Effect of quality of antenatal care on the perinatal outcome: A cross sectional study

Manisha Kasat, Nikita R Vijay, Anjali Kawthalkar

Abstract


Antenatal care is one of the major way by which we can avoid many complications related to pregnancy outcome by very minute and cost effective interventions. Antenatal care is a way of monitoring pregnancy to lead to a successful outcome. A cross sectional study was conducted at tertiary care hospital to know the effect of antenatal care on pregnancy outcome, association of risk factors with poor pregnancy outcome, reasons for poor antenatal care and to increase the awareness about regular antenatal check-up. For this, 100 postnatal women whose baby shifted to NICU were included in this study. Majority (62%) of the study subjects were from urban areas, were educated up to upper primary and belonged to Class 3 socioeconomic status. About 26% of cases had irregular ANC check-up and 74% had check-up more than or equal to 4 during their ANC period. Most common risk factor was anaemia followed by pre-eclampsia and PROM in our study. Among the neonatal risk factors, low birth weight was the most common risk factors. Among all the factors associated with the regularity of the ANC check-up, rural residents had more irregular check-up when compared to the urban areas (p<0.05). Educational status of mother and socioeconomic status of the family had significant influence over the regularity of the ANC check-up. All antenatal risk factors except for obstructed labour were significantly higher in the patients who had irregular ANC check-up. Further, low birth weight, preterm birth and infections were also more common in mothers having irregular check-up during the ANC period (p<0.01). The present study highlights that regularity of the ANC check-up reduces the perinatal complications. Some factors like socioeconomic status, educational status of mother and residence affect the regularity of the ANC check-up, indirectly affecting the perinatal outcome.

 Keywords: Antenatal care, Perinatal outcome, Check-up.


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References


Park K. Park’s Textbook of Preventive and Social Medicine. 2015.

Who.int (Internet). World Health Organisation guidelines on Antenatal Care (Updated 2017 Apr; Cited 2018 June). Available from: http://www.who.int/gho/urban_health/services/antenatal_care_text/en/

Nair H, Panda R. Quality of maternal healthcare in India: Has the National Rural Health Mission made a difference? J Glob Health 2011;1(1):79–86.

Abbas AM, Rabeea M, Hafiz HAA, Ahmed NH. Effects of irregular antenatal care attendance in primiparas on the perinatal outcomes: a cross sectional study. Proc Obs Gynecol 2017;7(2):2.

Polite IO, Ozed Williams I, Kolawole A, Adze J. The effect of frequency of antenatal visits on pregnancy outcome in Kaduna, Northern Nigeria. Trop J Obstet Gynaecol 2016; 33(3):317.

Sah R, Gaurav K, Baral D, Jha N, Pokharel P. Antenatal care practices in hilly area of eastern region of Nepal. J Chitwan Med Coll 2013;3(4):12–5.

Raatikainen K, Heiskanen N, Heinonen S. Under-attending free antenatal care is associated with adverse pregnancy outcomes. BMC Public Health 2007;7: 421.

Beeckman K, Louckx F, Putman K. Determinants of the number of antenatal visits in a metropolitan region. BMC Public Health 2010; 10: 527.

Brown CA, Sohani SB, Khan K, Lilford R, Mukhwana W. Antenatal care and perinatal outcomes in Kwale district, Kenya. BMC Pregnancy Childbirth 2008; 8:1–11.

Gupta R, Talukdar B. Frequency and timing of antenatal care visits and its impact on neonatal mortality in EAG states of India. J Neonatal Biol 2017;06 (3):1.

Tuladhar H, Dhakal N. Impact of antenatal care on maternal and perinatal outcome: A study at Nepal Medical College Teaching Hospital. Nepal J Obstet Gynaecol 2012; 6(2): 37–43.

Arunda M, Emmelin A, Asamoah BO. Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: Analysis of national survey data. Glob Health Action 2017;10(1):21.

Sibiya MN, Ngxongo TSP, Bhengu TJ. Access and utilization of antenatal care services in a rural community of eThekwini district in KwaZulu-Natal. Int J Africa Nurs Sci 2018; 8:1–7.

Viegas Andrade M, Noronha K, Singh A, Rodrigues CG, Padmadas SS. Antenatal care use in Brazil and India: Scale, outreach and socioeconomic inequality. Heal Place 2012;18(5):942–50.

Kuhnt J, Vollmer S. Antenatal care services and its implications for vital and health outcomes of children: evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open 2017;7(11):e017122.

Chingle MP, Jonah M. Antenatal care and pregnancy outcomes among mothers who delivered in a rural hospital in Nigeria. Int J Innov Res Dev 2017;6(3):7–16.

Pell C, Meñaca A, Were F, Afrah NA, Chatio S, Manda-Taylor L, et al. Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi. PLoS One 2013;8(1): 32.

Jolly P, Respress ET, Jolly PE, Osia C, Williams ND, Sakhuja S, et al. A cross-sectional study of antenatal care attendance among pregnant women in Western Jamaica. J Preg Child Heal 2017;4(4):22.

Eldin HA, Mohamed SH. Factors causing lack of attendance to antenatal clinics in primiparas. IOSR J Dent Med Sci 2017;6(5):65–72.

Onasoga OA, Afolayan JA, Oladimeij, BD. Factors influencing utilization of antenatal care services among pregnant women in Ife Central Lga, Osun State Nigeria. Adv Appl Sci Res 2012;3(3):1309–15.

Oladapo OT, Iyaniwura CA, Sule-Odu AO. Quality of antenatal services at the primary care level in southwest Nigeria. Afr J Reprod Health 2008;12(3):71–92.

Mohamed Shaker El-SayedAzzaz A, Martïnez-Maestre MA, Torrejïn-Cardoso R. Antenatal care visits during pregnancy and their effect on maternal and fetal outcomes in pre-eclamptic patients. J Obstet Gynaecol Res 2016;42(9):1102–10.

Mhrd. Gov.in (Internet). Indian Standard Classification of Education- 2014 (Updated Jan 2015; Cited June 2018). Available from: http://mhrd.gov.in/sites/upload_files/mhrd/files/statistics/InSCED2014_1.pdf

Cutland CL, Lackritz EM, Mallett-Moore T, Bardají A, Chandrasekaran R, Lahariya C, et al. Low birth weight: Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 2017;35(48):6492–500.

Un.org (Internet). Sustainable Development Goals- 2016 (Updated Apr 2016; Cited 2017 Apr 10). Available from: http://www.un.org/sustainabledevelopment/hunger/