Preterm births remain a major global public health
challenge. Globally it’s estimated that 15 million babies are born preterm
annually and this number is raising 1. Approximately, 1.1 million babies die annually
due to complications of prematurity, with vast majority occurring in
sub-Saharan Africa. 2 For the babies that survive, many face a lifetime of
significant disabilities, including learning, visual and hearing problems.
Early commencement of antenatal care is well-known to be an effective method in
improving birth outcomes 3, 15.
The World Health Organisation (WHO) recommends a
minimum of 4 antenatal visits (ANC), the first not more than 12 weeks pregnant
3. However, global estimates indicate that only about half of all pregnant
women complete the recommended number of ANC visit 4. Among many factors, previous studies have identified physical access to
health facilities, lack of health education and misconceptions of antenatal
care (ANC) as factors influencing timing and attendance of ANC 8,12.
Although there has been substantial progress
towards the sustainable development goal 3, adverse birth outcomes from
preventable pregnancy and birth related complications remain high in low and
middle income countries 2, 9.
Uganda is one
of the countries grappling with high rates of preterm births (14%) compared to
global estimates of 11%. Complications of prematurity are the leading cause of
neonatal mortality and are directly responsible for 38% of neonatal deaths 5,
6. According to Uganda health demographic survey (2016), 93.7% of the young
mothers attend atleast 1 ANC visit, however only 51% report for the first ANC
visit before 12 weeks pregnant. Several studies have highlighted an interaction
between preterm births and maternal age. Young mothers have been found to be
more vulnerable to having preterm births compared to their counterparts 16-17.
Although research has showed ANC
to be an effective method of preventing adverse pregnancy outcomes 12-14,
however little is known on the impact of ANC timing and number of ANC visits on
the occurrence of preterm births especially among the young mothers. Therefore,
this research will focus on the delayed entry and number of ANC visits and its
association to preterm births among young mothers in Uganda.
To assess whether ANC attendance (?4 versus