Impact of reduced prenatal visit frequency on obstetric outcome in low-risk mothers.
OBJECTIVE
To determine an association between reduced prenatal visit frequencies and pregnancy outcome in women, found to be at low-risk of obstetric complications at initial prenatal visit.


METHODS
Prospective cohort study.


METHODS
Mother and Child Health Center, Pakistan Institute of Medical Sciences, Islamabad. from January to December 2002.


METHODS
The hospital case records of 1290 women, who were found to be at low risk of obstetric complications at their first prenatal visit. Prenatal visits were categorized into '<3', '3-6' and 'z 7 visits groups'. 'z7 visits were taken as controls. The main outcome measures were peripartum maternal complications, obstetric interventions and perinatal outcome.


RESULTS
The median number of prenatal visits was four, (range 1-14; lower quartile 2, upper quartile 6). Women with less than 3 prenatal visits had significantly higher risk of antepartum complications, low birth weight neonates (<2500 grams), pre-term deliveries, neonatal morbidity, and peri-natal mortality. (OR: 2.58, 2.66, 6.3, 1.57 and 2.2 respectively). However, they were at equal risk of obstetric interventions and postpartum maternal morbidity. No significant difference was found between 3-6 visits and z7 visits group, except significantly higher risk of preterm deliveries in the former group (OR: 2.84).


CONCLUSIONS
Less than 3 prenatal visits were associated with significantly higher incidence of prenatal feto-maternal complications and low birth weight babies compared to 7 or more visits but were at equal risk of obstetric interventions and postpartum maternal morbidity.The obstetric outcome of 3-6 visits group was similar to 7 or more visits group except considerably higher incidence of preterm deliveries in the former group.
Tasnim
Nasira
N
Department of Obstetrics and Gynecology, MCH Center, Pakistan Institute of Medical Sciences, Islamabad.
Mahmud
Ghazala
G
Arif
Mohammed Shafique
MS
D000328:Adult; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors