Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University.
Leading Program, Graduate School of Biomedical Sciences, Graduate School of Biomedical Sciences, Nagasaki University.
Acta Med Okayama. 2020 Dec;74(6):495-503. doi: 10.18926/AMO/61209.
In many economically developing countries, and especially in the rural regions of sub-Saharan African coun-tries, there have been only limited investigations into the association between antenatal care (ANC) and adverse pregnancy outcomes. We obtained information on ANC and pregnancy outcomes between 2011 and 2016 from hospital files of pregnant women (n = 4,960) served at a rural hospital in Rwanda, and we examined the associa-tions between their ANC visits and the adverse pregnancy and neonatal outcomes by using univariate and mul-tivariate logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Most of the pregnant women had ≥ 4 ANC visits, but 39% (n = 1,911) did not have ≥ 3 visits before delivery. The prev-alence of low birth weight (LBW) and that of preterm birth (PTB) were 12% and 9.9%, respectively. Compared to the women who attended only one ANC visit, those who attended ≥ 4 ANC visits had lower risks of LBW (OR 0.20; 95%CI: 0.11-0.36) and PTB (OR 0.28; 95%CI: 0.11-0.76). Frequent ANC visits were also associ-ated with better postnatal outcomes of the newborns. Encouraging women to attend ANC visits before delivery can markedly reduce PTB-related and LBW-related complications, especially in resource-limited settings.
在许多经济发展中国家，尤其是撒哈拉以南非洲国家的农村地区，仅对产前护理 (ANC) 与不良妊娠结局之间的关系进行了有限的调查。我们从卢旺达一家农村医院的孕妇病历中获取了 2011 年至 2016 年期间的 ANC 和妊娠结局信息（n=4960），并通过单变量和多变量逻辑回归模型来检查 ANC 就诊次数与不良妊娠和新生儿结局之间的关联，以估计比值比 (OR) 和 95%置信区间 (CI)。大多数孕妇有≥4 次 ANC 就诊，但 39%（n=1911）在分娩前没有≥3 次就诊。低出生体重 (LBW) 和早产 (PTB) 的发生率分别为 12%和 9.9%。与仅接受一次 ANC 就诊的妇女相比，接受≥4 次 ANC 就诊的妇女 LBW（OR 0.20；95%CI：0.11-0.36）和 PTB（OR 0.28；95%CI：0.11-0.76）的风险较低。频繁的 ANC 就诊也与新生儿的产后结局更好相关。鼓励妇女在分娩前接受 ANC 就诊可以显著减少与 PTB 和 LBW 相关的并发症，尤其是在资源有限的环境中。
