Postnatal care services use by mothers: A comparative study of defaulters versus attendees of postnatal clinics in Enugu.

INTRODUCTION: Despite much emphasis on the reproductive health of women, maternal mortality is still high, especially in postnatal period. OBJECTIVE: To assess the prevalence of postnatal care use and reasons for defaults among mothers attending the child immunization clinics in Enugu, Nigeria. METHODS: This was a cross-sectional comparative study of 400 consecutive nursing mothers who presented at the Institute of Child Health of UNTH and ESUTH, Enugu for Second dose of the Oral Polio Vaccine (OPV2) for their babies at 10 weeks postpartum. Data was collected using Interviewer-administered questionnaire and subsequently analyzed with version 22.0 IBM SPSS software, Chicago, Illinois. A p-value of less than 0.05 was considered as statistically significant. RESULT: The prevalence of the 6th week postnatal clinic attendance among the mothers was 59%. The majority of the women (60.6%) who had antenatal care by skilled birth attendants attended postnatal clinic. Unawareness and being healthy were the main reasons for not attending postnatal clinic. Following multivariate analysis, place of antenatal (OR = 2.870, 95% C.I = 1.590-5.180, p < 0.001) and mode of delivery (OR = 0.452, 95% C.I = 0.280-0.728, p = 0.001) were the only significant predictors of postnatal clinic attendance (p < 0.05). CONCLUSION: Postnatal clinic attendance by women in Enugu is still suboptimal. The main reason for non-attendance of the 6th week postnatal clinic was lack of awareness. There is need for healthcare professionals to create awareness about the importance of postnatal care and encourage mothers to attend.

The effect of short interpregnancy interval on birthweight and other pregnancy outcomes in Enugu, Southeast Nigeria.

The time interval between one pregnancy and the next is a modifiable risk factor, and has an effect on pregnancy outcomes. This study compared the effects of short interpregnancy interval (IPI) on fetal birthweight and selected pregnancy outcomes amongst parturients in Enugu, Nigeria. Group A (Subjects) consisted of parturients with short IPI (IPI < 18 months), while group B (Controls) consisted of parturients with normal IPI (IPI ≥ 18 months). Relevant obstetric data were collected at delivery. Mean birthweight was 2664.13 ± 339.25g vs 3670.63 ± 452.69g in women with short IPI and normal IPI respectively (p < .0001). Women with short IPI were more likely to have low birthweight babies compared to those with normal IPI (OR = 7.331, p < .001). Maternal anaemia, preeclampsia and caesarean delivery were significantly more associated with short IPI. Women with short IPI are at greater risk of delivering newborn babies with significantly lower mean birthweight and other associated pregnancy complications than women with normal IPI.Impact StatementWhat is already known on this subject? Short interpregnancy interval has an adverse effect on pregnancy outcomes as shown in studies from Europe and the Americas.What do the results of this study add? This study adds to the body of evidence of the deleterious effects of inadequately spaced pregnancies and draws attention to this in West Africa, sub-Saharan Africa, and an area with low contribution to studies on the effect of short IPI on pregnancy outcomes.What are the implications of these findings for clinical practice and/or further research? With evidence from our own environment, it will further boost evidence for proper education of our mothers on the need for adequate birth spacing to avoid the adverse effects of a short IPI on the next pregnancy.