Is timing of the first antenatal visit associated with adverse birth outcomes? Analysis from a population-based birth cohort

• Published in: The Lancet (British edition) 2016-11, Vol.388, p.S18-S18
• Main Authors: Alwan, Nisreen A, Dr, Roderick, Paul J, Prof, Macklon, Nick S, Prof
• Format: Article
• Language: English
• Subjects: Internal Medicine
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(16)32254-1

Abstract Background Adequate antenatal care can improve maternal and child health outcomes. The UK National Institute for Health and Care Excellence (NICE) recommends that the first antenatal visit with a health-care professional should occur by 10 weeks' gestation. The WHO Focused Antenatal Care Protocol recommends that it happens no later than 16 weeks' gestation. We aimed to examine the associations between timing of the first antenatal booking visit and adverse birth outcomes including low birthweight, preterm birth, and stillbirth. Methods Antenatal and delivery records from a population-based cohort consisting of all women receiving maternity care at University Hospital Southampton, UK, during 2000–13 were analysed (74 449 pregnancies of which 64 739 had delivery data). We conducted multiple logistic modelling to assess the associations of interest. All models computed a cluster-robust standard error of the difference to account for clustering in women with more than one pregnancy included. Findings 74 220 pregnancies had booking timing information. Mean gestational age at booking was 12·6 weeks (SD 5·3), with 21 482 pregnancies (29%) having their booking visit by 10 weeks' gestation, 45 015 (61%) by 12 weeks', 59 986 (81%) by 14 weeks', and 65 755 (89%) by 16 weeks'. Of the 64 246 livebirths, 4009 (6·2%) were of low birthweight (