Antenatal care and pregnancy outcome in Ghana, the importance of women\'s education

Abstract

The antenatal characteristics of 503 pregnant women attending maternal and child health clinics in Accra were studied to ascertain the influence of antenatal care on pregnancy outcome. Gestation age of first antenatal care attendance, duration of nutrients supplementation during pregnancy, infant birth-weight and level of education in relation to seeking early antenatal care were studied. A sub-sample comprising 128 were selected for a longitudinal study which assessed monthly haemoglobin concentration of the pregnant women when they reported for antenatal care. Results showed that the level of educational of the pregnant women was important in seeking early antenatal care. Higher educational level associated with early antenatal care attendance. Majority of the subjects attended antenatal care in the 3rd month of pregnancy. The average birth-weight of infants delivered by the 503 pregnant women was 3.02 ± 0.45 kg and the prevalence of low birth-weight (birthweight < 2.5 kg) was 8.3%. Pregnant women who sought antenatal care before the end of the 3rd month delivered infants whose birth-weights were significantly better compared to those who sought care later (3.08 ± 0.44 vs 2.85 ± 0.46 kg, respectively, P < 0.0001). Those who received antenatal care before the end of the 3rd month had on average 3.2 times (95% CI: 1.9 – 5.2, P < 0.0001) better chance of giving birth to a normal weight infant. Pregnant women who received antenatal care and were on multivitamin and mineral supplements for more than 5 months had infants who weighed better than those who received care for lesser duration (3.04 ± 0.44 vs 2.88 ± 0.55 kg, respectively P < 0.0001). The longitudinal haemoglobin study showed an average haemoglobin concentration of 11.5 ± 0.6 g/dL, n = 128. The anaemia rate among the pregnant women ranged from 24 - 38% depending on gestation age. Early antenatal care was associated with significant improvement in haemoglobin concentration (r = +0.35, P < 0.0001, n = 128). It was concluded that early antenatal care is crucial to favourable outcome of pregnancy in this population.