Obstetric outcomes of delayed initiation of antenatal care at a university teaching hospital in southwest Nigeria

Abstract

Background: Antenatal care (ANC) is vital for the health of both mother and fetus. Generally, it has been observed that lack of prenatal care or inadequate utilization of antenatal care culminates in adverse maternal outcomes including maternal mortality.Objective: To compare the obstetric outcomes in pregnant women that commenced ANC in the third trimester with those that initiated ANC contacts early.Materials and Methods: This was a prospective cohort study conducted on antenatal attendees that booked and delivered at the Department of Obstetrics and Gynaecology of Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, southwest Nigeria from 1st of January, 2015 to 31st December, 2015. Data gathered were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were used to examine the data, with results expressed as numbers and percentages. Associations between maternal factors, obstetric outcomes and delayed commencement of ANC were examined by Pearson Chi-square. The significance levels were set at p<0.05.Results: During the study period, 1633 women received antenatal care and delivered in our centre. Out of these 1633 women, 547(33.5%) had delayed initiation of antenatal care. Women with pre-existing medical illnesses were likely not to experience delayed initiation of ANC (X2 =8.31 p value=0.02). Women who initiated antenatal care in the third trimester were more likely to develop preeclampsia (X2 =7.86 p value=0.02) and prelabour rupture of the fetal membranes (X2 =11.59, p value=0.003).Conclusion: The proportion of women who delayed initiation of ANC was high and they may be predisposed to developing preeclampsia. There is, therefore, a pressing need to increase advocacy on the need for early booking for antenatal care.