Factors associated with time to start antenatal care within 12 weeks gestational age among mothers in Mahasarakham province, Thailand

Abstract

Time to start antenatal care (ANC) within 12 weeks gestational age (GA) was important to reduce maternal mortality.  This  study  aimed  to  determine  factors  associated  with  time  to  start  antenatal  care  within  12 weeks  GA  among  postpartum  women  in  Mahasarakham  province.  A  cross-sectional  descriptive  study  was conducted  among  537  postpartum  women  delivered  in  all  hospitals  of  Mahasarakham  Province,  Thailand by using stratified sampling with proportion to size method. The self-administered questionnaires were used for this survey. Data were collected during June 1 to December 15, 2014 by using stratified sampling with proportional to size method. All cases of postpartum women who delivered in Mahasarakham province were included, except  minority  ethnic  and  illiteracy  postpartum  women.

This  study  found  that  99.6%  postpartum  women  took  at  least  1  time  to  use  services  at  ANC.  50.4% started  ANC  within  12  weeks  GA  and  18.6%  were  teenage  (age<19  years)  pregnancies.  Only  6.6%  had awareness  of  right  time  to  start  ANC  within  12  weeks  GA.   After  adjusted  for  confounding  factors,  the study  found  that  teenage  pregnancy  was  2.39  times  risk  of  delay  ANC  compare  to  adult  pregnancy  (Adj OR=2.39,  95%  CI=  1.32-4.34)  and  women  with  universal  health  coverage  insurance  was  1.66  times  (Adj OR=1.66,  95% CI =1.11-2.49)   risk of delay  ANC compare  to  the  non-UC group.

This study indicated that the first time to start ANC within 12 weeks GA should be greater publicized and  wider  campaigned  among  women  of  reproductive  age  especially  the  teenage  group.  Moreover,  the reasons  that  the  teenage  and  universal  health  coverage  group  delay  ANC  utilization  should  be  investigated more  using  a  qualitative  research.