The Relationship of Poor Antenatal Care and Low Birth Weight and Preterm Labor

Abstract

The Relationship of Poor Antenatal Care and Low Birth Weight and Preterm Labor

Visut             Suvithayasiri              MD*

Manit            Sripramote                  MD*

Pramote      Chredrattanarak        MD*

* Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To study the relationship of poor antenatal care and low birth weight and preterm labor.

Study design: Retrospective cohort study.

Subjects: Six hundred pregnant women, who attended antenatal care and delivered in BMA Medical College and  Vajira Hospital between January 1, 2001 and December 31, 2001.

Methods: The general demographic data, incidence of preterm labor and low birth weight from antenatal and labor records of 600 pregnant women were collected by simple random sampling into 2 groups, with 300 in each group.  The first group was the women who had poor antenatal care (ANC), characterized by first ANC at or after 24 weeks of gestation or the visiting numbers of total ANC less than 4 times.  The second group was the women who had good ANC, defined having first ANC before 24 weeks of gestation and at least 4 times of ANC.  Then the data was statistically analysed.

Main outcome measures: Incidence of low birth weight infant and preterm labor in both groups of pregnant women.

Results: This study showed that the age under 20 years old in poor ANC group was more than in good ANC group (23.3% and 13.7% respectively).  Percentage of women who were the employee in good ANC  group were more than in poor ANC group (48.7% and 28.3% respectively).  In poor ANC group, house wife women were more common than women in good ANC group (60.0% and 38.3% respectively).  In good ANC group, they had got the education equal to or more than bachelor's degree more than in poor ANC group (6.3% and 303% respectively).  In poor ANC group, women had only one child more than in good ANC group (80.3% and 69.0% respectively).  In poor ANC group, 17.67% of women presented low birth weight infants compared to 3.67% in good ANC group and the relative risk was 4.189 (95%CI = 2.178-8.059).  In poor ANC group, 27.33% of women presented preterm labor compared to 12.33% in good ANC group and the relative risk was 2.007 (95% CI = 1.350-2.983).

Conclusion: The pregnant  women with poor ANC had the risk of increasing incidence of low birth weight infants and preterm labor.  The relative risk of low birth weight infant and preterm labor in poor ANC group were 4.189 and 2.007 respectively compared to good ANC group.

Key word: good antenatal care, poor antenatal care, low birth weight, preterm labor

Vajira Med J 2003 ; 47 : 9 - 16