Determinants of antenatal booking time in a South-Western Nigeria setting

Utilisation of antenatal services and early booking are important factors in the reduction of maternal mortality and morbidity and these are influenced negatively by social, cultural and religions factors. To determine factors that influence the booking time in South Western Nigeria with the intention of identifying areas needing educational intervention. A descriptive cross-sectional study of 327 antenatal patients done between January to March 2005. Using both structured and semi-structured questionnaires information were collected on the socio-demographic and complete medical history. Two hundred and forty-six (90.4%) out of the 272 women who met the inclusion criteria were interviewed. The mean (SD) age of patients was 30.47 (5.52) years, of which 60% of the mothers were educated beyond secondary school level and 44.3% of the patients booked late. Late booking was thrice as common in multiparae as in nulliparae. Variables that were significantly associated with time of booking included educational level of the husband (P = 0.005), parity (P = 0.012), previous miscarriage (P < 0.001) and medical problem in the index pregnancy. Stepwise regression analysis showed the latter two factors as predictors of booking time. (Beta of -0.566 and -0.643, respectively). 57.3% of pregnant mothers felt that women should book by the first trimester but half of them actively booked late. Early detection of problems was the commonest reason for the choice of time of booking. The socio-cultural and religious determinants of health-seeking behaviours need to be researched further and unless these are modified by interventional campaigns good education may not easily translate to optimum utilisation of antenatal services.