Deciphering the Association of Antenatal Care Visits and Pregnancy Outcomes from South Africa

Optimal antenatal care (ANC) opens the windows of opportunities for timely identification and interventions for the prevention of maternal and foetal morbidity and mortality. The objectives were to determine the antenatal care utilisation patterns and its association with adverse pregnancy outcomes. A retrospective cohort study of all women giving childbirths between January 2018 to September 2019 at a midwife obstetric unit was undertaken. All variables were significant on bivariate analysis (p 4 and only 24.9% had > 8 ANC visits. Half (52.5%) of them had booking visit at or before 20 weeks gestation. There was no maternal death. Low birthweight (LBW), stillbirth and neonatal death rates were 9%, 17 and 7 per 1000 live births respectively. The number of antenatal visit was a significant predictor for stillbirth, neonatal death and LBW. Women who did not attend ANC were 22 times (OR=21.8, 95% CI: 2.51: 189.24, p=0.005), 17 times (OR=17.31, 95% CI; 1.9:157.1, p=0.001) and 11 times (OR=11.0, 95% CI; 5.4:22.19, p=0.000) more likely to have stillbirths, neonatal deaths and LBW respectively. Increasing the number of ANC visits decreased the likelihood of stillbirth, neonatal death and LBW. Few pregnant women received > 8 ANC visits. Higher numbers of ANC visits were positively associated with decreased occurrences of LBW, still births and neonatal deaths. Strengthening the ANC services should be prioritised in SA.