Nasira Tasnim, Ghazala Mahmud, Mohammed Shafique Arif.
Impact of reduced prenatal visit frequency on obstetric outcome in low-risk mothers.
J Coll Physicians Surg Pak Jan ;15(1):26-9.

Objective: To determine an association between reduced prenatal visit frequencies and pregnancy outcome in women, found to be at low-risk of obstetric complications at initial prenatal visit. Design: Prospective cohort study. Place and Duration of Study: Mother and Child Health Center, Pakistan Institute of Medical Sciences, Islamabad. from January to December 2002. Patients and Methods: The hospital case records of 1290 women, who were found to be at low risk of obstetric complications at their first prenatal visit. Prenatal visits were categorized into `<3`, `3-6` and `>=7 visits groups`. `>7` visits were taken as controls. The main outcome measures were peripartum maternal complications, obstetric interventions and perinatal outcome. Results: The median number of prenatal visits was four, (range 1-14; lower quartile 2, upper quartile 6). Women with less than 3 prenatal visits had significantly higher risk of antepartum complications, low birth weight neonates (<2500 grams), pre-term deliveries, neonatal morbidity, and peri-natal mortality. (OR: 2.58, 2.66, 6.3, 1.57 and 2.2 respectively). However, they were at equal risk of obstetric interventions and postpartum maternal morbidity. No significant difference was found between 3-6 visits and >7 visits group, except significantly higher risk of preterm deliveries in the former group (OR: 2.84). Conclusion: Less than 3 prenatal visits were associated with significantly higher incidence of prenatal feto-maternal complications and low birth weight babies compared to 7 or more visits but were at equal risk of obstetric interventions and postpartum maternal morbidity.The obstetric outcome of 3-6 visits group was similar to 7 or more visits group except considerably higher incidence of preterm deliveries in the former group.

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