Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria.
BMC Pregnancy Childbirth. 2022 Oct 5;22(1):750. doi: 10.1186/s12884-022-05079-y.
Delayed first antenatal care contact refers to first antenatal care contact occurring above twelfth weeks of gestation. Studies in Nigeria and in other countries have examined the prevalence and predictors of delayed first antenatal care contact. Nevertheless, existing studies have rarely examined the predictors among primiparous women. In addition, the evidence of higher health risks associated with primigravida emphasizes the need to focus on primiparous women. This study, therefore, examined the predictors of delayed first antenatal care contact among primiparous women in Nigeria.
The study was a descriptive cross-sectional design that analyzed data extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a weighted sample of 3,523 primiparous women. The outcome variable was delayed first antenatal care contact. explanatory variables were grouped into predisposing, enabling, and need factors. The predisposing factors were maternal age, education, media exposure, religion, household size, The knowledge of the fertile period, and women's autonomy. The enabling factors were household wealth, employment status, health insurance, partner's education, financial inclusion, and barriers to accessing healthcare. The need factors were pregnancy wantedness and spousal violence during pregnancy. Data were analyzed using Stata 14. Two multivariable logistic regression models were fitted. Statistical significance was set at p < 0.05.
Nearly two-thirds (65.0%) of primiparous women delayed first antenatal care contact. Maternal age, maternal education, media exposure, religion, household membership, and knowledge of the fertile period were predisposing factors that significantly influenced the likelihood of delayed first antenatal care contact. Also, household wealth, employment status, health insurance, partner's education, perception of distance to the health facility, and financial inclusion were enabling factors that had significant effects on delayed first antenatal care contact. Pregnancy wantedness was the only need factor that significantly influenced the likelihood of delayed first antenatal care contact.
The majority of primiparous women in Nigeria delayed first antenatal care contact and the delay was predicted by varied predisposing, enabling, and need factors. Therefore, a public health education program that targets women of reproductive age especially primiparous women is needed to enhance early antenatal care contact in the country.
延迟首次产前保健接触是指在妊娠 12 周后进行首次产前保健接触。尼日利亚和其他国家的研究已经检查了延迟首次产前保健接触的流行率和预测因素。然而，现有研究很少检查初产妇的预测因素。此外，与初产妇相关的更高健康风险的证据强调需要关注初产妇。因此，本研究检查了尼日利亚初产妇延迟首次产前保健接触的预测因素。
该研究是一项描述性的横断面设计，分析了 2018 年尼日利亚人口与健康调查中提取的数据。该研究分析了 3523 名初产妇的加权样本。因变量为延迟首次产前保健接触。解释变量分为倾向因素、促成因素和需要因素。倾向因素包括母亲年龄、教育程度、媒体接触、宗教信仰、家庭规模、对生育期的了解以及妇女自主权。促成因素包括家庭财富、就业状况、医疗保险、伴侣教育程度、金融包容性和获得医疗保健的障碍。需要因素包括怀孕意愿和怀孕期间的配偶暴力。数据使用 Stata 14 进行分析。拟合了两个多变量逻辑回归模型。统计显著性设置为 p<0.05。
近三分之二（65.0%）的初产妇延迟了首次产前保健接触。母亲年龄、母亲教育程度、媒体接触、宗教信仰、家庭人数以及对生育期的了解是影响延迟首次产前保健接触可能性的倾向因素。此外，家庭财富、就业状况、医疗保险、伴侣教育程度、对医疗机构距离的感知以及金融包容性是对延迟首次产前保健接触有显著影响的促成因素。怀孕意愿是唯一显著影响延迟首次产前保健接触可能性的需要因素。
尼日利亚大多数初产妇延迟了首次产前保健接触，延迟的原因是多种倾向因素、促成因素和需要因素。因此，需要开展一项针对育龄妇女特别是初产妇的公共卫生教育计划，以提高该国的早期产前保健接触率。
