Adequacy of prenatal careTo investigate the effect of low antenatal clinic attendance on obstetric outcomes, we performed a subgroup analysis of 210 teenagers with inadequate prenatal care compared with 6905 teenagers with adequate care. Teenagers with inadequate prenatal care were significantly more likely to be single (33.3% (n=67) vs 22.1% (n=1526), p<0.001) and to live in an urban area (73.9% (n=155) vs 66.4% (n=485), p=0.03). Although the rate of smoking during pregnancy did not differ statistically significantly in the two groups (43.9% (n=92) vs 37.3% (n=2576), p=0.07), teenagers with inadequate prenatal care were less likely to quit smoking during the first trimester (6.3% (n=13) vs 12.8% (n=884), p=0.008). No significant differences between the groups emerged as regard being underweight (11.4% (n=138) vs 10.4% (n=718), p=0.62) or obese (4.7% (n=10) vs 6.3(n=435), p=0.40), or misuse of alcohol or drugs during pregnancy (0.5% (n=1) vs 1.2% (n=81), p=0.73).Teenagers with inadequate prenatal care were at significantly higher risks of eclampsia and UTI, even afteradjustment for confounding factors (table 5). No excess risks of delivery complications were seen. The increased risk of stillbirth and neonatal mortality was almost entirely explained by premature births among teenagers with inadequate prenatal care.
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