Quality of Antenatal Care and Outcome of Pregnancy in a Semi-Urban Area in Fako Division, Cameroon: A Cross-Sectional Study

Abstract

The outcome of pregnancy depends, to a large extent, on the availability and effectiveness of antenatal care. Unskilled care before, during and after child birth, late start and inconsistent attendance of Antenatal care (ANC), and poor ANC package are seen frequently. However, the extent to which these practices affect pregnancy outcome are not known in Fako Division, South West Region, Cameroon. Objective: The objective of this study was to determine the relationship between the outcome of pregnancy and the quality of ANC in the aforementioned setting. Patients and Methods: This was a hospital based cross-sectional study that involved 300 immediate post-partum women in three hospitals in Fako Division, Cameroon. Data was collected using a structured questionnaire in a two-step manner; face-to-face interview, and from women's case notes during ANC and their delivery records. Data was analyzed using Epi Info version 7.1.4.0 (CDC, Atlanta, USA, 2015) statistical software. Results: Mean gestational age at start of ANC was 19.2 weeks (SD 4.2 years), 99% of participants attended at least one ANC consultation, 15.5% started ANC early; 58% attended 4 ANC visits. Six-seven percent of them received adequate care. There was a strong negative correlation between gestational age at start of ANC and overall adequate care (p-value 0.001). Inadequate care, being a teenager, and single were associated with adverse pregnancy outcomes. Inadequate care was also associated with pre-term birth, post-term birth, labour induction, dystocia, labour augmentation, stillbirth, low APGAR score, and low birth weight. (All p-values <0.05). Conclusion: Adverse pregnancy outcomes in this region were associated with poor quality ANC. Sensitization of women on the benefit of quality ANC, better health care services with well-trained health care personnel, and research to find out a more precise diagnosis of causes of adverse foeto-maternal outcomes will lead to reduced fetal and maternal morbidity and mortality.