Relationship Between Uptake of Antenatal Care Services and Low Birth Weight in the Gushegu District of Northern Ghana
DOI:
https://doi.org/10.6000/1929-4247.2013.02.03.6Keywords:
Antenatal care utilization, Low birth weight, Birth weight, pregnancy, deprived environment, Northern GhanaAbstract
Objective: Little is known about the relative contribution of prenatal care utilization on pregnancy outcome in developing country setting where other equally important predictors of low birth weight (LBW) including malarial infection and poor diet predominate. This study investigated whether the utilization of antenatal care (ANC) services is an independent predictor of LBW in Northern Ghana.
Methods: In this community based cross sectional study, we compared pregnancy outcome (birth weight) across groups of 407 women who received different amounts of ANC.
Results: The incidence of low birth weight (LBW) of newborn babies was 18.2 % (74/407). The main finding was that women who made at least four ANC visits had 63.0 % protection against delivering a LBW (AOR = 0.37, 95 % CI: 0.19, 0.69).
Conclusion: The results of this study suggest that adequate antenatal care is effective in preventing LBW in a rural setting but its effect was more discernible among women who were not in gainful employment (suggestive of low socio-economic status).
References
WHO: World Health Statistics 2008. Geneva: WHO 2008.
Morris SS, Victora CG, Barros FC, Halpern R, Menezes AB, Cesar JA, et al. Length and ponderal index at birth: associations with mortality, hospitalizations, development and post-natal growth in Brazilian infants. Int J Epidemiol 1998; 27: 242-47. http://dx.doi.org/10.1093/ije/27.2.242
Barker DJP. The origins of the developmental origins theory. J Inter Med 2007; 261: 412-17. http://dx.doi.org/10.1111/j.1365-2796.2007.01809.x
De Boo HA, Harding JE. The developmental origins of adult disease (Barker) hypothesis. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2006; 46: 4-14. http://dx.doi.org/10.1111/j.1479-828X.2006.00506.x
Black SE, Devereux P, Salvanes KG. From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes. Quarterly J Econom 2007; 22(1): 409-39. http://dx.doi.org/10.1162/qjec.122.1.409
Oreopoulos P, Stabile M, Walld R, Roos L. Short, Medium, and Long Term Consequences of Poor Infant Health: An Analysis Using Siblings and Twins. J Infect Dis Human Resour 2008; 43(1): 88-138.
IOM (Ed.). Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC.: The National Academies Press 2005.
Warner G. Prenatal Care Demand and Birthweight Production of Black Mothers. Am Econom Rev 1995; 85(2): 132-37.
Liu GG. Birth Outcomes and the Effectiveness of Prenatal Care. Health Services Res 1998; 32(6): 805-23.
Rous JJ, Jewell RT, Brown RW. The effect of prenatal care on birthweight: a full-information maximum likelihood approach. Health Econom 2003; 13: 251-64. http://dx.doi.org/10.1002/hec.801
Smith Conway K, Partha D. Is Prenatal Care Really Ineffective? Or, is the 'Devil' in the Distribution?” Hunter College Department of Economics Working Papers 2004; 02(2).
Krueger PM, Scholl TO. Adequacy of prenatal care and pregnancy outcome. JAOA 2000; 100(8): 485-92.
Deb P, Sosa-Rubi S. Does onset or quality of prenatal care matter more for infant health? HEDG Working Paper 2005; 5(11).
Guilkey DK, Popkin BM, Akin JS, Wong E. Prenatal Care and Pregnancy Outcome in the Philippines. J Develop Econom 1989; 30: 241-72. http://dx.doi.org/10.1016/0304-3878(89)90003-5
Ministry of Health: Annual report 2007, 2nd ed. edition. Accra, Ghana: Ministry of Health 2007.
WHO: Antenatal Care Department of Technical Working Group 1994 WHO/FRIt/msm/968. Geneva: WHO 1999.
Villar JH, Ba’aqeel G, Piaggio P, Lumbiganon JM, Belizán U, Farnot Y, et al. WHO antenatal care randomized trial for the evaluation of a new model of routine antenatal care. Lancet 2001; 357: 1551-64. http://dx.doi.org/10.1016/S0140-6736(00)04722-X
UNICEF: Multiple Indicator Cluster Survey (MICS). Accra: UNICEF, Ghana Health Service 2009.
Kotelchuck M. An Evaluation of the Kessner Adequacy of Prenatal-Care Index and A Proposed Adequacy of Prenatal-Care Utilization Index. Am J Public Health 1994; 84: 1414-20. http://dx.doi.org/10.2105/AJPH.84.9.1414
MOH: Annual report 2010, Accra, Ghana: Ministry of Health 2010.
US Department of Health and Human Services: Maternal, Infant, and Child Health. In Healthy People Vol II, . 2nd ed. Washington, DC: Available: http: //www.healthypeople.gov /document/html/volume2/16mich.htm], Accessed 12-10-2012.
Berg CJ. Prenatal care in developing countries: the World Health Organization Technical Working Group on Antenatal Care. J Am Med Women’s Assoc 1995; 50(5): 182-86.
Kogan MD, Alexander GR, Mor JM, Kieffer EC. Ethnic-specific predictors of prenatal care utilisation in Hawaii. Paediatr Perinat Epidemiol 1998; 12: 152-62. http://dx.doi.org/10.1046/j.1365-3016.1998.00105.x
Koroukian SM, Rimm AA. The Adequacy of Prenatal Care Utilization (APNCU) index to study low birth weight: is the index biased? J Clin Epidemiol 2002; 55: 296-305. http://dx.doi.org/10.1016/S0895-4356(01)00471-1
Kwast BE, Luff JM. Factors associated with maternal mortality in Addis Ababa. Ethiopia. Intl Epidemiol 1988; 17: 115-21. http://dx.doi.org/10.1093/ije/17.1.115
UNICEF: Women’s health in Pakistan. In Fact sheets prepared for Pakistan National Forum on Women’s Health, Karachi, Pakistan: UNICEF, Pakistan 1997: 16-17.
Hussain MT. Factors affecting the use of antenatal care in Urban Bangladesh. Urban Health Dev Bul 1998; 1-4.
Griffiths P, Stephenson R. Understanding the user's perspectives of barriers to maternal health care in Maharashtra. Indian J Biosocial Sci 2001; 33: 339-59. http://dx.doi.org/10.1017/S002193200100339X
CRS Ghana: Encouraging Positive Practices for Improving Child Survival (EPPICS) Knowledge, Practice and Coverage (KPC) survey , Tamale: Catholic Relief Services 2011.
Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 1987; 65: 663-37.
Institute of Medicine: Preventing low birthweight. Washington, DC: National Academy Press 1985.
Frick KD, Lantz PM. Selection Bias in Prenatal Care Utilization: An Interdisciplinary Framework and Review of the Literature. Med Care Res Rev 1996; 53(4): 371-96. http://dx.doi.org/10.1177/107755879605300401
Alexander GR, Korenbrot CC. The Role of Prenatal Care in Preventing Low Birth Weight The Future of Children 1995; 5(1): 103-20.
Kramer MS, Se´guin L, Lydon J, et al. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000; 14(3): 194-10. http://dx.doi.org/10.1046/j.1365-3016.2000.00266.x
Doyle W, Wynn AHA, Crawford MA, et al. Nutritional counseling and supplementation in the second and third trimester of pregnancy, a study in a London population. J Nutr Med 1992; 3(3-4): 249-56. http://dx.doi.org/10.3109/13590849208997980
Scholl TO, Hediger ML, Bendich A, et al. Use of multivitamin/ mineral prenatal supplements: influence on the outcome of pregnancy. Am J Epidemiol 1997; 146(2): 134-41. http://dx.doi.org/10.1093/oxfordjournals.aje.a009244
Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy [electronic article]. Cochrane Database Syst Rev (CD004905) 2006.
Shah PS, Ohlsson A. Knowledge Synthesis Group on Determinants of Low Birth Weight and Preterm Births. Effects of prenatal multimicronutrient supplementation on pregnancy outcomes: a meta-analysis. CMAJ 2009; 180(12): E99-E108. http://dx.doi.org/10.1503/cmaj.081777
Nazim NH, Fan L. Does prenatal healthcare improve child birth weight outcomes in Azerbaijan? Results of the national demographic and health survey. Econom Human Biol 2011; 9(1): 56-65. http://dx.doi.org/10.1016/j.ehb.2010.08.003
Jewell RT, Triunfo P. The Impact of prenatal care on birth weight: The case of Uruguay. Health Econom 2006; 15(11): 1245-50. http://dx.doi.org/10.1002/hec.1121
Rous JF, Jewell RT, Brown RW. The effect of prenatal care on birth weight: A full-information maximum likelihood approach. Health Econom 2004; 13(3): 251-64. http://dx.doi.org/10.1002/hec.801
Raatikainen K, Heiskanen N, Heinonen S. Under-attending free antenatal care is associated with adverse pregnancy outcomes. BMC Public Health 2007; 7: 268. http://dx.doi.org/10.1186/1471-2458-7-268
Goldani MZ, Barbieri MA, Silva AAM, Bettiol H. Trends in prenatal care use and low birthweight in Southeast Brazil. Am J Public Health 2004; 94(8): 1366-71. http://dx.doi.org/10.2105/AJPH.94.8.1366
Mwabu G. The production of child health in Kenya: a structural model of birth weight. J Afr Econom 2009; 18(2): 212-60. http://dx.doi.org/10.1093/jae/ejn013
Wehby GL, Murray JC, Castilla EE, Lopez-Camelo JS, Ohsfeldt RL. Qunatile effects of prenatal care utilization on birth weight in Argentina. Health Econom 2009; 18(11): 1307-21. http://dx.doi.org/10.1002/hec.1431
Frank RG, Strobino DM, Salkever DS, Jackson CA. Updated estimates of the impact of prenatal care on birthweight outcomes by race. J Human Lactation Resour 1992; 27(4): 629-42. http://dx.doi.org/10.2307/146078
Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC. Risk factors accounting for racial differences in the rate of premature birth. N Engl J Med 1987; 317: 743-48. http://dx.doi.org/10.1056/NEJM198709173171206
Alexander GR, Cornely DA. Racial disparities in pregnancy outcomes: the role of prenatal care utilization and maternal risk status. Am J Prev Med 1987; 3: 254-61.
Garrido GG. The impact of adequate prenatal care in a developing country: Testing the WHO recommendations. Available at (www.ttp: //paa2010.princeton.edu/papers/ 100732), accessed on 18-10-2012; 2009.
Fiscella K. Does prenatal care improve birth outcomes? A critical review. Obstet Gynecol 1995; 85: 468-79. http://dx.doi.org/10.1016/0029-7844(94)00408-6
Alexander GR, Kotelchuck M. Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research. Public Health Rep 2001; 116: 306-16.
Shoham-Vardi I, Levy E, Belmaker I, Mazor M, Goldstein D. Utilisation of prenatal services and birth outcomes: a community-based study in Israel. Paediatr Perinat Epidemiol 1997; 11: 271-86. http://dx.doi.org/10.1111/j.1365-3016.1997.tb00005.x
Kogan MD, Alexander GR, Kotelchuck M, et al. Trends in twin birth outcomes and prenatal care utilization in the United States, 1981-1997. JAMA 2000; 284: 335-41. http://dx.doi.org/10.1001/jama.284.3.335
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
