The effect of frequency of antenatal visits on pregnancy outcome in Kaduna, Northern Nigeria

Context: The benefit of antenatal care is no longer in doubt, but the ideal number of encounters to achieve those benefits has been the subject of discussion among maternity care stakeholders. Objective: To study the effect of frequency of antenatal visits on pregnancy outcome. Materials and Methods: This is a prospective study of 228 pregnant women attending the antenatal clinic of the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, over a 3-month period. Maternal and fetal outcome were compared against the frequency of antenatal visits. Results: The mean frequency of visits was 6.77. Majority of the women 124 (54.4%) attended less than seven times. Compliance with antenatal drugs and mean hemoglobin level at delivery increased with increasing frequency of visits reaching 93.7% and 11.44 g/dl, respectively, in the moderate attendees (4–6 visits). Prevalence of anemia was high (56.7%) among the unbooked but lowest (9.5%) with moderate attendees. Thereafter, there was no significant improvement. Delivery mode, malaria parasitemia, and gestational age at delivery were fairly uniform in all the groups. The prevalence of low birth weight was 20% in the unregistered and decreased from 22% in the low frequency (1–3 visits) group, to 4.8% in the moderate attendees, and to 0% in the very high-frequency (ten and above visits) group. Mean Apgar scores at 1 and 5 min were also best (7.1/8.1) in the moderate attendees and worst in the unregistered. Conclusion: More than six visits conferred no significant advantage on fetomaternal outcome. Therefore, the new WHO recommendation on reduced antenatal visits can be satisfactorily implemented in Kaduna.