Correlations of APNCU index and fetomaternal out come in tribal area of Chhattisgarh

Abstract

Objective: Adequacy of prenatal care utilization index [APNCU] assesses the adequacy of prenatal care by the time of and number of visits. The present study was conducted with the aim to find out the correlation of APNCU index with fetomaternal outcome in the tribal area of Chhattisgarh.

Material and Method: This cross sectional observational study was conducted in the newly started medical college of Surguja district which is a tribal area of Chhattisgarh. It involved 400 women with singleton pregnancy who reported in the labor room for delivery. APNCU index was calculated and categorized as 1) Intensive: 110% (>16) received.2) Adequate:  80% to 109% (13-16), c) Intermediate: 50% to 79% (8-15) and d) Inadequate: < 50% (<8) visits received. Care started by 4th month in first three and after that in the last category. The primary outcome was a composite arithmetic sum of adverse perinatal outcomes including fresh stillbirth, 5-minute Apgar score < 7 and NICU admission as well as the maternal outcome.

Results: 206 (51.5%) had Inadequate APNCU index whereas 187(46.75%) had Intermediate and only 07(1.75%) had Adequate and nobody had intensive index. Composite adverse perinatal outcome was significantly higher in the inadequate group women in comparison to intermediate and adequate groups. These cases also had poorer maternal outcome. Poverty, illiteracy and social/cultural taboos and access to antenatal care were the main reasons for poor PNC indices in our study.

Conclusion: Prenatal care is important to improve the fetomaternal outcome but needs awareness and optimization in tribal area of Chhattisgarh.