Pregnancy Outcomes and Factors Associated with Inadequate Antenatal Care Visits among Women Delivering at Sinza Hospital, Dar es Salaam Tanzania

Abstract

Background: The goal of antenatal care (ANC) services is to ensure that every pregnancy ends with delivery of a healthy baby without adversely affecting maternal health. ANC services should begin from early stages of pregnancy. Women can access ANC services by visiting antenatal care clinics. Inadequate ANC visits occurs when a women has made less than 4 ANC visits or started her first ANC visit after 16 weeks of pregnancy. Inadequate ANC visits still a major problem in developing countries and in Tanzania about half of women have inadequate antenatal care visits. This may be associated with poor pregnancy outcomes, high maternal and perinatal mortality. Understanding the factors associated with inadequate antenatal care visits will help to improve pregnancy, maternal and fetal health. Objective: This study aimed at determining pregnancy outcomes and factors associated with inadequate antenatal care visits among women delivering at Sinza hospital. Methods: A cross sectional study was conducted at Sinza hospital in Dar es Salaam. A systematic sampling method was used to obtain participants for the study, whereby after every 2 post-delivery women in the day discharge register a woman was selected beginning from the first person to systematically reach sample size of 422 post-delivery women. The principal investigator and one research assistant collected data through Swahili structured questionnaires. Data were coded, entered, cleaned and analysed using SPSS, statistical software version 23. Statistical analysis using descriptive statistics was used to determine the proportion of women with inadequate ANC visits and pregnancy outcomes such as maternal outcomes (mode of delivery, maternal survival status) and fetal outcomes (term or preterm delivery, alive or still births). Bivariate and multivariate logistic regression were done to identify factors associated with inadequate antenatal care visits with a p-value <0.05 considered statistically significant. Results: 21.1% of women delivering at Sinza hospital had inadequate antenatal care visits. Factors that showed significant association with adequacy antenatal care visits were maternal education level (AOR=4.07, 95% CI=1.31-18.18); number of times husband/partner accompanied his wife/partner to the clinic (AOR=7.04, 95% CI=0.95 – 52.35) and gestational age at delivery (AOR=2.73, 95% CI=1.3-5.76). There was a significant association of preterm deliveries in women with inadequate antenatal care visits (p-value = 0.012). Conclusion: Almost one-fifth of women delivering at Sinza hospital had inadequate antenatal care visits. Factors that showed significant association with inadequate antenatal care visits were maternal education, total number of times husband/partner accompanied his wife/partner to the clinic and gestational age at birth. There was a significant association of preterm delivery in women with inadequate antenatal care visits. Women with inadequate ANC visits were two times more likely to deliver preterm babies as compared to women with adequate ANC visits.