Examining prenatal care's predictive role in maternal haemoglobin concentration at childbirth

Prenatal care and maternal haemoglobin concentration at childbirth: insights from a district hospital

Abstract

Background: Antenatal care (ANC) encompasses clinical assessments, health advice, and medical guidance on maternal changes, nutrition, and supplements to promote maternal and fetal well-being and thus prevent pregnancy-related complications. Despite these efforts, maternal anaemia remains prevalent in resource-limited settings such as the Kwaebibirim district in the eastern region of Ghana.
Objective: This study aimed to explore the link between the frequency of ANC visits and increased maternal haemoglobin concentration (mHgbc) levels.
Methods: This study employed an analytical cross-sectional design using secondary data from birth registers in the district hospital’s labour suite to assess variations in mHgbc levels across different ANC visit frequencies. Statistical analyses included descriptive analysis, one-way ANOVA and unpaired two-sample t-tests.
Results: The mean number of ANC visits was 6.06 (SD 3.23), and the mean mHgbc was 10.34 g/dl (SD 1.42). ANC visits ranged from 0 to 16, while mHgbc levels ranged from 1.6 g/dl to 16.3 g/dl. Most women attended 4 - 8 ANC visits (54.7%), followed by 0 - 3 visits (23.25%) and ≥ 9 visits (22.1%). A higher frequency of ANC visits was associated with higher mHgbc levels. One-way ANOVA revealed significant differences in mean mHgbc among the 0 - 3, 4 - 8, and ≥ 9 ANC visit groups. Post hoc unpaired two-sample t-tests confirmed significant differences in mean mHgbc between 0 - 3 vs. 4 - 8 and 4 - 8 vs ≥ 9 visits. However, no significant differences were observed between 0 - 3 and 4 - 8 visits in women aged 21 – 30 years, those with senior high school education, formal occupations, and multiparae. Similarly, preterm or early-term deliveries and women with blood group A showed no significant differences between 4 - 8 and ≥ 9 visits.
Conclusion: Increased ANC visit frequency is associated with higher mHgbc levels. However, further prospective studies are needed to identify which ANC components underlie this observation and further address the limitations of secondary data.