Earlier the Patients Entering Into Prenatal Care, Higher the Cesarean Rates: Analysis of 17.035 Cases

Abstract

Objective: To analyze whether the time the patients entering into prenatal care affects the route of delivery, maternal, and fetal outcomes.

Study Design: The electronic medical files of 17,035 women who delivered at the same hospital between January 2008 and December 2014, were retrospectively reviewed. Pregnant women were distributed into one of 5 groups (No-prenatal-visit group, Only-pregestational-visit group, First-visit-prior-to-24-weeks-follow-up group, Early-third-trimester-follow-up group, Late-third-trimester-follow-up group) according to the time of their first pregnancy follow-up visit. The route of delivery, maternal anemia, and fetal outcomes were compared among the groups.

Results: Pregnant women in the no-prenatal-visit group were younger and showed higher rates of vaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to-24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%), and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p<0.001).

Conclusion: The rates of cesarean deliveries were found to be increased prominently in pregnant women who began antenatal care early in pregnancy with frequent follow-ups.