Abstract
Objective: To identify the level of utilisation of prenatal services amongst varying risk mothers, to study the factors associated with prenatal care utilisation & to study the association between level of prenatal care utilisation amongst high & low risk women to pregnancy outcome. Methods: This was a cross sectional study interviewing all the consecutive mothers admitted in post natal ward of the hospital during June July 2018 using a semi structured questionnaire. Mothers not consenting or from whom complete information could not be obtained were excluded from the study. Kotelchuck’s Adequacy of Prenatal Care Utilisation (APNCU) index was used to study utilisation of prenatal care amongst varying risk women & relate it to their pregnancy outcome. Results: Out of total of 650 women interviewed, 80.76% of them belonged to low risk category & remaining 19.24% were high risk category. 82% of the women had inadequate ANC utilisation. Age, residence or parity had no significant effect on utilisation level of prenatal care. Education positively affected utilisation of prenatal care. The numbers of ultrasound examinations per prenatal visit 0.54 & it was significantly higher in low risk mothers as compared to high risk mothers. Conclusion: Only less than one fifth of the women had adequate ANC utilisation. High risk women had significantly higher ANC utilisation level as compared to low risk women. Education significantly affected higher utilisation of prenatal care. Overuse of obstetric sonography was observed. Higher chances of low birth weight babies & NICU admissions were observed amongst women with inadequate APNCU index.
Highlights
India has achieved a significant socio-economic development in the last decade
This study was conducted with the objective to identify the level ofutilisation of prenatal services amongst varying risk mothers, study the factors associated with prenatal care utilisation & to study the association between level of prenatal care utilisation amongst high & low risk women to pregnancy outcome
The present study shows alarmingly high rates of inadequate ANC utilisation (82.6%) irrespective of risk category
Summary
India has achieved a significant socio-economic development in the last decade. The progress in maternity outcome is stagnating [1]. Prenatal care is one of the most important factor determining pregnancy outcomes [2]. Few studies have quantified prenatal care & studied its effectiveness. In order to have an impact on pregnancy outcome, prenatal care has to be adequate. There are several guidelines to describe adequate prenatal care initiation, frequency of visits & prenatal care content [3,4,5]. The adequacy of prenatal care is usually determined by the initiation of care & number of prenatal visits [6]. Kotelchuck’s Adequacy of Prenatal Care Utilisation (APNCU) index is globally accepted & widely used prenatal care utilisation index [7]
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