Antenatal Care Attendance, a Surrogate for Pregnancy Outcome? The Case of Kumasi, Ghana

Abstract

Objective Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8–13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). Method A quantitative cross-sectional study was conducted on 629 women, age 19–48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July-November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using chi-square and logistic regression. Results Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended <4 ANC visits. In an unadjusted model, these women had an increased likelihood of experiencing an adverse outcome (OR = 2.27; 95 CI% = 1.30–3.94; p = 0.0038). High parity was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40% and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending <4 antenatal visits was associated with adverse pregnancy outcome compared with ≥4 ANC visits (Adjusted OR = 2.55; 95% CI = 1.16– 5.63; p = 0.0202). Conclusion Attending <4 antenatal visits and high parity were associated with adverse pregnancy outcomes for uncomplicated pregnancies.

Factors associated with the quality of prenatal care: an approach to premature birth

“…These results corroborate other studies that have also found a higher proportion of inadequate prenatal care for women with unfavorable characteristics, such as ethnicity/black and brown skin color (24) , who did not plan their pregnancy and unmarried, which tend to start Prenatal care late and perform fewer visits (1,(25)(26)(27) . Also, there was association of inadequate prenatal care to mothers who have made combined prenatal care (OR=3.9 in the univariate analysis and AOR=5.7 in the multivariate analysis).…”

“…Recent studies highlight proper prenatal care as a determining factor in preventing maternal and child morbimortality (1)(2)(3) , as it contributes to more favorable outcomes from the accomplishment of the basic procedures such as conducting clinical and laboratory tests and monitoring the pregnancy through regular visits that enable detection and timely treatment of risk factors that bring complications for the mother and child health.…”

Factors Influencing Antenatal Care Utilization in the East Akim Municipality of Ghana

“…This study also nds that a high proportion of mothers (83.5%) made the WHO recommended 4 + ANC visits during pregnancy. This observation also compares well with those by Asundep et al (2014) who reported that 89% of mothers in the Ashanti region of Ghana access 4 + ANC visits (24); Yeji et al (2015) who found 86.1% of pregnant women in three regions of Ghana receiving four or more (4+) ANC visits (26); and the Ghana Demograpic and Health Survey (GDHS, 2014), which put the proportion of women receiving 4 + ANC visits at 87% (27). These observations demonstrate that Ghana has been successful at expanding coverage of maternal health services, and antenatal care in particular across the country, as indicated in its national strategic plan of 1999, with commensurate policies on Health Insurance to reduce nancial barriers to maternal health care (22,23).…”

“…This observation is comparable to the outcome of the 2017 Maternal Health Survey, where 64% of mothers had their rst ANC visit in the rst trimester (13), in line with WHO recommendations (10). Asundep et al (2014) also reported that 61% of mothers in the Ashanti region of Ghana initated ANC during the rst trimester of pregnancy (24). Early timing of rst ANC visits is required for early detection, treatment and prevention of conditions that may have adverse consequences for the pregnant woman and her unborn baby.…”

Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study

“…Previous published articles have supported the view that a higher count of ANC visits is associated with better outcomes of pregnancy. This view was further tested in low-resource countries; Asundep et al [15] concluded that <4 ANC visits was associated with an increase in adverse outcomes of pregnancy using adjusted models. Riaz et al [16] showed that pregnancies with ≥3 ANC visits were associated with far better and healthier outcomes than those with <3 visits, in Pakistan; moreover, the WHO's latest recommendations that had been released on 7 November 2016 in Geneva stated that a minimum of eight visits for ANC can reduce perinatal deaths by up to 8 per 1000 births when compared to a minimum of four visits [17].…”