University of Zimbabwe- Clinical Trials Research Centre, 15 Philips Avenue Belgravia, Harare, Zimbabwe.
University of the Western Cape, School of Public Health, Robert Sobukwe Road, Bellville, Cape Town, 7535, South Africa.
BMC Pregnancy Childbirth. 2022 Nov 5;22(1):817. doi: 10.1186/s12884-022-05131-x.
The success of prevention of mother to child transmission of HIV (PMTCT) programs dependents on pregnant women accessing antenatal care (ANC) services. Failure to access ANC throughout the course of pregnancy presents a missed opportunity to fully utilize PMTCT services and a high risk for vertical HIV transmission. Whilst not booking for ANC was about 6% in Zimbabwe, according to the 2015 Zimbabwe Demographic and Health Survey, it is important to determine the local burden of pregnant women both un-booked for ANC and living with HIV. in Chitungwiza city, to inform local response. This study aimed at determining the proportion of women un-booked for antenatal care and among them, the proportion of women who were with HIV and to identify risk factors associated with not-booking for ANC in Chitungwiza city in Zimbabwe.
A cross-sectional study was conducted involving a review of clinic records for 4400 women who received postnatal care at all 4 maternity clinics in Chitungwiza city between 01 January 2017 and 31 December 2017. Bivariate and multiple logistic regression analysis with Chi squared test were used to determine risk factors associated with booking status while adjusting for other study variables. All statistics tests' decisions were concluded at 5% level of significance. All data analysis was performed using STATA (version 13) statistical package.
A total of 4400 women were attended to and of these, 19% were un-booked for ANC, while a total of 3% of the women were both un-booked and living with HIV. The women with HIV were 0.24 times less likely to book for ANC than HIV negative women, adjusted OR = 0.76 (95% CI: 0.61-0.98). Women aged 20-34 years were 1.3 times more likely to book than the teenagers, adjusted OR = 1.3 (95% CI: 1.04-1.62).
The proportion of women not booked for ANC of 19% was unexpectedly high. With 3% of pregnant women in Chitungwiza having both HIV and no access to ANC, the risk for vertical HIV transmission remains. More need to be done to improve ANC access, targeting teenage mothers and those living with HIV who are more less likely to access ANC.
预防母婴传播艾滋病毒（PMTCT）项目的成功取决于孕妇接受产前护理（ANC）服务的情况。如果孕妇在整个怀孕期间未能获得 ANC 服务，那么就会错失充分利用 PMTCT 服务的机会，并且垂直传播艾滋病毒的风险很高。虽然根据 2015 年津巴布韦人口与健康调查，津巴布韦的孕妇中有 6%未预约 ANC，但确定奇通圭扎市未预约 ANC 和感染艾滋病毒的孕妇的当地负担非常重要，以便为当地做出回应。本研究旨在确定未预约 ANC 的孕妇比例，以及在这些孕妇中感染艾滋病毒的比例，并确定奇通圭扎市未预约 ANC 的相关风险因素。
本研究为横断面研究，对 2017 年 1 月 1 日至 2017 年 12 月 31 日期间在奇通圭扎市的所有 4 家产科诊所接受产后护理的 4400 名妇女的临床记录进行了审查。采用卡方检验的二变量和多变量逻辑回归分析来确定与预约状况相关的风险因素，同时调整其他研究变量。所有统计检验的决策均在 5%的显著水平下得出。所有数据分析均使用 STATA（版本 13）统计软件包进行。
共接待了 4400 名妇女，其中 19%未预约 ANC，而共有 3%的妇女既未预约 ANC，又感染了艾滋病毒。感染艾滋病毒的妇女预约 ANC 的可能性比艾滋病毒阴性妇女低 0.24 倍，调整后的比值比为 0.76（95%CI：0.61-0.98）。20-34 岁的妇女比青少年妇女更有可能预约 ANC，调整后的比值比为 1.3（95%CI：1.04-1.62）。
未预约 ANC 的妇女比例为 19%，这一比例出人意料地高。奇通圭扎市有 3%的孕妇既感染了艾滋病毒，又无法获得 ANC，因此垂直传播艾滋病毒的风险依然存在。需要进一步努力改善 ANC 的获取途径，重点关注不太可能获得 ANC 的青少年母亲和感染艾滋病毒的妇女。
