Birth outcomes among booked and unbooked women at a secondary health facility in southwest Nigeria

Abstract

A case-controlled analytic study involving 406 singleton unbooked and 396 singleton booked births was conducted. Unbooked births constituted 16.6% of all births during the study. Booked births were half as likely to preterm than unbooked births (43, 10.9% vs 81, 20.0%; p<0.001). Unbooked births were seven times more likely to be stillbirth than booked births (80, 17.7% vs 13, 3.3%; p< 0.001). Booked births were a third as likely to have a low birth weight as unbooked births (36, 9.1% vs 104, 25.6%; p< 0.001). Unbooked births had a significantly lower mean birth weight of 2.95 ± 0.53 kg than 3.08 ± 0.45 kg of booked births (p< 0.001). Unbooked births had a significantly lower mean Apgar score at 1 minute and 5 minutes than booked births (6.64 ± 1.42 vs 7.08 ± 1.12 and 9.16 ± 1.40 vs 9.64 ± 1.00; p< 0.001) respectively. Unbooked births are common and their birth outcomes may result in high morbidity and disability, thereby contributing to the high child mortality in developing countries. Strengthening perinatal health services through professional skilled care at birth and providing quality services for all unbooked births may lead to improved birth outcomes.

Attendance at antenatal clinics in inner-city Johannesburg, South Africa and its associations with birth outcomes: analysis of data from birth registers at three facilities

“…By not attending ANC, it is not possible to identify women who have high-risk pregnancies and refer them for closer monitoring during childbirth, or for an elective Caesarean section at a secondary or tertiary centre [24]. Thus, not surprisingly, not attending antenatal care was associated with a considerably higher risk for preterm delivery and stillbirths in this population, consistent with previous reports [4, 25–28]. Similarly, the high levels of maternal mortality in women not attending ANC in the country can likely be ascribed to the women not having attended the appropriate level of care during pregnancy and childbirth, and not having received interventions during pregnancy such antiretroviral treatment [13, 14].…”

“…Rates of ANC attendance, however, remain suboptimal in many low- and middle-income countries (LMICs) [4, 5]. Within the southern and eastern regions of Africa, coverage ranges from 60% in Lesotho to 95% in Rwanda, with most countries around the 80% mark [6].…”

Study of Maternal and Fetal Outcome among Booked and Unbooked Patients at tertiary Hospital

“…Similar to the mother, the perinatal health is also hampered by the absence of antenatal visits.Unbooked cases were also more prone to have preterm delivery (14.7% vs 39%) and deliver low birth weight babies (24.5% vs 9.8%). Similar 3 findings were noted in the studies by Owolabiet al and 13 Osungbade et al Increased incidence of anemia in unbooked pa ents could also be a risk factor for preterm 11 delivery as noted in study done by Tucker et al…”

Stillbirth in cases of severe acute maternal morbidity

“…The findings of adverse perinatal outcomes among women referred from peripheral healthcare facilities may be a reflection of the quality of EMOC available in those centers. Missed opportunities for early detection and prompt management of fetal and maternal conditions that adversely compromise fetal survival are responsible for unfavorable birth outcomes among women without prenatal care [19].…”