Prevalence and factors associated with late antenatal booking among pregnant women at Kawempe National Referral Hospital.

Abstract

Introduction: Booking early for antenatal is associated with earlier detection and management of pregnancy complications which in turn improves pregnancy outcomes. Yet the majority of pregnant women book late for ANC. The objective of this study was to determine the prevalence and factors associated with late antenatal booking among pregnant women at Kawempe National Referral Hospital (KNRH). Methods: This was a cross sections-sectional study involving 438 systematically sampled pregnant women attending ANC at KNRH. The prevalence of late antenatal booking was computed as a proportion expressed as a percentage. Factors associated with late antenatal booking were explored using generalized linear models with a Poisson family and log link (modified Poisson regression) with robust standard errors. Prevalence ratios were estimated along with their 95% confidence intervals. Findings: The median age of the participating mothers was 24 years. The median gestation age of the participating mothers was 26 weeks. The prevalence of late antenatal booking in this study was 61.9%. Being single/ divorced/ separated (aPR = 1.33, p-value = 0.001), respondents considering >16 weeks as appropriate for ANC initiation (aPR = 1.70, p-value< 0.001), friends and relatives advising respondent to start ANC (aPR = 1.73, p-value< 0.001); and experiencing complications during the current pregnancy (aPR = 1.31, p-value = 0.006) were associated with increasing prevalence of late antenatal booking. Respondents who were educated were associated with decreased prevalence of late antenatal booking compared to those who had not been to school ((aPR 0.50 CI 0.37-0.65, p-value<0.001), (aPR 0.56 CI 0.45-0.69, p-value<0.001) and (0.53 CI 0.40-0.71, p-value<0.001) for primary, secondary and post-secondary participants respectively)). Long waiting time at the previous ANC (aPR = 0.76, p-value<0.002) and having complications during the previous pregnancy (aPR = 0.79, p-value<0.040) were associated with decreased prevalence of late antenatal booking. Conclusions and recommendations: Almost two-thirds of women booked late for ANC. Being single/divorced/separated, lack of education, lack of correct knowledge on the right time to book for ANC, need for one to be advised to start ANC, and complications in the present pregnancy were found to be significantly associated with the late antenatal booking. Health education on appropriate ANC practices and the timing of antenatal booking should be emphasized to women of reproductive age to maximize the benefits offered by antenatal care.