PDF(Pubmed)
Abstract：
BACKGROUND: Early antenatal care visit is important for optimal care and health outcomes for women and children. In the study area, there is a lack of information about the time to initiation of antenatal care. So, this study aimed to determine the time to initiation of antenatal care visits and its predictors among pregnant women who delivered in Arba Minch town public health facilities.
METHODS: An institution-based retrospective follow-up study was performed among 432 women. A systematic random sampling technique was employed to select the study participants. The Kaplan-Meier survival curve was used to estimate the survival time. A Multivariable Cox proportional hazard regression model was fitted to identify predictors of the time to initiation of antenatal care. An adjusted hazard ratio with a 95% confidence interval was used to assess statistical significance.
RESULTS: The median survival time to antenatal care initiation was 18 weeks (95% CI = (17, 19)). Urban residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in a previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR = 0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.
CONCLUSIONS: Half of the women initiate their antenatal care visit after 18 weeks of their pregnancy which is not in line with the recommendation of the World Health Organization. Urban residence, tertiary and above level of education of the women, having pregnancy-related complications in a previous pregnancy, not having previous antenatal care visits and unplanned pregnancy were predictors of the time to initiation of antenatal care. Therefore, targeted community outreach programs including educational campaigns regarding antenatal care for women who live in rural areas, who are less educated, and who have no previous antenatal care experience should be provided, and comprehensive family planning services to prevent unplanned pregnancy are needed.
METHODS: An institution-based retrospective follow-up study was performed among 432 women. A systematic random sampling technique was employed to select the study participants. The Kaplan-Meier survival curve was used to estimate the survival time. A Multivariable Cox proportional hazard regression model was fitted to identify predictors of the time to initiation of antenatal care. An adjusted hazard ratio with a 95% confidence interval was used to assess statistical significance.
RESULTS: The median survival time to antenatal care initiation was 18 weeks (95% CI = (17, 19)). Urban residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in a previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR = 0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.
CONCLUSIONS: Half of the women initiate their antenatal care visit after 18 weeks of their pregnancy which is not in line with the recommendation of the World Health Organization. Urban residence, tertiary and above level of education of the women, having pregnancy-related complications in a previous pregnancy, not having previous antenatal care visits and unplanned pregnancy were predictors of the time to initiation of antenatal care. Therefore, targeted community outreach programs including educational campaigns regarding antenatal care for women who live in rural areas, who are less educated, and who have no previous antenatal care experience should be provided, and comprehensive family planning services to prevent unplanned pregnancy are needed.
摘要：
背景：早期产前检查对于妇女和儿童的最佳护理和健康结果很重要。在研究区,缺乏有关开始产前护理的时间的信息。所以,本研究旨在确定在ArbaMinch镇公共卫生设施分娩的孕妇开始产前护理就诊的时间及其预测因素.
方法：对432名女性进行了基于机构的回顾性随访研究。采用系统随机抽样技术选择研究参与者。Kaplan-Meier生存曲线用于估计生存时间。拟合了多变量Cox比例风险回归模型，以确定开始产前护理时间的预测因素。使用具有95%置信区间的经调整的风险比评估统计学显著性。
结果：产前护理开始的中位生存时间为18周（95％CI=（17，19））。城市住宅(AHR=2.67；95%CI=1.52，4.71)，妇女的高等教育及以上水平（AHR=1.90；95％CI=1.28，2.81），在先前的妊娠中有妊娠相关的并发症（AHR=1.53;95％CI=1.08,2.16），既往妊娠未接受产前护理(AHR=0.39;95%CI=0.21,0.71)和非计划妊娠(AHR=0.66;95%CI=0.48,0.91)是统计学显著的预测因素.
结论：一半的妇女在怀孕18周后开始产前护理，这不符合世界卫生组织的建议。城市住宅,妇女的高等教育水平，在以前的怀孕中有妊娠相关的并发症，未进行过产前护理访问和计划外妊娠是开始产前护理时间的预测因素.因此,有针对性的社区外联方案，包括关于农村地区妇女产前护理的教育运动，受教育程度较低的人，并且应该提供以前没有产前护理经验的人，需要提供全面的计划生育服务，以防止计划外怀孕。
方法：对432名女性进行了基于机构的回顾性随访研究。采用系统随机抽样技术选择研究参与者。Kaplan-Meier生存曲线用于估计生存时间。拟合了多变量Cox比例风险回归模型，以确定开始产前护理时间的预测因素。使用具有95%置信区间的经调整的风险比评估统计学显著性。
结果：产前护理开始的中位生存时间为18周（95％CI=（17，19））。城市住宅(AHR=2.67；95%CI=1.52，4.71)，妇女的高等教育及以上水平（AHR=1.90；95％CI=1.28，2.81），在先前的妊娠中有妊娠相关的并发症（AHR=1.53;95％CI=1.08,2.16），既往妊娠未接受产前护理(AHR=0.39;95%CI=0.21,0.71)和非计划妊娠(AHR=0.66;95%CI=0.48,0.91)是统计学显著的预测因素.
结论：一半的妇女在怀孕18周后开始产前护理，这不符合世界卫生组织的建议。城市住宅,妇女的高等教育水平，在以前的怀孕中有妊娠相关的并发症，未进行过产前护理访问和计划外妊娠是开始产前护理时间的预测因素.因此,有针对性的社区外联方案，包括关于农村地区妇女产前护理的教育运动，受教育程度较低的人，并且应该提供以前没有产前护理经验的人，需要提供全面的计划生育服务，以防止计划外怀孕。
