The association between timing of initiation of antenatal care and stillbirths : a retrospective cohort study of pregnant women in Cape Town, South Africa

dc.contributor.authorBeauclair, Roxanneen_ZA
dc.contributor.authorPetro, Gregen_ZA
dc.contributor.authorMyer, Landonen_ZA
dc.date.accessioned2016-07-14T06:19:26Z
dc.date.available2016-07-14T06:19:26Z
dc.date.issued2014-06-13
dc.descriptionCITATION: Beauclair, R., Petro, G. & Myer, L. 2014. The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa. BMC Pregnancy and Childbirth, 14:204, doi:10.1186/1471-2393-14-204.
dc.descriptionThe original publication is available at http://bmcpregnancychildbirth.biomedcentral.com
dc.description.abstractBackground There is renewed interest in stillbirth prevention for lower-middle income countries. Early initiation of and properly timed antenatal care (ANC) is thought to reduce the risk of many adverse birth outcomes. To this end we examined if timing of the first ANC visit influences the risk of stillbirth. Methods We conducted an analysis of a retrospective cohort of women (n = 34,671) with singleton births in a public perinatal service in Cape Town, South Africa. The main exposure was the gestational age at the first ANC visit. Bivariable analyses examining maternal characteristics by stillbirth status and gestational age at the first ANC visit, were conducted. Logistic regression, adjusting for maternal characteristics, was conducted to determine the risk of stillbirth. Results Of the 34,671 women who initiated ANC, 27,713 women (80%) were retained until delivery. The population stillbirth rate was 4.3 per 1000 births. The adjusted models indicated there was no effect of gestational age at first ANC visit on stillbirth outcomes when analyzed as a continuous variable (aOR 1.01; 95% CI: 0.99-1.04) or in trimesters (2nd Trimester aOR 0.78, 95% CI: 0.39-1.59; 3rd Trimester OR 1.03, 95% CI: 0.50-2.13, both with 1st Trimester as reference category). The findings were unchanged in sensitivity analyses of unobserved outcomes in non-retained women. Conclusion The timing of a woman’s first ANC visit may not be an important determinant of stillbirths in isolation. Further research is required to examine how quality of care, incorporating established, effective biomedical interventions, influences outcomes in this setting.en_ZA
dc.description.urihttp://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-204
dc.description.versionPublisher's version
dc.format.extent10 pages
dc.identifier.citationBeauclair, R., Petro, G. & Myer, L. 2014. The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa. BMC Pregnancy and Childbirth, 14:204, doi:10.1186/1471-2393-14-204.
dc.identifier.issn1471-2393 (online)
dc.identifier.otherdoi:10.1186/1471-2393-14-204
dc.identifier.urihttp://hdl.handle.net/10019.1/99179
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectStillbirth -- South Africa -- Cape Townen_ZA
dc.subjectAntenatal care -- South Africa -- Cape Townen_ZA
dc.subjectGestational ageen_ZA
dc.subjectPrenatal care -- South Africa -- Cape Townen_ZA
dc.titleThe association between timing of initiation of antenatal care and stillbirths : a retrospective cohort study of pregnant women in Cape Town, South Africaen_ZA
dc.typeArticleen_ZA
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