and
• A few may improve (e.g., autoimmune diseases due to physiological immunosuppression).
• Previous abdominal or pelvic surgeries can cause adhesions. The surgeon can anticipate and prepare for operative difficulty during cesarean section.
• Difficulties are anticipated during cesarean section in cases with previous abdominal surgeries
Significance of personal history
Personal habits can significantly influence pregnancy outcomes.
Substance Use
• Alcohol consumption is associated with fetal alcohol spectrum disorders (FASD) and intrauterine growth restriction (IUGR).
• Smoking is linked to spontaneous abortion, placental abruption, and low birth weight infants (IUGR).
Sleep and Fatigue
• Sleep deprivation affects maternal glucose regulation, mood, and blood pressure.
• Poor sleep may reflect anaemia, thyroid disorders, or mental health issues.
Encourage a regular sleep schedule, a comfortable left-lateral sleeping position in late pregnancy, and adequate rest during the day.
Physical Activity and Exercise
• Moderate exercise improves cardiovascular fitness and reduces the risk of gestational diabetes.
• Excessive exertion or heavy work may lead to preterm labour or musculoskeletal strain.
Domestic Violence and Safety
• Intimate partner violence may worsen during pregnancy and lead to injury or miscarriage.
Immunization
• Tetanus and influenza vaccination protect both mother and baby.
Medication and Traditional Remedies
• Unsupervised drug or herbal remedy use may be harmful to the fetus.
Significance of dietary history
Assessing dietary patterns helps identify nutritional deficiencies or excesses that may impact maternal and fetal health.
Dietary counseling should be individualized, for example:
• For gestational diabetes, emphasis is placed on a balanced diabetic diet with controlled carbohydrate intake;
• For anemia, an iron- and protein-rich diet is recommended.
• Evaluating vegetarian or restrictive diets is also essential to prevent micronutrient deficiencies.
Significance of family history:
Certain medical and genetic disorders tend to run in families and influence the risk in pregnancy.
• A family history of diabetes mellitus (DM), particularly type 2, increases the risk of gestational diabetes mellitus (GDM) in pregnant women.
• Similarly, a family history of hypertension (HT) is associated with risk of pregnancy-induced hypertension (PIH) or gestational hypertension
• Hereditary diseases such as thalassemia or cystic fibrosis may be inherited in an autosomal pattern.
• A history of multiple pregnancies or congenital anomalies increases the chance of recurrence in the current pregnancy.
This warrants early screening and closer monitoring for GDM, PIH etc. to prevent adverse maternal and fetal outcomes
References
1. Ministry of Health and Family Welfare, Government of India. Guidelines for Antenatal Care and Skilled Attendance at Birth, 2010
2. Dutta DC. Textbook of Obstetrics. 9th ed. New Delhi: Jaypee Brothers Medical Publishers; 2023.
3. Padubidri VG, Daftary SN. Shaw’s Textbook of Gynaecology. 18th ed. New Delhi: Elsevier; 2022.
4. Park K. Park’s Textbook of Preventive and Social Medicine. 28th ed. Jabalpur: Bhanot Publishers; 2025.
5. Babu SA. Clinical Obstetrics and Gynecology. 2nd ed. New Delhi: Wolters Kluwer India Pvt Ltd; 2025
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