The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa

BMC Pregnancy and Childbirth

Landon Myer²  Greg Petro¹  Roxanne Beauclair² 

[1] Department of Obstetrics and Gynecology, University of Cape Town and New Somerset Hospital, Cape Town, South Africa;Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

关键词: South Africa;    Prenatal care;    Gestational age;    Antenatal care;    Stillbirths;   

Others  :  1127206
DOI  :  10.1186/1471-2393-14-204

 received in 2013-09-25, accepted in 2014-06-10,  发布年份 2014

【 摘 要 】

Background

There is renewed interest in stillbirth prevention for lower-middle income countries. Early initiation of and properly timed antenatal care (ANC) is thought to reduce the risk of many adverse birth outcomes. To this end we examined if timing of the first ANC visit influences the risk of stillbirth.

Methods

We conducted an analysis of a retrospective cohort of women (n = 34,671) with singleton births in a public perinatal service in Cape Town, South Africa. The main exposure was the gestational age at the first ANC visit. Bivariable analyses examining maternal characteristics by stillbirth status and gestational age at the first ANC visit, were conducted. Logistic regression, adjusting for maternal characteristics, was conducted to determine the risk of stillbirth.

Results

Of the 34,671 women who initiated ANC, 27,713 women (80%) were retained until delivery. The population stillbirth rate was 4.3 per 1000 births. The adjusted models indicated there was no effect of gestational age at first ANC visit on stillbirth outcomes when analyzed as a continuous variable (aOR 1.01; 95% CI: 0.99-1.04) or in trimesters (2^nd Trimester aOR 0.78, 95% CI: 0.39-1.59; 3^rd Trimester OR 1.03, 95% CI: 0.50-2.13, both with 1^st Trimester as reference category). The findings were unchanged in sensitivity analyses of unobserved outcomes in non-retained women.

Conclusion

The timing of a woman’s first ANC visit may not be an important determinant of stillbirths in isolation. Further research is required to examine how quality of care, incorporating established, effective biomedical interventions, influences outcomes in this setting.

【 授权许可】

   
2014 Beauclair et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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