Comparative Study of the Obstetric Outcome between Booked and Unbooked Mothers at the Federal Medical Centre, Abeokuta: A Two-Year Review

Abstract

Pregnancy is a physiological process but sometimes becomes complicated. Antenatal care is aimed at preventing, early detection and treatment of these complications when they occur. The study aimed to determine the prevalence of unbooked pregnancies delivered at our centre and compare their socio-demographic pattern, pregnancy outcomes and maternal/perinatal morbidity/mortality with those who booked and delivered during the same period. It was a retrospective comparative study carried out among unbooked and booked mothers who delivered at our obstetric unit over a two-year period of January 2014 to December 2015. The casenotes were retrieved and analyzed. There were 2232 deliveries during the period under review. Unbooked pregnancies were 235 (10.52% of total deliveries). Unbooked women were younger compared to the booked(29.24 ±5.74 years versus 30.99 ± 4.17 years), less educated, and nine times more likely to be single (23.92% versus 2.56% respectively). Emergency caesarean section was performed in 58.72% of the unbooked mothers while 60.14% of their booked counterparts had spontaneous vaginal deliveries. Instrumental vaginal deliveries were also more common among the unbooked group. Birth asphyxia and perinatal morbidity/mortality were commoner in the unbooked group. Maternal mortality was 25 times more likely with the unbooked compared to booked mothers. In conclusion, low socio-demographic status has direct correlation with booking status of pregnancy in our environment. Unbooked pregnancies were more associated with poor pregnancy outcomes and maternal mortality compared to the booked ones. It is recommended that affordable and quality antenatal care services be made available in every community while also educating the healthcare givers on need for early referral of high risk pregnancies