Prenatal care and pregnancy outcomes: A cross-sectional study in Luanda, Angola.
OBJECTIVE
To describe prenatal care in Angolan women delivered at a large tertiary care unit, and to explore the association between prenatal care and selected perinatal outcomes.


METHODS
We conducted a cross-sectional study between December 2012 and February 2013, involving 995 women aged 13-46years, delivered at Lucrécia Paím Maternity, Luanda. Trained interviewers collected information on timing, frequency, place, and satisfaction with prenatal care; sociodemographic and clinical characteristics; birth weight; and gestational age. Logistic regression models were fitted, and odds ratios with 95% confidence intervals (OR, 95%CI) estimated.


RESULTS
Quantitatively inadequate prenatal care (<4 visits) was more common in younger, less educated, poorer women, followed in public institutions, and those who felt more dissatisfied with care. More visits, both in primiparas and multiparas, were independently associated with more cesarean deliveries. After adjustment, having fewer than four visits was significantly associated with low birth weight (OR 2.00; 95% CI, 1.15-3.50) and preterm delivery (OR 2.74; 95% CI, 1.69-4.44 for 2-4 visits); similar associations were found regarding late entrance into care.


CONCLUSIONS
Early entrance into prenatal care and the recommended number of visits are major determinants of mode of delivery and pregnancy outcomes, constituting targets to improve perinatal health.
Epidemiology Research Unit, Institute of Public Health University of Porto, Porto, Portugal; Faculty of Medicine of Agostinho Neto University, Luanda, Angola.
Tazi
T
Nimi
Epidemiology Research Unit, Institute of Public Health University of Porto, Porto, Portugal.
Sílvia
S
Fraga
Epidemiology Research Unit, Institute of Public Health University of Porto, Porto, Portugal.
Diogo
D
Costa
Faculty of Medicine of Agostinho Neto University, Luanda, Angola.
Paulo
P
Campos
Epidemiology Research Unit, Institute of Public Health University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. Electronic address: hbarros@med.up.pt.
Henrique
H
Barros
D000293:Adolescent; D000328:Adult; D000810:Angola / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data; D008429:Maternal Welfare / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000517:prevention & control; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D055815:Young Adult
Angola; Cross-sectional study; Low birth weight; Pregnancy outcomes; Prenatal care