School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
BMC Pregnancy Childbirth. 2022 Dec 9;22(1):921. doi: 10.1186/s12884-022-05270-1.
Antenatal care is one of the components of the maternal and child continuum of care. Timely booking ANC during pregnancy is of utmost importance to guarantee the best possible health outcomes for women and children. Inappropriate timing of the first ANC booking is associated with poor pregnancy outcomes, including perinatal death, stillbirth, and early neonatal death. According to WHO focused ANC recommendation, every mother should start booking ANC within the first 12 weeks of gestational age. However, in developing countries, including Ethiopia, many pregnant mothers were not booking ANC at the recommended time. Thus, this study aims to assess the time to first ANC booking and its determinants in Ethiopia.
A survival analysis was conducted to determine time to first ANC booking among 3917 weighted study subjects. The data were extracted from EDHS 2019 using STATA version 17 software. A Kaplan Meier survivor curve was computed to estimate the time of first ANC booking. A Long-rank test was used to compare the difference in survival curves. Weibull Inverse Gaussian shared frailty model was used to identify significant predictors. On multivariable analysis, variables having a p-value of ≤ 0.05 are considered statistically significant.
The overall median survival time was four months. The significant determinant of time to first ANC booking are residence (rural [ϕ = 1.111, 95CI: 1.060, 1.164), mother educational level (primary education [ϕ = 0.945, 95CI: 0.915, 0.977], secondary and above educational [ϕ = 0.857, 95CI: 0.819, 0.896]) and wealth index (middle [0.948 (ϕ = 0.948, 95CI: 0.911, 0.986) and rich [ϕ = 0.904, 95CI: 0.865, 0.945]) CONCLUSION: The median time for first ANC booking is 4 month, which is higher than the WHO recommended time. The timing of the first ANC booking in Ethiopia was mainly influenced by the residence of women, mother educational level, and wealth index. It is strongly recommended to expose mothers to educational materials and other awareness-creation campaigns, as well as to support disadvantaged women, such as the uneducated, poor, and those living in rural or remote areas.
产前护理是母婴连续护理的组成部分之一。在怀孕期间及时预约 ANC 对于保证妇女和儿童的最佳健康结果至关重要。首次 ANC 预约时间不当与不良妊娠结局有关，包括围产期死亡、死产和新生儿早期死亡。根据世卫组织的重点 ANC 建议，每位母亲都应在妊娠 12 周内开始预约 ANC。然而，在包括埃塞俄比亚在内的发展中国家，许多孕妇没有在推荐的时间预约 ANC。因此，本研究旨在评估埃塞俄比亚首次 ANC 预约的时间及其决定因素。
对 3917 名加权研究对象进行生存分析，以确定首次 ANC 预约的时间。数据是从 EDHS 2019 中使用 STATA 版本 17 软件提取的。计算 Kaplan-Meier 生存曲线估计首次 ANC 预约的时间。使用 Long-rank 检验比较生存曲线的差异。使用威布尔逆高斯共享脆弱性模型确定显著预测因素。在多变量分析中，p 值≤0.05 的变量被认为具有统计学意义。
总体中位生存时间为四个月。首次 ANC 预约时间的显著决定因素包括居住地（农村[φ=1.111，95%CI：1.060，1.164]）、母亲教育程度（小学教育[φ=0.945，95%CI：0.915，0.977]）和教育程度（中学[φ=0.948，95%CI：0.911，0.986]和富裕[φ=0.904，95%CI：0.865，0.945]）
首次 ANC 预约的中位时间为 4 个月，高于世卫组织推荐的时间。埃塞俄比亚首次 ANC 预约时间主要受妇女居住地、母亲教育程度和财富指数的影响。强烈建议向母亲提供教育材料和其他宣传运动，并支持处境不利的妇女，如未受过教育、贫困和生活在农村或偏远地区的妇女。
