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Antenatal Care Attendance, a Surrogate for Pregnancy Outcome? The Case of Kumasi, Ghana

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Abstract

Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8–13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19–48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended <4 ANC visits. In an unadjusted model, these women had an increased likelihood of experiencing an adverse outcome (OR 2.27; 95 % CI 1.30–3.94; p = 0.0038). High parity (>5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36 % (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending <4 antenatal visits was associated with adverse pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95 % CI 1.16–5.63; p = 0.0202). Attending <4 antenatal visits and high parity were associated with adverse pregnancy outcomes for uncomplicated pregnancies.

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Acknowledgments

Special thanks to the women who participated in this study. We are grateful for the support from all the staff of The Directorate of Obstetrics/Gynaecology KATH and Manhyia and the Public Health Nurse Incharge, Kumasi Metro Health Directorate, Joana Tawia Burgesson. We are also grateful to all the research assistants especially Ada Agidi. We thank Catherine Sreenan for editing this manuscript. This study was funded by the Minority Health International Research Training (MHIRT) Grant #5T37MD001448 from the National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), 1665 University Boulevard, RPHB 217, Birmingham, AL, 35294, USA

    Ntui N. Asundep, Pauline E. Jolly & April Carson

  2. Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Cornelius A. Turpin

  3. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA

    Kui Zhang

  4. Center for Computational Epidemiology, Bioinformatics and Risk Analysis (CCEBRA), Tuskegee University, Tuskegee, AL, 36088, USA

    Berhanu Tameru

Authors
  1. Ntui N. Asundep
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  2. Pauline E. Jolly
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  3. April Carson
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  4. Cornelius A. Turpin
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Correspondence to Ntui N. Asundep.

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Asundep, N.N., Jolly, P.E., Carson, A. et al. Antenatal Care Attendance, a Surrogate for Pregnancy Outcome? The Case of Kumasi, Ghana. Matern Child Health J 18, 1085–1094 (2014). https://doi.org/10.1007/s10995-013-1338-2

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  • DOI: https://doi.org/10.1007/s10995-013-1338-2

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