Antenatal Care and Pregnancy Outcomes among Mothers Who Delivered in a Rural Hospital in Nigeria
Background: Most countries in sub-Saharan Africa are faced with high levels of maternal and infant mortality. The causes of these deaths are mostly preventable through proper care during pregnancy. This care offered during antenatal visits is a public health intervention made available to women during pregnancy to ensure a positive pregnancy outcome while the mother remains healthy.
Aim: The aim of the research is to determine the association between antenatal care attendance and pregnancy outcome and the predictors of baby’s birth outcome in a rural hospital in Nigeria.
Methodology: A retrospective cohort study design was used to answer the research question. This is a non-experimental study design that utilises available secondary data obtained routinely in the health facility in the year 2013. IBM SPSS statistical software version 21 was used for statistical analysis. Summary measures were used to describe the study population. Chi squared test was used to establish the association between antenatal care and pregnancy outcomes. Multivariate linear regression model was used to determine the predictors of baby’s birth weight, while logistic regression model was used to ascertain the predictors of baby’s APGAR score
Findings:680 records of delivery were analysed. The mean age of women who delivered in the health facility was 24.89 ±5.77 years. A statistically significant association exist between antenatal care and baby’s birth outcome (p= 0.014), as well as between antenatal care and baby’s birth weight (p= 0.017). Mother’s age (p= 0.000, 95% CI 0.005 to 0.017) and booking status (p= 0.016, 95% CI -0.205 to -0.021) were significantly associated with baby’s weight at delivery. Mothers’ age (OR 0.959, 95% CI 0.923 to 0.997) was significantly associated with baby’s APGAR score, just as being a student (OR 0.115, 95% CI 0.014 to 0.922) and being booked for antenatal care (OR 0.337, 95% CI 0.150 to 0.756) were significant in predicting baby’s birth outcome.
Conclusion: Antenatal care has a positive association with pregnancy outcomes in this setting. Hopefully, the findings of this study will help stakeholders and policy makers recognise the importance of antenatal care on pregnancy outcomes and view antenatal care as a means of attaining the Sustainable Development Goals.
- i. Beeckman K, Louckx F, Masuy-Stroobant G, Downe S, Putman K. The development and application of a new tool to assess the adequacy of the content and timing of antenatal care. BMC Health Serv Res. 2011;11:213.
- ii. Ekabua J, Ekabua K, Njoku C. Proposed framework for making focused antenatal care services accessible: a review of the nigerian setting. ISRN obstetrics and gynecology. 2011;2011:253964.
- iii. Challenges facing the realization of MDGs in Education Reform in Nigeria.pdf>.
- iv. Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bulletin of the World Health Organization. 2007;85(10):812-9.
- v. World Health Organisation. WHO Antenatal Care Randomized Trial: Manual for the Implementation of the New Model [online]. Geneva: World Health Organisation; 2002. Available from: http://whqlibdoc.who.int/hq/2001/WHO_RHR_01.30.pdf (accessed 2014 May 9
- vi. World Health Organisation Regional Office for Europe's Health Evidence. What is the efficacy/effectiveness of antenatal care and the financial and organizational implications? [online]. Copenhagen: World Health Organisation; 2003. Available from: http://www.euro.who.int/__data/assets/pdf_file/0007/74662/E82996.pdf (accessed 2014 June 6)
- vii. Focussed Antenatal Care: Providing Intergrated Individualized care during pregnancy. United States Agency for International Development. 2007
- viii. World Health Organisation, United Nations Childrens Fund. Antenatal Care in Developing Countries. Promises, achievements and missed opportunities: An analysis of trends, levels and differentials, 1990-2001 [online]. Geneva: World Health Organisation; 2003. Available from: http://www.childinfo.org/files/antenatal_care.pdf (accessed 2014 May 8)
- ix. Villar J, Ba’aqeel H, Piaggio G, Lumbiganon P, Belizán JM, Farnot U, et al. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. The Lancet [online].
- ;357:1551–1564. Available from: http://www.sciencedirect.com/science/article/pii/S014067360004722X (accessed 2014 June 9)
- x. Villar J and Bergsjo P: World Health Organisation. Antenatal Care Randomized trial: Manual for the implementation of new model. 2004. Geneva: The World Health Orgnisation
- xi. United Nations Childrens Fund (UNICEF). At a glance: Nigeria. [Internet]. [Cited 2014 June 17]; Available from : http://www.unicef.org/infobycountry/nigeria_statistics.html
- xii. Moller B, Lushino O, Kabukoba J, Kavishe F, Gebre-Medhin M, Meirik O, et al. A prospective area-based study of the outcome of pregnancy in rural Tanzania. Ups J Med Sci. 1989;94(1):101-9.
- xiii. Castello A, Rio I, Martinez E, Rebagliato M, Barona C, Llacer A, et al. Differences in preterm and low birth weight deliveries betwee1. Moller B, Lushino O, Kabukoba J, Kavishe F, Gebre-Medhin M, Meirik O, et al. A prospective area-based study of the outcome of pregnancy in rural Tanzania. Ups J Med Sci. 1989;94(1):101-9.
- xiv. Stella Nwenebunha Chuku ECD. Graduate School of Development Studies. Low Birth Weight in Nigeria: Does Antenatal care helps? Research paper. 2008.pdf>.
- xv. Magadi, M. A., I. Diamond, N. Madise and P. Smith (2004) ‘Pathways of the determinants of unfavourable birth outcomes in Kenya’, Journal of Biosocial Science 36:153-76
- xvi. Mustard, C.A and N.P Roos (1994) ‘The relationship of prenatal care and pregnancy complications to birth weight in Winnipeg, Canada’, American Journal of Public Health 84(9):1450-57
- xvii. Munjanja SP, Lindmark G, Nystrom L. Randomised controlled trial of a reduced-visits programme of antenatal care in Harare, Zimbabwe. Lancet. 1996;348(9024):364-9.
- xviii. Petrou S, Kupek E, Vause S, Maresh M. Antenatal visits and adverse perinatal outcomes: results from a British populationbased study. Eur J Obstet Gynecol Reprod Biol. 2003;106(1):40-9.
- xix. Allen J, Gamble J, Stapleton H, Kildea S. Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature. Women Birth. 2012;25(2):54-63.
- xx. Brown CA, Sohani SB, Khan K, Lilford R, Mukhwana W. Antenatal care and perinatal outcomes in Kwale district, Kenya. BMC Pregnancy & Childbirth. 2008;8:2.
- xxi. Lumbiganon P. Appropriate technology: antenatal care. International Journal of Gynaecology & Obstetrics. 1998;63 Suppl 1: S91-5.
- xxii. Sikorski J, Wilson J, Clement S, Das S, Smeeton N. A randomized controlled trial comparing two schedules of antenatal visits: the antenatal care project. Br Med J 1996; 312:546]553.
- xxiii. Jegede AS. Understanding informed consent for participation in international health research. Developing world bioethics. 2009;9(2):81-7.
- xxiv. Nigeria: Reproductive health at a glance. World Bank. [Internet]. [Cited 2014 June 12]. Available from: http://siteresources.worldbank.org/INTPRH/Resources/376374-1303736328719/Nigeria42211web.pdf
- xxv. World Bank. Adjusted savings: education expenditure (Percentage of GNI) 2012.
- xxvi. Bangdiwala S, Okoye O, Tollman S. Workforce for Health in Developing Countries. Public Health Reviews. 32(1):296-318.
- xxvii. Petrou S, Kupek E, Vause S, Maresh M. Antenatal visits and adverse perinatal outcomes: results from a British populationbased study. Eur J Obstet Gynecol Reprod Biol. 2003;106(1):40-9.
- xxviii. Chigbu B, Onwere S, Kamanu CI, Aluka C, Okoro O, Adibe E. Pregnancy outcome in booked and unbooked mothers in South Eastern Nigeria. East African medical journal. 2009;86(6):267-71.
- xxix. Osungbade KO, Ayinde OO. Birth outcomes among booked and unbooked women at a secondary health facility in southwest Nigeria: implications for strengthening perinatal health services. J Child Health Care. 2011;15(4):320-8.
- xxx. Owolabi AT, Fatusi AO, Kuti O, Adeyemi A, Faturoti SO and Obiajuwa PO. 2008. Maternal complications and perinatal outcomes in booked and unbooked Nigerian mothers. Singapore Medical Journal. 49 (7): 526-31
- xxxi. Chigbu B, Onwere S, et al. 2009. Pregnancy outcomes in booked and unbooked mothers in South Eastern Nigeria. East African Medical Journal: 86 (6): 267-271
- xxxii. Abou- Zahr CL, Wardlaw T: Antenatal care in developing countries: Promises, achievements and missed opportunities: An analysis of trends, levels and differentials, 1990-2001. Geneva, WHO: 2003
- xxxiii. Nigeria Demographic and Health Survey (2008). National Populations Commissions, Abuja, Nigeria
- xxxiv. Kenya Demographic and Health Survey (2003). Nairobi, Kenya. Central Bureau of Statistics; 2003
- xxxv. Khatib N, Zahiruddin QS, Gaidhane AM, Waghmare L, Srivatsava T, Goyal RC, et al. Predictors for antenatal services and pregnancy outcome in a rural area: a prospective study in Wardha district, India. Indian J Med Sci. 2009;63(10):436-44.
- xxxvi. Van Eijk AM, et al. Use of antenatal services and delivery care among women in rural western Kenya: a community based survey. Reproductive Health 2006.
- xxxvii. Mbuagbaw LC, Gofin R. A new measurement for optimal antenatal care: determinants and outcomes in Cameroon. Matern Child Health J. 2011;15(8):1427-34.
- xxxviii. Foong RX, Rajasingam D. Learning from low-resource maternity care using pregnancy outcomes from the Solomon Islands. International Journal of Gynaecology & Obstetrics. 2012;119(3):284.
- xxxix. Hassan AA, Abubaker MS, Radi EA, Adam I. Education, prenatal care, and poor perinatal outcome in Khartoum, Sudan. International Journal of Gynaecology & Obstetrics. 2009;105(1):66-7.
- xl. Heaman MI, Newburn-Cook CV, Green CG, Elliott LJ, Helewa ME. Inadequate prenatal care and its association with adverse pregnancy outcomes: a comparison of indices. BMC Pregnancy & Childbirth. 2008;8:15.
- xli. Gould JB, Madan A, Qin C, Chavez G. Perinatal outcomes in two dissimilar immigrant populations in United States: A dual epidemiologic paradox. Pediatrics. 2003:111;676-682
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