Inadequate antenatal care in women attending tertiary care hospital for delivery: Causes and consequences

Aim: To study the various causes of inadequate antenatal care in pregnant females and to evaluate the effect of inadequate antenatal care on delivery outcome.Methods: This was a case control study in which 220 women with inadequate antenatal care and 1780 women with adequate care presenting to the Department of obstetrics and gynecology, LNJP hospital, MAMC, New Delhi were evaluated in the immediate postpartum period with the help of a questionnaire to evaluate patient related factors and quality of care issues in inadequate antenatal care. The study was conducted from July 2011 to July 2012.Results: In the 220 women with inadequate antenatal care, patient related factors were responsible in 92.1% cases and in 7.9% there was deficiency in the quality of antenatal care they received. Fifty five (24.09%) women in the inadequate antenatal care had no knowledge about any component of antenatal care. Rate of maternal complications like eclampsia (p<0.0001), severe anemia (p<0.0001), obstructed labour (p=0.012) and postpartum haemorrhage (p<0.006) were significantly higher in this group. Admission in intensive care unit due to obstetric complications (18 vs 3, p<0.0001), maternal mortality (4 vs 0; p<0.0001) and perinatal complications (p<0.001) were significantly higher in women with inadequate antenatal care.Conclusion: The inadequate antenatal care was present in 11% of the women in the study group. The commonest patient related factors associated were illiteracy, low socioeconomic status and unawareness. Life threatening maternal complications, ICU admissions and maternal mortality as well as perinatal morbidity and mortality was significantly associated with inadequate antenatal care.