Antenatal care and fetal outcome, especially low birthweight, in Port Harcourt, Nigeria

1989 ◽  
Vol 9 (3) ◽  
pp. 173-177 ◽  
Author(s):  
R.S. Oruamabo ◽  
C.T. John
Keyword(s):  
Antenatal Care ◽  
Low Birthweight ◽  
Fetal Outcome ◽  
Port Harcourt

scholarly journals Towards stronger antenatal care: Understanding predictors of late presentation to antenatal services and implications for obstetric risk management in Rwanda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256415
Author(s):  
Christina N. Schmidt ◽  
Elizabeth Butrick ◽  
Sabine Musange ◽  
Nathalie Mulindahabi ◽  
Dilys Walker
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Antenatal Care ◽  
Low Birthweight ◽  
Secondary Data ◽  
Neonatal Morbidity ◽  
Late Presentation ◽  
Health Centers ◽  
Logistic Regression Models ◽  
Pregnancy Testing

Background Early antenatal care (ANC) reduces maternal and neonatal morbidity and mortality through identification of pregnancy-related complications, yet 44% of Rwandan women present to ANC after 16 weeks gestational age (GA). The objective of this study was to identify factors associated with delayed initiation of ANC and describe differences in the obstetric risks identified at the first ANC visit (ANC-1) between women presenting early and late to care. Methods This secondary data analysis included 10,231 women presenting for ANC-1 across 18 health centers in Rwanda (May 2017-December 2018). Multivariable logistic regression models were constructed using backwards elimination to identify predictors of presentation to ANC at ≥16 and ≥24 weeks GA. Logistic regression was used to examine differences in obstetric risk factors identified at ANC-1 between women presenting before and after 16- and 24-weeks GA. Results Sixty-one percent of women presented to ANC at ≥16 weeks and 24.7% at ≥24 weeks GA, with a mean (SD) GA at presentation of 18.9 (6.9) weeks. Younger age (16 weeks: OR = 1.36, 95% CI: 1.06, 1.75; 24 weeks: OR = 1.33, 95% CI: 0.95, 1.85), higher parity (16 weeks: 1–4 births, OR = 1.55, 95% CI: 1.39, 1.72; five or more births, OR = 2.57, 95% CI: 2.17, 3.04; 24 weeks: 1–4 births, OR = 1.93, 95% CI: 1.78, 2.09; five or more births, OR = 3.20, 95% CI: 2.66, 3.85), lower educational attainment (16 weeks: primary, OR = 0.75, 95% CI: 0.65, 0.86; secondary, OR = 0.60, 95% CI: 0.47,0.76; university, OR = 0.48, 95% CI: 0.33, 0.70; 24 weeks: primary, OR = 0.64, 95% CI: 0.53, 0.77; secondary, OR = 0.43, 95% CI: 0.29, 0.63; university, OR = 0.12, 95% CI: 0.04, 0.32) and contributing to household income (16 weeks: OR = 1.78, 95% CI: 1.40, 2.25; 24 weeks: OR = 1.91, 95% CI: 1.42, 2.55) were associated with delayed ANC-1 (≥16 and ≥24 weeks GA). History of a spontaneous abortion (16 weeks: OR = 0.74, 95% CI: 0.66, 0.84; 24 weeks: OR = 0.70, 95% CI: 0.58, 0.84), pregnancy testing (16 weeks: OR = 0.48, 95% CI: 0.33, 0.71; 24 weeks: OR = 0.41, 95% CI: 0.27, 0.61; 24 weeks) and residing in the same district (16 weeks: OR = 1.55, 95% CI: 1.08, 2.22; 24 weeks: OR = 1.73, 95% CI: 1.04, 2.87) or catchment area (16 weeks: OR = 1.53, 95% CI: 1.05, 2.23; 24 weeks: OR = 1.84, 95% CI: 1.28, 2.66; 24 weeks) as the health facility were protective against delayed ANC-1. Women with a prior preterm (OR, 0.71, 95% CI, 0.53, 0.95) or low birthweight delivery (OR, 0.72, 95% CI, 0.55, 0.95) were less likely to initiate ANC after 16 weeks. Women with no obstetric history were more likely to present after 16 weeks GA (OR, 1.18, 95% CI, 1.06, 1.32). Conclusion This study identified multiple predictors of delayed ANC-1. Focusing existing Community Health Worker outreach efforts on the populations at greatest risk of delaying care and expanding access to home pregnancy testing may improve early care attendance. While women presenting late to care were less likely to present without an identified obstetric risk factor, lower than expected rates were identified in the study population overall. Health centers may benefit from provider training and standardized screening protocols to improve identification of obstetric risk factors at ANC-1.

scholarly journals Routine deworming during antenatal care decreases risk of neonatal mortality and low birthweight: A retrospective cohort of survey data

2021 ◽  
Vol 15 (4) ◽  
pp. e0009282
Author(s):  
Bhavneet Walia ◽  
Brittany L. Kmush ◽  
Sandra D. Lane ◽  
Timothy Endy ◽  
Antonio Montresor ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Retrospective Cohort ◽  
Low Birthweight ◽  
Health Benefit ◽  
Low Transmission ◽  
Random Intercept ◽  
Poor Access ◽  
The Impact

Background Soil transmitted helminths (STH) are a common infection among pregnant women in areas with poor access to sanitation. Deworming medications are cheap and safe; however, the health benefit of deworming during pregnancy is not clear. Methods / Principal findings We created a retrospective cohort of more than 800,000 births from 95 Demographic and Health Survey datasets to estimate the impact of deworming medicine during routine antenatal care (ANC) on neonatal mortality and low birthweight. We first matched births on the probability of receiving deworming during ANC. We then modeled the birth outcomes with the matched group as a random intercept to estimate the effect of deworming during antenatal care after accounting for various risk factors. We also tested for effect modification of soil transmitted helminth prevalence on the impact of deworming during ANC. Receipt of deworming medication during ANC was associated with a 14% reduction in the risk of neonatal mortality (95% confidence interval = 10–17%, n = 797,772 births), with no difference between high and low transmission countries. In low transmission countries, we found an 11% reduction in the odds of low birth weight (95% confidence interval = 8–13%) for women receiving deworming medicine, and in high transmission countries, we found a 2% reduction in the odds of low birthweight (95% confidence interval = 0–5%). Conclusions / Significance These results suggest a substantial health benefit for deworming during ANC that may be even greater in countries with low STH transmission.

scholarly journals The value of routine mid-trimester ultrasound in low-risk pregnancies at primary care level

2008 ◽  
Vol 13 (4) ◽  
pp. 41-49 ◽  
Author(s):  
B Van Dyk ◽  
JA Motto ◽  
EJ Buchmann
Keyword(s):  
Antenatal Care ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Open Cluster ◽  
Mode Of Delivery ◽  
Low Risk ◽  
Control Group ◽  
Ultrasound Scan ◽  
Second Trimester ◽  
Ultrasound Scanning

This study investigated the effect of routine second-trimester ultrasound scanning on obstetric management and pregnancy outcomes. This was an open cluster, randomised, controlled trial. Clusters of women with low-risk pregnancies presenting in the second trimester were randomised to receive an ultrasound scan followed by usual antenatal care, or to an unscanned control group undergoing conventional antenatal care only. Out of the 962 women randomised, follow-up was successful for 804 (83.6%), with 416 allocated to the ultrasound scan group and 388 controls. There were no significant differences between the ultrasound scan group and the control group in terms of prenatal hospitalisation, mode of delivery, miscarriage, perinatal mortality rate and low birthweight rate. Ultrasound dating was associated with a lower rate of induction of labour for post-term pregnancy (1.4% vs. 3.6%; P=0.049). However, ultrasound scanning in low-risk pregnancies was not associated with improvements in pregnancy outcome. Opsomming Hierdie studie het die effek van roetine mid-trimester ultraklankskandering op swangerskapsorg en –uitkomste ondersoek. Dit was ’n oop tros, lukrake, beheerde proef. Groepe vroue met laerisikoswanger- skap in die midtrimester is lukraak toegewys vir ’n ultraklank-skandering, gevolg deur voorgeskrewe voorgeboor-tesorg, of vir ’n kontrolegroep wat voorgeboortesorg volgens nasionaal voorgeskrewe protokol sonder skandering ontvang het. Van die 962 vroue wat aan die steekproef deelgeneem het kon data vir 804 (83.6%) suksesvol opgevolg word, met 416 in die ultraklankgroep en 388 in die kontrolegroep. Geen beduidende verskille is tussen die twee groepe gevind ten opsigte van voorgeboorte-hospitalisasie, geboortemetode, miskraamstatistiek, perinatale komplikasies of laegeboortegewig nie. Ultraklankdatering van swangerskappe is met minder kraaminduksie (1.4% teen 3.6%; P=0.049) vir natrimesterswangerskap geassosieer. Roetine ultraklankskandering in laerisikoswangerskap het egter geen verbetering in swangerskapsuitkomste te weeg gebring nie.

Smoking During Pregnancy:Possibilities of Prevention in Antenatal Care

1992 ◽  
Vol 8 (S1) ◽  
pp. 96-100 ◽  
Author(s):  
Bernhard Svanberg
Keyword(s):  
Antenatal Care ◽  
Fetal Outcome ◽  
Maternal Attitudes ◽  
Smoking In Pregnancy ◽  
Special Support ◽  
Self Help ◽  
In Pregnancy

AbstractPrevention of smoking in pregnancy is a mission of utmost importance since the fetal outcome is improved when the mother quits smoking. Methods to prevent smoking have to consider maternal attitudes and characteristics and be based on pedagogical and behavioral principles. A well-motivated staff, a self-help manual accepted by most women, and special support to those who want it are minimal requirements.

scholarly journals Determinants of Disparity between Antenatal Bookings and Institutional Deliveries in Port Harcourt, Southern Nigeria

2020 ◽  
pp. 21-30
Author(s):  
Terhemen Kasso ◽  
Ojimah Chibianotu ◽  
Rosemary Ogu
Keyword(s):  
Qualitative Study ◽  
Antenatal Care ◽  
Health Workers ◽  
Structured Interview ◽  
Cost Of Care ◽  
Skilled Birth Attendants ◽  
Mortality And Morbidity ◽  
Birth Attendants ◽  
Port Harcourt ◽  
Depth Interviews

Aim: To determine the reasons why women deliver outside institutions where they register for antenatal care. Study Design: Qualitative study. Place and Duration of Study: Antenatal clinic of the University of Port Harcourt Teaching Hospital in February 2018. Methodology: A qualitative study using in-depth interviews (IDIs) was conducted in Port Harcourt, Nigeria to collect information on various reasons why women do not deliver where they received antenatal care (ANC) or with skilled birth attendants (SBAs). This was done using structured interview guides. Specifically, we asked 30 pregnant women to elucidate the circumstances that lead women to deliver in places other than where they had received antenatal care, and recommendations to enhance the number of women delivering with skilled birth attendants. All in-depth interviews were audio-taped, transcribed and content-analyzed. Results: Thirty IDIs were carried out. The women were all pregnant; aged 20 to 43 years old with mean age of 32.9 ± 5.5 years. The broad themes that emerged from their responses: Cost/financial reasons relating to inability to afford the cost of care in the hospitals, personal reasons such as fear of Caesarean section, and hospital-related reasons such as health workers’ strike action. Conclusion:  Evidence from our study indicates that pregnant women’s non-use of skilled birth attendants during childbirth even when they received antenatal care in the hospital is mainly due to financial, personal and hospital-related reasons. These factors are modifiable and should be targeted to increase delivery with skilled attendants, a key strategy for the reduction of maternal and neonatal mortality and morbidity.

scholarly journals Incidence of Vertical-Transmission of HIV and Its Correlation with Maternal Gestational Age at Antenatal Booking in Port-Harcourt, Nigeria

2019 ◽  
pp. 1-13
Author(s):  
Fiekumo Igbida Buseri ◽  
Evelyn Mgbeoma Eze ◽  
Ngowari Golden
Keyword(s):  
Single Dose ◽  
Hiv Infection ◽  
Antenatal Care ◽  
Vertical Transmission ◽  
Gestational Age ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Port Harcourt ◽  
Vertical Transmission Of Hiv ◽  
Hiv Exposed

Background: Pregnancy associated with human immunodeficiency virus (HIV)- infection poses risk to the fetus due to vertical-transmission. This can be prevented through administration of antiretroviral drugs. Our objective was to investigate the incidence of vertical-transmission of HIV and its correlation with maternal gestational age at antenatal booking with immediate commencement of antiretroviral therapy in Port-Harcourt, Nigeria. Methods: All antenatal attendees and their HIV-exposed newborns were screened for HIV-infection between April, 2016 and May, 2017 using qualitative rapid ELISA kits and HIV-DNA PCR technique. The HIV-positive antenatal attendees were placed on daily single-dose triple antiretroviral regimen (efavirenz, lamivudine, tenofovir, 600/300/300mg tablet) with multivitamins from the first day of booking and continued afterward. The HIV-exposed babies were placed on 5ml daily single-dose triple antiretroviral chemoprophylaxis on the first day of delivery and continued until blood collection at 6 weeks for HIV diagnosis. Statistical Package for Social Science (SPSS) software (version 17.0) was used for data analysis. Results: We found 4.34% overall prevalence of HIV-1 infection among the antenatal attendees and 7.57% incidence of mother-to-child transmission. There was significant difference between gestational age at booking with commencement of ART and the number of HIV-positive babies (χ2=7.113, df=2, P<0.05). There was no vertical transmission among the attendees who booked at first trimester, 35.7% at second trimester and 64.3% at third trimester. There was no statistically significant gender difference (P>0.05) between the number of infected males, 42.9% and females, 57.1%. Conclusion: High incidence of vertical-transmission of HIV was obtained from those HIV-positive mothers who registered late for antenatal care. Therefore, strong advocacy for early entry into antenatal care is solicited.

scholarly journals Magnitude of low birthweight in malaria endemic settings of Nanoro, rural Burkina Faso: a secondary data analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Moussa Lingani ◽  
Serge H. Zango ◽  
Innocent Valéa ◽  
Daniel Valia ◽  
Maïmouna Sanou ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Low Birthweight ◽  
Public Health Problem ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Important Public Health Problem ◽  
Cross Sectional ◽  
Significance Level ◽  
Maternal Characteristics

AbstractLow birthweight (LBW) is a worldwide problem that particularly affects developing countries. However, limited information is available on its magnitude in rural area of Burkina Faso. This study aimed to estimate the prevalence of low birthweight and to identify its associated factors in Nanoro health district. A secondary analysis of data collected during a cross-sectional survey was conducted to assess the prevalence of low birthweight in Nanoro health and demographic surveillance system area (HDSS). Maternal characteristics extracted from antenatal care books or by interview, completed by malaria diagnosis were examined through a multi-level logistic regression to estimate odd-ratios of association with low birthweight. Significance level was set at 5%. Of the 291 neonates examined, the prevalence of low birthweight was 12%. After adjustment for socio-demographic, obstetric and malaria prevention variables, being primigravid (OR = 8.84, [95% CI: 3.72–21.01]), or multigravid with history of stillbirth (OR = 5.03, [95% CI: 1.54–16.40]), as well as the lack of long-lasting insecticide treated bed net use by the mother the night preceding the admission for delivery (OR = 2.5, [95% CI: 1.1–5.9]) were significantly associated with neonate low birthweight. The number of antenatal visits however did not confer any direct benefit on birthweight status within this study area. The prevalence of low birthweight was high in the study area and represents an important public health problem in Burkina Faso. In light of these results, a redefinition of the content of the antenatal care package is needed.

scholarly journals Adverse birth outcomes in a malarious area

2005 ◽  
Vol 134 (3) ◽  
pp. 659-666 ◽  
Author(s):  
B. F. KALANDA ◽  
F. H. VERHOEFF ◽  
L. CHIMSUKU ◽  
G. HARPER ◽  
B. J. BRABIN
Keyword(s):  
Antenatal Care ◽  
Preterm Delivery ◽  
Fetal Growth ◽  
Low Birthweight ◽  
Venereal Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Maternal Malnutrition ◽  
Factors Associated ◽  
Intra Uterine Growth Retardation

To determine factors associated with fetal growth, preterm delivery and stillbirth in an area of high malaria transmission in Southern Malawi, a cross-sectional study of pregnant women attending and delivering at two study hospitals was undertaken. A total of 243 (17·3%) babies were preterm and 54 (3·7%) stillborn. Intra-uterine growth retardation (IUGR) occurred in 285 (20·3%), of whom 109 (38·2%) were low birthweight and 26 (9·1%) preterm. Factors associated with IUGR were maternal short stature [adjusted odds ratio (AOR) 1·6, 95% confidence interval (CI) 1·0–2·5]; primigravidae (AOR 1·9, 95% CI 1·4–2·7); placental or peripheral malaria at delivery (AOR 1·4, 95% CI 1·0–1·9) and maternal anaemia at recruitment (Hb <8 g/dl) (AOR 1·9, 95% CI 1·3–2·7). Increasing parasite density in the placenta was associated with both IUGR (P=0·008) and prematurity (P=0·02). Factors associated with disproportionate fetal growth were maternal malnutrition [mid-upper arm circumference (MUAC) <23 cm, AOR 1·9, 95% CI 1·0–3·7] and primigravidae (AOR 1·8, 95% CI 1·0–3·1). Preterm delivery and stillbirth were associated with <5 antenatal care visits (AOR 2·2, 95% CI 1·3–3·7 and AOR 3·1, 95% CI 1·4–7·0 respectively) and stillbirth with a positive Venereal Disease Research Laboratory (VDRL) test (AOR 4·7, 95% CI 1·5–14·8). Interventions to reduce poor pregnancy outcomes must reduce the burden of malaria in pregnancy, improve antenatal care and maternal malnutrition.

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