Abstract
Introduction: Antenatal care (ANC) provides monitoring and regular follow-up of maternal and fetal health during pregnancy. Women with appropriate ANC tend to have better delivery and birth outcomes. This study describes the patterns of ANC utilization and factors associated with appropriate ANC initiation in the United Arab Emirates (UAE) for the first time.Methods: Baseline cross-sectional data from pregnant women who participated in the Mutaba'ah—Mother and Child Health Study between May 2017 and January 2019 was analyzed. Participants were recruited during ANC visits and completed a self-administered questionnaire that collected socio-demographic and pregnancy-related information and assessed whether it was their first ANC appointment. Regression models assessed the relationship between socio-demographic and pregnancy-related variables and “appropriate” (≤ 4 months' gestation) vs. “late” ANC initiation (>4 months' gestation).Results: At recruitment, 841 participants reported that it was their first ANC visit and half (50.2%) of these women were late initiating their ANC. Mothers who were more educated, had previous infertility treatment or previous miscarriages were all more likely to achieve appropriate ANC initiation [adjusted odds ratio (aOR): 1.66, 95% confidence interval (CI): 1.05–2.62; aOR: 3.68, 95% CI: 1.50–9.04; aOR: 1.80, 95% CI: 1.16–2.79, respectively]. Women worrying about childbirth were less likely to achieve appropriate ANC initiation (aOR: 0.54, 95% CI: 0.34–0.85).Conclusion: Half of pregnant women in this study did not achieve the global consensus guidelines on appropriate ANC initiation. Interventions among less educated women and those with previous pregnancy complications and childbirth anxiety are recommended to ensure appropriate ANC initiation.
Highlights
Antenatal care (ANC) provides monitoring and regular follow-up of maternal and fetal health during pregnancy
The World Health Organization (WHO) recommends that ANC should be initiated within the first trimester of gestation with at least four, and optimally eight visits during the pregnancy [1]
Women with previous birth complications such as miscarriages [odds ratio (OR): 1.52, 95% confidence intervals (CI) 1.10–2.10] and stillbirths (OR: 2.43, 95% CI 1.15–5.15), as well as women who had previous infertility treatment (OR: 2.06, 95% CI: 1.23–3.44) were more likely to initiate appropriately (Table 2)
Summary
Antenatal care (ANC) provides monitoring and regular follow-up of maternal and fetal health during pregnancy. Antenatal care (ANC) is the care provided by skilled healthcare professionals to women throughout their pregnancy. It includes risk identification and screening, prevention and management of pregnancy-related or concurrent diseases, and health education and promotion [1]. Global guidelines recommend frequent medical care visits during the antenatal period to decrease the Antenatal Care in the UAE risk of maternal and perinatal mortality [1,2,3]. Women are recommended to initiate their ANC appropriately during pregnancy as it will help to reduce complications, provide wider platforms for a healthier pregnancy, and maximize the benefits of monitoring fetal and maternal health [1]. The WHO advises pregnant women to initiate contact during the first 12 weeks’ gestation, with subsequent contacts taking place at 20, 26, 30, 34, 36, 38, and 40 weeks’ gestation [1]
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