FACTORS ASSOCIATED WITH PREGNANCY OUTCOME AMONG ANC CLINIC ATTENDEES IN ODEDA LGA OF OGUN STATE

Abstract

The concept of antenatal care has been universally-recognized as a very good model of preventive health care. Over the years, it has impacted positively on improving birth-outcomes in many countries. However, this has not been the case here, as Nigeria still maintains her place among countries with enormous loss of lives through pregnancy. This informed the present retrospective cross-sectional study to determine which socio-demographic, obstetric and other factors are associated with low birth-weight deliveries, an adverse pregnancy outcome. The study area, Odeda Local Government Area, is essentially a rural LGA in Ogun State with an estimated population of over 100,000. The study population comprised pregnant women attending antenatal care (ANC) clinics in two of the LGA's Health Facilities at Obantoko and Orile-Ilugun within the 3-year period starting July 2004 - June 2007. A total 416 of the registered pregnant women were surveyed using prepared structured checklist for collecting data from subjects' ANC cards and delivery records. Data were analysed using SPSS software. Frequency tables were generated, and chi-square test used to investigate associations between categorical variables at 5% significance level. Of the 416 subjects, majority (69.4%) were aged 20 - 29 years, and 6.7% were teenagers. Their mean age was 25.5 ± 5.3 years while their spouses' mean age was 33.5 ± 6.8 years. As at the time of their ANC booking, 93.5% were married, 70.4% had at least primary education, while 98.1 % were low-income petty-traders and farmers. Mean number of pregnancies was 3.0 ± 1.8, mean parity was 1.9 ± 1.7, mean number of subjects' living children was 1.6 ± 1.4. Findings on ANC service utilization include mean number of ANC visits (3.5 ± 2.4), mean gestational-age-at-booking (2.17 ± 9.0), 45.5% ultrasound scan usage, and 61.5% Tetanus Toxoid immunization coverage. Mean gestational age at labour was 38.2 ± 3.4 weeks; male : female babies' sex ratio was approximately 1.5 : 1.0, while low birth-weight prevalence found was 3.4%. Following multivariate analysis, factors that significantly increased the risk of low birth-weight deliveries among booked pregnant women include being a teenage mother [0.R = 48.6; (C.I = 5.3 - 440.5); p< 0.005]; and being a never-married mother [O.R = 70.4; (C.I = 9.7 - 512.6); p< 0.005)]. Early booking for ANC i.e. before 28 weeks [0.R = 0.1; (C.I = 0.0 l - 0.56); p< 0.05], and attaining term pregnancy prior to labour [0.R = 0.02; (C.I = 0.002 - 0.098); p < 0.005] were both significantly protective against low birth-weight. Attending ANC only once and receiving <2 doses of TT were both non-significant LBW risk factors. A good number of pregnant women using public health facilities in Odeda LGA are accessing the inherent benefits of antenatal care services. They should be further encouraged to avoid teenage pregnancy and single parenthood, both of which had exposed them to low birth weights and similar adverse pregnancy outcomes.