Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study
| Autor: | Evelyn K. Ansah, Diederick E. Grobbee, Kerstin Klipstein-Grobusch, Irene Akua Agyepong, Gbenga A. Kayode, Mary Amoakoh-Coleman |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Antenatal care
Maternal Ghana 0302 clinical medicine Pregnancy Risk Factors Neonatal Obstetrics and Gynaecology Infant Mortality 030212 general & internal medicine Prospective Studies 030219 obstetrics & reproductive medicine Obstetrics Incidence (epidemiology) Obstetrics and Gynecology Anemia Prenatal Care Stillbirth Checklist Practice Guidelines as Topic Premature Birth Female Guideline Adherence medicine.symptom Cohort study Research Article Adult medicine.medical_specialty Reproductive medicine Outcomes 03 medical and health sciences Young Adult First antenatal visit medicine Journal Article Humans Retrospective Studies Public Sector business.industry Postpartum Hemorrhage Infant Newborn Infant Guideline Hypertension Pregnancy-Induced Infant Low Birth Weight medicine.disease Pregnancy Complications Low birth weight Adherence Relative risk Emergency medicine Health Facilities business |
| Zdroj: | BMC Pregnancy and Childbirth BMC Pregnancy and Childbirth [E], 16. BioMed Central |
| ISSN: | 1471-2393 |
| Popis: | Background Guideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resource setting. Methods Women delivering in 11 health facilities in the Greater Accra region of Ghana were recruited into a cohort study. Their first antenatal visit records were reviewed to assess providers’ adherence to the guidelines, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected. Participants were followed up for 6 weeks post-partum to complete data collection on outcomes. The incidence of maternal and neonatal complications was estimated. The effects of complete adherence on risk of maternal and neonatal complications were estimated and expressed as relative risks (RRs) with their 95% confidence intervals (CI) adjusted for a potential clustering effect of health facilities. Results Overall, 926 women were followed up to 6 weeks post-partum. Mean age (SD) of participants was 28.2 (5.4) years. Complete adherence to guidelines pertained to the care of 48.5% of women. Incidence of preterm deliveries, low birth weight, stillbirths and neonatal mortality were 5.3, 6.1, 0.4 and 1.4% respectively. Complete adherence to the guidelines decreased risk of any neonatal complication [0.72 (0.65–0.93); p = 0.01] and delivery complication [0.66 (0.44–0.99), p = 0.04]. Conclusion Complete provider adherence to antenatal care guidelines at first antenatal visit influences delivery and neonatal outcomes. While there is the need to explore and understand explanatory mechanisms for these observations, programs that promote complete adherence to guidelines will improve the pregnancy outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1167-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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