Lee Seungwon, Adam Eminai, Kanyike Andrew Marvin, Wani Solomon, Kasibante Samuel, Mukunya David, Nantale Ritah
Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Department of Research and Innovation, Sanyu Africa Research Institute, Mbale, Uganda.
PLoS One. 2024 Dec 9;19(12):e0314769. doi: 10.1371/journal.pone.0314769. eCollection 2024.
The World Health Organization (WHO) recommends at least 8 antenatal care (ANC) contacts during pregnancy, but many women in low and middle-income countries do not adhere to this schedule, which may contribute to high rates of maternal and neonatal mortality. This study assessed compliance to the WHO recommended 8+ ANC contacts schedule and associated factors among postpartum mothers in eastern Uganda.
This was a cross-sectional multicenter study conducted between July and August 2022 at four selected hospitals in Eastern Uganda using quantitative techniques. We recruited postnatal mothers who had given birth within 48 hours with records of their ANC contacts. Compliance to the WHO recommended 8+ ANC contacts schedule was defined as having received the recommended ANC contacts as per the gestational age at childbirth following the current ANC for a positive pregnancy experience WHO guidelines. We conducted multivariable logistic regression analysis to assess the association between compliance to the WHO recommended 8+ ANC contacts schedule and selected independent variables.
A total of 1104 postpartum mothers participated in the study with a mean age (± standard deviation) of 26 ± 6.4 years, and a majority had given birth from a referral hospital (n = 624 56.5%). Compliance to the WHO recommended 8+ ANC contacts schedule was low (n = 258, 23.4%), and only 23.2% (196) of the women had attended their first antenatal care contact within the first trimester. Factors associated with compliance to the WHO recommended 8+ ANC contacts were: attending the first antenatal care contact within 12 weeks of gestation [AOR: 6.42; 95% CI: (4.43 to 9.33)], having 2 to 4 children [AOR: 0.65; 95% CI: (0.44 to 0.94)], having a spouse who is unemployed [AOR: 1.71; 95% CI: (0.53 to1.08)] and having insurance coverage [AOR: 2.31; 95% CI: (1.17 to 4.57)].
Compliance with the 8+ ANC contacts schedule remains very low. Efforts should focus on increasing health education, particularly for multiparous women, and encouraging mothers to begin ANC in their first trimester. Exploring the dynamics of partner support, especially with employment status, may offer insights into improving ANC attendance.
世界卫生组织（WHO）建议孕期至少进行8次产前检查（ANC），但许多低收入和中等收入国家的妇女并未遵循这一检查安排，这可能导致孕产妇和新生儿死亡率居高不下。本研究评估了乌干达东部产后母亲对WHO建议的8次及以上产前检查安排的依从性及其相关因素。
这是一项于2022年7月至8月在乌干达东部四家选定医院采用定量技术开展的横断面多中心研究。我们招募了在48小时内分娩且有产前检查记录的产后母亲。对WHO建议的8次及以上产前检查安排的依从性定义为根据当前产前检查情况，按照分娩时的孕周接受了WHO推荐的产前检查次数，以获得积极的孕期体验。我们进行了多变量逻辑回归分析，以评估对WHO建议的8次及以上产前检查安排的依从性与选定自变量之间的关联。
共有1104名产后母亲参与了本研究，平均年龄（±标准差）为26±6.4岁，大多数产妇在转诊医院分娩（n = 624，56.5%）。对WHO建议的8次及以上产前检查安排的依从性较低（n = 258，23.4%），只有23.2%（196名）妇女在孕早期进行了首次产前检查。与对WHO建议的8次及以上产前检查安排的依从性相关的因素有：在妊娠12周内进行首次产前检查[AOR：6.42；95%CI：（4.43至9.33）]、育有2至4个孩子[AOR：0.65；95%CI：（0.44至0.94）]、配偶失业[AOR：1.71；95%CI：（0.53至1.08）]以及有保险覆盖[AOR：2.3；95%CI：（1.17至4.57）]。
对8次及以上产前检查安排的依从性仍然很低。应着力加强健康教育，尤其是针对经产妇的健康教育，并鼓励母亲在孕早期开始进行产前检查。探索伴侣支持的动态情况，特别是与就业状况相关的情况，可能有助于了解如何提高产前检查的参与率。
