Introduction:
Early entry to antenatal care (ANC) is important for early
detection and treatment of adverse pregnancy related
outcomes. Antenatal care evolved over a period of about
a century, with the trend changing gradually from in-
patient to out-patient form of care that we have
today.1,2 This form of care for pregnant women has
become an important pillar in the safe motherhood
programme, as the aim is to improve the outcome of
pregnancy for both the mother and the fetus.2,3 The
usual recommendations nowadays is for booking (first
antenatal visit) to take place in early pregnancy, prior to
14 weeks. The World Health Organization (WHO)
recommends that pregnant women in developing
countries should seek ANC within the first 4 months of
pregnancy.4 In developed countries such as the United
Kingdom and the United States, ANC is recommended
within the first 12 weeks of pregnancy.5,6
Early booking, makes fairly accurate dating feasible, es-
pecially in women who are unsure of their last menstrual
period, certain baseline measurements, such as blood
pressure, body mass index and urinalysis done at this
gestational age give a fair idea of the pre-pregnancy
state of the patient.7,8
Various studies have reported factors associated with
late entry to ANC , these include place of residence 9-11,
ethnicity 12, age 10, education 11,13,14, employment sta-
tus12,15, parity 10- 12,14, intention to get pregnant 9,12, use of
contraceptive method 12, economic status 9,12,13, health in-
surance 9-11,13,16 and travel time.9
However, in spite of advantages of early booking, late
booking is common in the developing world.17,18 Studies
from Benin and Sokoto, in other regions of Nigeria
showed that mean gestational ages at booking among
the pregnant women were 23.7 and 23.55 weeks, respec-
tively.17,18
The aims of this study were to assess the proportion of
pregnant women who booked late for Antenatal care in
South Western Nigeria during calendar year 2006 and to
identify factors related to late booking.
Materials and Methods:
Structured questionnaires were administered to willing
pregnant women attending antenatal clinic at Ladoke
Akintola University Teaching Hospital, State Hospital and
Primary health Centre, Osogbo, Nigeria. Ethical approval
was obtained from ethical committee of the institution
and verbal consent was also obtained from the
participants. Descriptive statistics was used, mean and
standard deviation for continuous variables and
frequency for categorical variables. Test of association
was carried out using chi-square. Multivariate stepwise
logistic regression was performed to identify significant
predictors, all at 5% level of significance. Data analyses
was done using SPSS version 10 (Statistical Package for
Social Sciences, SPSS Inc., Chicago, IL, USA).
Results:
Four hundred and eighty questionnaires were
administered, four hundred and seventy (97.9%) were
returned. Mean age of the respondents was 28 ± 4.6
years (17 - 41). Eighty four (18.5%) booked within 13
weeks of gestation while majority, 370(81.5%) booked
after 13 weeks. Mean gestational age at booking was 20.3
± 6.2 weeks. Three hundred ninety three (83.6%) were in
monogamous union and sixty four (14.0%) were
polygamous. Three hundred and eighty-eight (82.6%)
were carrying singleton fetus, 22(4.7%) multiple
pregnancies and 60(12.8%) were unsure.
Majority, 324(69.3%) of the respondents were aged 25 -
34 years and were mostly Yoruba of ethnic
group,443(92.5%). Most, 215(46.2%) had secondary edu-
cation while majority, 207(44.6%) were self-employed.
Three hundred and thirty one (70.4%) were multiparous
while the remaining 139(29.6%) were nulliparous women
(Table 1).
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OJHAS Vol 7 Issue 1(4) Adekanle DA et al. Late Antenatal Care Booking And Its Predictors Among Pregnant Women In South Western Nigeria
http://ojhas.org