Antenatal Care Initiation Versus Delivery Outcomes Among Women Seeking Delivery Services at Kiambu Level Five Hospital, Kenya

Abstract

Background: Antenatal care is provided to pregnant women during pregnancy to ensure a safe pregnancy and delivery. The timing of first antenatal care (ANC) initiation is important for assessment and diagnosis of pre-existing conditions. Studies done elsewhere have shown high mortality among women who start ANC late and therefore there being no such study done in Kiambu, the researcher endeavored to establish initiation of ANC attendance versus delivery outcome thereof. Objective: To determine first antenatal timing versus delivery outcomes among women seeking delivery services in Kiambu level five hospital. Methodology: The study adopted a descriptive cross sectional design. Study population comprised of post-natal mothers who delivered in the hospital. Sample size of 235 respondents was used, calculated by Fishers‟ formula. Study participants were selected by simple random sampling. Data analysis was done using Statistical Package for Social Science (SPSS) version 21 software. Descriptive statistics involved calculation of measures of central tendency and frequencies. Inferential statistics involved seeking association between the variables where P value ≤ 0.05 was considered statistically significant. Ethical approval was sought from University of Nairobi/Kenyatta National Hospital Ethics and Research Committee and permission to carry out research in Kiambu Level five hospital was obtained from the Kiambu County Health Department and hospital administration. Results: A total of 235 mothers were interviewed during study period in the month of May 2019. Majority 53.1% (n=122) of the respondents initiated first ANC visit late, in the second and third trimester while less than half 46.9% (n=108) initiated first ANC visits early, in the first trimester. Majority, 51.3% (n=118) were aged between 15-25 years; 70% (n=161) were married; 44.3% (n=102) were para1; majority 37.8% (n=87), 42.6% (n=98) had secondary and tertiary education respectively; 53.9% (n=124) earned less than 5000Ksh per month. Of the demographic characteristics, only education had a significance association with first ANC initiation at P value of 0.028. Most respondents were aware of importance of ANC attendance. Of delivery outcome 72.6% (n=167) had vaginal delivery; 87.4% (n=201) had spontaneous onset of labor. There was a significant association of late ANC initiation and post-delivery complications at P-value 0.022.Of the neonates delivered 96.5% (n=222) were born alive while 3.5% (n=8) were still births; 82.9% had APGAR score of ≥7 in 5 minutes; 73.5% (n=191) weighed between 2500 and 3999grams, and 84% (n=188) were stable with their mothers 24hours after delivery. Perinatal outcomes analyzed did not show significant association with first ANC initiation. Conclusion: Despite majority of respondents having knowledge on importance of ANC attendance, most mothers initiated first ANC late after first trimester. Recommendation: Women need to be educated on early initiation of antenatal clinic attendance and the right time to initiate ANC would go a long in improving delivery outcome