Factors Predicting Completion of Four or More Antenatal Care Visits in Sarlahi District, Nepal.

Autor:	Yue Y; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Hazel EA; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Subedi S; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Zeger S; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health., Mohan D; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Mullany LC; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Tielsch JM; Department of Global Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue., Khatry SK; Nepal Nutrition Intervention Project, Sarlahi, 120 Sitakwa Margh, Jhamsikhel Pulchowk., LeClerq SC; Department of International Health, Johns Hopkins Bloomberg School of Public Health., Katz J; Department of International Health, Johns Hopkins Bloomberg School of Public Health.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2024 May 29. Date of Electronic Publication: 2024 May 29.
DOI:	10.21203/rs.3.rs-4467441/v1
Abstrakt:	Background: A significant number of women die from pregnancy and childbirth complications globally, particularly in low- and middle-income countries (LMICs). Receiving at least four antenatal care (ANC) visits may be important in reducing maternal and perinatal deaths. This study investigates factors associated with attending ≥ 4 ANC visits in Sarlahi district of southern Nepal. Methods: A secondary analysis was conducted on data from the Nepal Oil Massage Study (NOMS), a cluster-randomized, community-based longitudinal pregnancy cohort study encompassing 34 Village Development Committees. We quantified the association between receipt/attendance of ≥ 4 ANC visits and socioeconomic, demographic, morbidity, and pregnancy history factors using logistic regression; Generalized Estimating Equations were used to account for multiple pregnancies per woman. Results: All pregnancies resulting in a live birth (n=31,867) were included in the model and 31.4% of those pregnancies received 4+ ANC visits. Significant positive associations include socioeconomic factors such as participation in non-farming occupations for women (OR=1.52, 95% CI: 1.19, 1.93), higher education (OR=1.79, 95% CI: 1.66, 1.93) and wealth quintile OR=1.44, 95% CI: 1.31, 1.59), nutritional status such as non-short stature (OR=1.17, 95% CI: 1.07, 1.27), obstetric history such as adequate interpregnancy interval (OR=1.31, 95% CI: 1.19, 1.45) and prior pregnancy but no live birth (OR=2.14, 95% CI: 1.57, 2.92), symptoms such as vaginal bleeding (OR=1.35, 95% CI:1.11, 1.65) and awareness of the government's conditional cash transfer ANC program (OR=2.26, 95% CI: 2.01, 2.54). Conversely, belonging to the lower Shudra caste (OR=0.56, 95% CI: 0.47, 0.67), maternal age below 18 or above 35 (OR=0.81, 95% CI:0.74, 0.88; OR=0.77, 95% CI: 0.62, 0.96)), preterm birth (OR=0.41, 95% CI: 0.35, 0.49), parity ≥ 1 (OR=0.66, 95% CI: 0.61, 0.72), and the presence of hypertension during pregnancy (OR=0.79, 95% CI: 0.69, 0.90) were associated with decreased likelihood of attending ≥ 4 ANC visits. Conclusions: These findings underscore the importance of continuing and promoting the government's program and increasing awareness among women. Moreover, understanding these factors can guide interventions aimed at encouraging ANC uptake in the most vulnerable groups, subsequently reducing maternal-related adverse outcomes in LMICs. Trial Registration: The clinicaltrial.gov trial registration number for NOMS was #NCT01177111. Registration date was August 6 th , 2010. Competing Interests: Competing interests The authors declare that they have no competing interests.
Databáze:	MEDLINE
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