Timing of the First Antenatal Care Contact and Maternal-Fetal Outcomes at Jaramogi Oginga Odinga Teaching and Referral Hospital
Abstract
Introduction: Early antenatal care (ANC) is essential for optimising pregnancy outcomes by identifying and addressing potential risks at the earliest stage. Despite WHO recommendations to initiate ANC within the first trimester, delays remain prevalent in low-resource settings, including Kenya. This study assessed the relationship between the timing of the first ANC visit and maternal-fetal outcomes at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Methods: A cross-sectional study of 365 women delivering at the hospital was conducted using structured interviews and ANC booklets. Data on socio-demographics, timing of the first ANC visit, and maternal-fetal outcomes were analysed using Stata version 17. Chi-square and logistic regression techniques were employed to examine associations and predictors of ANC initiation. Results: Findings revealed that 88% of women initiated ANC late, with a median gestational age of 17 weeks at first contact. Late ANC was significantly associated with stillbirths (p=0.001), while maternal complications such as preterm delivery, postpartum haemorrhage, and preeclampsia were more frequent among late initiators, though not statistically significant. Marital status emerged as a strong predictor of early ANC attendance (AOR=2.67, p=0.010), suggesting the importance of partner support in maternal health-seeking behaviour. Conclusion: These findings underscore the need for targeted interventions promoting timely ANC initiation, improved awareness campaigns, and inclusion of male partners in maternal healthcare strategies. Recommendation: Strengthening health education and system-level improvements will be critical in reducing maternal and neonatal mortality in Kenya
Downloads
References
Adam, H., Ghenimi, N., Minsart, A. F., Narchi, H., Al Awar, S., Al Hajeri, O. M., Elbarazi, I., Al-Rifai, R. H., & Ahmed, L. A. (2025). Impact of major congenital anomalies on preterm birth and low birth weight. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-10020-2
Alhassan, Y., Otiso, L., Linet Okoth, Murray, L., Hemingway, C., Lewis, J. M., Mandela Oguche, Doyle, V., Muturi, N., Ogwang, E., Barsosio, H. C., & Taegtmeyer, M. (2024). Four antenatal care visits by four months of pregnancy and four vital tests for pregnant mothers: Impact of a community-facility health systems strengthening intervention in Migori County, Kenya. BMC Pregnancy and Childbirth, 24(1). https://doi.org/10.1186/s12884-024-06386-2
Alibhai, K. M., Ziegler, B. R., Meddings, L., Batung, E., & Luginaah, I. (2022). Factors impacting antenatal care utilization: A systematic review of 37 fragile and conflict-affected situations. Conflict and Health, 16(1). https://doi.org/10.1186/s13031-022-00459-9
Atitegeb Alebachew Amsalu, Alemayehu Worku Yalew, & Awgichew Kifle Zemlak. (2025). Prevalence and determinants of late first antenatal care initiation in western Ethiopia: Findings from a multi-centered cross-sectional study. Frontiers in Reproductive Health, 7. https://doi.org/10.3389/frph.2025.1551706
Bradley, E., Blencowe, H., Moller, A.-B., Okwaraji, Y. B., Sadler, F., Gruending, A., Moran, A. C., Requejo, J., Ohuma, E. O., & Lawn, J. E. (2025). Born too soon: Global epidemiology of preterm birth and drivers for change. Reproductive Health, 22(S2). https://doi.org/10.1186/s12978-025-02033-x
Ferreira, N., Ferreira, M., Santos, E., Ferreira, S., de Arriaga, M. T., & Costa, A. (2025). Health literacy and its determinants among pregnant women in Portugal. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-24225-7
Kase, B. F., Seifu, B. L., Mare, K. U., Abdu Hailu Shibeshi, Hiwot Altaye Asebe, Kebede Gemeda, Zufan Alamrie Asmare, Yordanos Sisay Asgedom, Bezawit Melak Fente, Afework Alemu Lombebo, & Tsion Mulat Tebeje. (2025). Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data). BMC Pregnancy and Childbirth, 25(1). https://doi.org/10.1186/s12884-025-07178-y
Kere, R. N., Omoto, J., & Marwa, P. N. (2025). Utilization of eight antenatal care contacts among adolescent and adult mothers at a referral hospital in western Kenya: A comparative cross-sectional study. MedRxiv. https://doi.org/10.1101/2025.09.14.25335701
Khalil, A., Samara, A., O’Brien, P., Conrado Milani Coutinho, Silvana Maria Quintana, & Ladhani, S. (2023). A call to action: The global failure to effectively tackle maternal mortality rates. The Lancet Global Health, 11(8), e1165–e1167. https://doi.org/10.1016/s2214-109x(23)00247-4
Kimario, A. D., Gibore, N. S., Ngowi, A. F., & Masika, G. M. (2025). Antenatal care services utilization and their associated factors among postnatal women in Dodoma city: A cross-sectional study. BMC Pregnancy and Childbirth, 25(1). https://doi.org/10.1186/s12884-024-07118-2
Lee, S., Adam, E., Kanyike, A. M., Wani, S., Kasibante, S., Mukunya, D., & Nantale, R. (2024). Compliance with the WHO recommended 8+ antenatal care contacts schedule among postpartum mothers in eastern Uganda: A cross-sectional study. PLOS ONE, 19(12), e0314769. https://doi.org/10.1371/journal.pone.0314769
Leta, M., Tura, A. K., Mezmur, H., Shiferaw, K., & Assefa, N. (2025). Adverse maternal outcomes among women who gave birth at public hospitals in eastern Ethiopia: A cross-sectional study. Frontiers in Global Women’s Health, 6. https://doi.org/10.3389/fgwh.2025.1569815
Mahamud Tohan, M., Islam, Md. A., & Rahman, Md. A. (2024). Exploring the factors behind socioeconomic inequalities in antenatal care (ANC) utilization across five South Asian nations: A decomposition approach. PLOS ONE, 19(8), e0304648. https://doi.org/10.1371/journal.pone.0304648
Meldgaard, M., Gamborg, M., & Terkildsen Maindal, H. (2022). Health literacy levels among women in the prenatal period: A systematic review. Sexual & Reproductive Healthcare, 34, 100796. https://doi.org/10.1016/j.srhc.2022.100796
Mina, M. N., Nuruzzaman, M., Habib, M. N., Rahman, M., Chowdhury, F. M., Ahsan, S. N., Ahmed, F. F., Azizi, S., & Mubin, N. (2023). The effectiveness of adequate antenatal care in reducing adverse perinatal outcomes: Evidence from a low- or middle-income country. Cureus, 15(12). https://doi.org/10.7759/cureus.51254
Mohammed, S., Yakubu, I., & Awal, I. (2020). Sociodemographic factors associated with women’s perspectives on male involvement in antenatal care, labour, and childbirth. Journal of Pregnancy, 2020, 1–9. https://doi.org/10.1155/2020/6421617
Rozeta Sokou, Lianou, A., Lampridou, M., Polytimi Panagiotounakou, Georgios Kafalidis, Styliani Paliatsiou, Paraskevi Volaki, Tsantes, A. G., Boutsikou, T., Zoi Iliodromiti, & Nicoletta Iacovidou. (2025). Neonates at risk: Understanding the impact of high-risk pregnancies on neonatal health. Medicina, 61(6), 1077–1077. https://doi.org/10.3390/medicina61061077
Shibeshi, A. H., Habtie, G. M., Arega, G. G., Hussen, N. M., Hamed, K. E., & Tareke, S. A. (2025). A multilevel analysis of receipt of adequate antenatal care and its determinants among pregnant women in 11 sub-Saharan African countries: Insights from recent demographic and health surveys. Clinical Epidemiology and Global Health, 102185. https://doi.org/10.1016/j.cegh.2025.102185
Singh, A. P., Vadakedath, S., & Kandi, V. (2023). Clinical research: A review of study designs, hypotheses, errors, sampling types, ethics, and informed consent. Cureus, 15(1). https://doi.org/10.7759/cureus.33374
Souza, J. P., Day, L., Rezende-Gomes, A. C., Zhang, J., Mori, R., Baguiya, A., Jayaratne, K., Osoti, A., Vogel, J. P., Campbell, R., Mugerwa, K., Lumbiganon, P., Tunçalp, Ӧ., Cresswell, J. A., Say, L., Moran, A. C., & Oladapo, O. T. (2023). A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health, 12(2). https://doi.org/10.1016/s2214-109x(23)00468-0
Teshale, M. Y., Bante, A., Belete, A. G., Crutzen, R., Spigt, M., & Stutterheim, S. E. (2025). Barriers and facilitators to maternal healthcare in East Africa: A systematic review and qualitative synthesis of perspectives from women, their families, healthcare providers, and key stakeholders. BMC Pregnancy and Childbirth, 25(1). https://doi.org/10.1186/s12884-025-07225-8
Twagirumukiza, E., Bubanje, V., Girimpundu, R., & Sebera, E. (2024). Evolution and determinants of antenatal care services utilization among women of reproductive age in Rwanda: A scoping review. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-12038-0
Copyright (c) 2025 Justine Mogire Ocharo, Aggrey Akula Otieno, Michael Mugaba
This work is licensed under a Creative Commons Attribution 4.0 International License.
