Comparison of antenatal care factors and pregnancy outcome in rural and urban context

¹ The Centre for Disease Prevention and Control of Latvia, Riga, Latvia
² Rıga Stradiņš University, Department of Obstetrics and Gynaecology, Riga, Latvia
³ Rıga Stradiņš University, Institute of Public Health, Riga, Latvia

^* Corresponding author: irisa.zile@spkc.gov.lv

Abstract

Antenatal care plays a basic role in the management of woman's health during pregnancy, and women who have not been registered to antenatal care are at increased risk of poor pregnancy outcome, including stillbirth. The aim of this study was to identify differences in maternal characteristics, antenatal care factors and perinatal mortality between urban and rural area in Latvia. The Medical Birth Register of Latvia (MBR) was used as a data source, all births in 2017 (n = 20,406) were included in the analysis. Mother's place of residence was categorized in 3 groups: Riga, other cities and rural area. Higher risk of smoking (OR = 1.4; p < 0.001), late first antenatal visit (after 12th gestation week) (OR = 1.2; p < 0.05) and incomplete antenatal care (including cases without care) (OR = 1.3; p < 0.05) were detected more in other regions (other cities and rural area) than in Riga. After adjustment by maternal age and education, just late first antenatal visit was significantly higher in other regions (ORadj = 1.2; p < 0.05) vs. Riga. New-born mortality in perinatal period is substantially higher in other regions vs. Riga. The results indicate health education gap and potential inequalities in receiving antenatal care and emergency obstetric care by regions.