Antenatal Risk Profiles and Distribution of Clinical and Obstetric Risk Factors Using the Modified Coopland Scoring System in Siaya County, Kenya
DOI:
https://doi.org/10.47604/gjhs.3804Keywords:
Antenatal Risk Stratification, Modified Coopland Scoring System, High-Risk Pregnancy, Resource-Limited Settings, Western Kenya, Maternal HealthAbstract
Purpose: Maternal mortality remains a major public health concern in low- and middle-income countries. Early identification of high-risk pregnancies is important for timely referral, follow-up, and appropriate care. The Modified Coopland Scoring System (MCSS) is a simple and low-cost antenatal risk stratification tool, but its use in routine antenatal care settings in western Kenya remains insufficiently described. This study described antenatal risk profiles among pregnant women attending level 4 health facilities in Siaya County, Kenya, using the MCSS.
Methodology: This was a secondary analysis of data from 175 pregnant women aged ≥30 weeks’ gestation who were enrolled in the intervention arm of a parent randomized controlled trial. Participants were assessed using a digital MCSS antenatal risk stratification tool. The MCSS categorized women as low risk, moderate risk, or high risk based on demographic, medical, surgical, obstetric, and current pregnancy-related factors. Descriptive statistics and Fisher’s exact tests were used to summarize and compare risk profiles across categories.
Findings: Most participants were classified as low risk (64.0%, n=112), while 25.6% (n=43) were moderate risk and 11.4% (n=20) were high risk. Maternal age and parity differed significantly across risk categories. The proportion of women aged >35 years increased from 6.3% in the low-risk group to 45.0% in the high-risk group. High parity was also more common among women classified as high risk. Malaria, moderate anemia, previous childbirth weight extremes, prolonged or difficult labor, previous caesarean section, hypertension, and multiple pregnancy were more frequently observed among women in higher risk categories.
Unique Contribution to Theory, Practice and Policy: The MCSS identified distinct antenatal risk profiles among pregnant women attending level 4 health facilities in Siaya County. Higher-risk classification was associated with older maternal age, higher parity, selected medical conditions, previous adverse obstetric history, and current pregnancy complications. These findings support the value of structured antenatal risk assessment to guide referral decisions and prioritize follow-up care in routine maternal health services.
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Copyright (c) 2026 Christabel Wesonga, Wanja Tenambergen, Job Mapesa
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