ABSTRACT
Background: Antenatal clinic attendance increases the opportunity for good labour outcomes. There is paucity of studies on how pattern of antenatal attendance modifies the labour outcome. This facility-based ex-post-facto study assessed the influence of pattern of antenatal attendance on labour outcomes. Method: Cross sectional study of 302 women (15 - 49 years) that delivered and are within first 24 hours postpartum in four selected hospitals in Owerri, Imo state, Nigeria. Observational checklist and structured questionnaire are instruments for data collection which was administered via interview. The maternal antenatal records were consulted for some obstetrics and gynecological data. Chi-square was used to analyze the data and level of significance was 5% (0.05). Result: Most of the participants 134 (44.4%) were within the age of 29 - 35 years with mean age of 30.00 ± 5.82. Majority of them were married 281 (93.0%), most 219 (72.5%) were multiparous and 179 (59.3%) had tertiary education while 7 (2.3%) had no formal education. Majority of the women that attended ANC visit > 5 times had the highest number of spontaneous vaginal delivery 58 (45.3%), normal birth weight 89 (47.8%), Apgar score 93 (49.7%) ≥ 7, favourable peripartum maternal condition 72 (55.4%) and postpartum neonatal conditions 99 (48.1%), while those that had less than five ANC visit especially those that had < 3 ANC visit had the highest number of maternal distress 22 (71%), obstructed labour 8 (57.1%), and retained placenta 15 (60.0%), assisted vaginal delivery 13 (43.3%), post term babies 22 (48.9%), still birth 16 (53.3%), low birth weight 22 (48.9%) and very poor Apgar score 22 (52.4%). Peripartum maternal condition, mode of delivery, postpartum neonatal condition, 5th minute Apgar score and birth weight had significant relationship with the number of ANC visit (P < 0.001). The gestational age at booking was also significantly associated with labour outcome (P < 0.001). Majority of the participants who booked within 13 - 28 weeks GA had spontaneous vaginal delivery 86 (67.2%), satisfactory peripartum condition 91 (70.0), the highest live birth, good 5th minute Apgar score 133 (71.1%) and normal birth weight 124 (66.7%). Those who booked at third trimester (>28 weeks) had the highest emergency CS 48 (47.1%), maternal distress 28 (90.3%), ruptured uterus 2 (100%), post term 31 (68.9%), while those that booked at first trimester (<13 weeks) had no prolonged labour 0 (0%), ruptured uterus 0 (0%) and post term. The number of intermittent preventive therapy for malaria (IPT) taken had a significant relationship with labour outcome (P < 0.001). Women who had 2 doses of IPT 143 (47.4%) had favourable labour outcome; 60 (46.9%) had SVD, 57 (43.8%) had no complication, 88 (42.7%) had live birth, 80 (42.8%) had good 5th minute Apgar score and 82 (444.1%) women had normal birth weight babies. Percentage of RDS taken is significantly associated with the labour outcome (P < 0.001). Among the 54 (17.9%) that took less than 9% of their given RDS, 15 (50.0%) had AVD, 25 (80.6%) had maternal distress, 14 (56.0%) had retained placenta 14 (56.0%), 27 (60.0%) had post term babies, 17 (56.7%) had still birth, 22 (52.4%) of their babies had poor 5th minute Apgar score, while 20 (44.4%) had LBW babies. Among 66 (21.9) women who took 70% or more of their RDS, 4 (13.35) had AVD, 1 (3.2%) had maternal distress, 0 (0.00%) had retained placenta, 0 (0.00%) had post term babies, 2 (6.7%) had still birth, 6 (14.3%) had poor 5th minute APGAR score, 16 (13.3%) had LBW babies. Conclusion: Poor antenatal health seeking behavior and non-adherence to antenatal advice are associated with some maternal and neonatal complications during labour and the postpartum period.