Abstract
Antenatal care plays a basic role in the management of woman's health during pregnancy, and women who have not been registered to antenatal care are at increased risk of poor pregnancy outcome, including stillbirth. The aim of this study was to identify differences in maternal characteristics, antenatal care factors and perinatal mortality between urban and rural area in Latvia. The Medical Birth Register of Latvia (MBR) was used as a data source, all births in 2017 (n = 20,406) were included in the analysis. Mother's place of residence was categorized in 3 groups: Riga, other cities and rural area. Higher risk of smoking (OR = 1.4; p < 0.001), late first antenatal visit (after 12th gestation week) (OR = 1.2; p < 0.05) and incomplete antenatal care (including cases without care) (OR = 1.3; p < 0.05) were detected more in other regions (other cities and rural area) than in Riga. After adjustment by maternal age and education, just late first antenatal visit was significantly higher in other regions (ORadj = 1.2; p < 0.05) vs. Riga. New-born mortality in perinatal period is substantially higher in other regions vs. Riga. The results indicate health education gap and potential inequalities in receiving antenatal care and emergency obstetric care by regions.
Highlights
Antenatal care is defined as the routine care of pregnant women provided between conception and the onset of labour
Younger mothers (≤20) were more often in rural regions (p < 0.001) – 6.2% (95%confidence interval (CI) 5.7–6.7) (n = 634) comparing with Riga 2.5% (95%CI 2.2–3.0) (n = 179)
There are no differences between regions in average gestational age and birth weight of new-borns, a higher proportion of new-borns with low birth weight (≤2499 g) was observed (p < 0.01) in rural regions 4.6% (95%CI 4.2–5.1) (n = 476) than in Riga and other cities
Summary
Antenatal care is defined as the routine care of pregnant women provided between conception and the onset of labour. Antenatal care is an opportunity to provide care for prevention and management of existing and potential causes of maternal and new-born mortality and morbidity [1]. Women who have not been registered to antenatal care are at increased risk of poor pregnancy outcomes, including stillbirth [1,2,3,4]. According to statistical data in the general population in 2017, 0.8% of live births occurred without antenatal care, but the rate of stillbirths that occurred without prenatal care was 8 times higher, at 6.9% [5]
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