Utilization of antenatal care and its influence on fetal-maternal outcome: a tertiary care experience

Background: To compare the sociodemographical characteristics, obstetrical complications, and fetal-maternal outcomes in booked and unbooked mothers.Methods: In a prospective study over an 18 month period, outcomes of pregnancy booked for antenatal care were compared with that of unbooked women, who delivered in the Department of Obstetrics and Gynecology, NEIGRIHMS. Results: 802 patients were recruited to study. 479 (59.73%) were unbooked and 323 cases (40.27%) were booked. Compared with booked mothers, majority of unbooked mothers belonged to lower social class, came from remote areas and had a significant higher incidence of teenage pregnancy and Grand multiparity. Unbooked mothers had higher incidence of anemia (p< 0.0001), pregnancy induced hypertension (p= 0.033), post dated pregnancy (p<0.0001) and malpresentation (p= 0.013). Three maternal deaths were noted in the unbooked group compared to only one death in the booked group. Overall, maternal morbidity was 4.74%, with a significant difference between the two groups (p< 0.0001). 10.33% babies of unbooked and 6.12% of booked cases needed neonatal intensive care (p= 0.036). The incidence of meconium stained amniotic fluid, birth asphyxia, perinatal deaths, low birth weight and APGAR score <7 at 1 min and 5 min were significantly higher in babies of unbooked mothers.Conclusion: Poor utilization of antenatal care is associated with adverse fetal and maternal outcome