A comprehensive pregnancy risk assessment includes which domains?

• A. Past obstetric, surgical, medical, social, and substance history
• B. Only current pregnancy history
• C. Genetic testing only
• D. Vaccination history only

Answer: (A)

A comprehensive pregnancy risk assessment looks at all the factors that can influence outcomes for both mother and baby, not just what happens in the current pregnancy. The five domains—past obstetric history, surgical history, medical history, social history, and substance history—each add important context. Past obstetric history helps anticipate recurrent risks like preterm birth or previous pregnancy complications. Surgical history, especially prior uterine surgery or cesarean sections, informs potential delivery options and placental concerns. Medical history captures chronic conditions and medications that can affect monitoring and treatment needs during pregnancy. Social history reveals determinants such as housing, support, access to care, stress, and safety, all of which shape adherence, nutrition, and timely care. Substance history identifies exposures like tobacco, alcohol, or other drugs that can significantly impact fetal development and maternal health. Focusing only on the current pregnancy misses these layers of risk. While genetic testing and vaccination status are important parts of prenatal care, they don’t by themselves provide the full risk assessment framework needed to guide individualized care.