Pregnancy Outcomes of Women with Early and Late Antenatal Care Booking At Sinza Hospital, Dar Es Salaam

Abstract

Background: Antenatal Care (ANC) often presents the first contact opportunity for a pregnant woman to with health services thus offering an entry point for integrated care, promoting healthy practices, influencing health seeking behaviors, and linking women with pregnancy complications to a referral system. Antenatal care attendance reduces maternal and perinatal morbidity and mortality through detection and treatment of pregnancy-related complications and identification of women at increased risk of developing complications during labor and delivery. Objective: This study aimed at determining the proportion of women with early and late ANC booking, and compared the provision of first visit antenatal care components and pregnancy outcomes among women delivered at Sinza hospital October to November 2019. Methodology: A hospital based cross-sectional study was conducted at Sinza Hospital from 17th October to 21st November 2019. Systematic sampling was used to reach a sample size of 320 women. Data was collected using a structured Swahili Questionnaire. Variables such as early and late booking defined as booking before 16 weeks and after 16 weeks of gestation respectively, components of first ANC visit and pregnancy outcomes such as Anemia in pregnancy, Gestational diabetes, hypertensive disorders in pregnancy, cesarean delivery, Spontaneous vertex delivery, obstetric hemorrhage, low Apgar score, low birth weight, preterm delivery and perinatal deaths were coded, entered, cleaned and analyzed using Statistical Package for Social Sciences (SPSS) version 23.0. Descriptive statistical analysis was done to determine the proportion of women with early antenatal care booking, to compare provision of first visit antenatal care components between women with early and late ANC booking, compared the outcomes and to determine the association between time of ANC booking and pregnancy outcomes (maternal and fetal). Chi square test was done to determine the association and p-value <0.05 was considered statistically significant. Results were summarized and presented using frequency distribution tables, figures and texts. Results: The proportion of women with early(<16wks GA) ANC booking among women delivered at Sinza hospital was 32.8%.: The proportion of women with early(<16wks GA) ANC booking among women delivered at Sinza hospital was 32.8%.The ANC services offered to most clients who booked early and late respectively were history of the participants(100%, 93.5%), HIV test(100% ,84.7%), hemoglobin test (99.1%,80.9%), blood Grouping test (99.1%,84.7%),iron supplements (98.1%,85.1%) and client counselling (91.1%,93.5%). Fetal mortality (p value =0.049) was significantly associated with late ANC booking. Fetal mortality (p value =0.049) was significantly associated with late ANC booking. Conclusion: Only a small proportion of women booked for first trimester ANC.The provision of first visit ANC components was adequately offered in the group that booked early. Only perinatal deaths among the pregnancy outcomes, showed significant association with late ANC booking.