Predictors of Pregnant Women’s Delayed Initiation of Antenatal Care in Central Thailand

Suphangphim Rattasumpun, Nithinan Sirabarameesith

Abstract


Background: Delayed initiation of antenatal care leads to adverse effects on maternal and fetal health outcomes. This study aimed to identify the predictors of delayed initiation of antenatal care among pregnant women. Materials and Methods: This descriptive cross‑sectional study used a purposive sample of 330 women attending a hospital’s antenatal clinic in Central Thailand, divided into two groups: those attending the first antenatal visit before 12 weeks of gestation and those attending the first antenatal visit 12 weeks or more after. From May to October 2024, data were collected on sociodemographic information, knowledge, beliefs about pregnancy and antenatal care, antenatal care service setting, and social support. Data were analyzed using descriptive and multivariate logistic regression. Results: The predictors of delayed initiation of antenatal care were attitude (95% CI: 3.65–17.59; P < 0.001; OR = 8.02), social support (95% CI: 3.29–14.91; P < 0.001; OR = 7.00), perceived benefit (95% CI: 2.65–17.59; P < 0.001; OR = 5.91), unplanned pregnancy (95% CI: 1.72–8.46; P = 0.001; OR = 3.81), and perceived risk (95% CI: 1.58–7.08; P = 0.002; OR = 3.34). Conclusions: Healthcare providers should address these predictors to encourage timely antenatal care before 12 weeks of gestation.

 


Keywords


Logistic models, pregnant people, prenatal care

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References


World Health Organization. Geneva: Maternal Mortality; 2025. Available from: https://www.who.int/news‑room/fact‑sheets/detail/maternal‑mortality. [Last accessed on 2025 May 05].

Cresswell JA, Alexander M, Chong MYC, Link HM, Pejchinovska M, Gazeley U, et al. Global and regional causes of maternal deaths 2009‑20: A WHO systematic analysis. Lancet Glob Health 2025;13:e626‑34.

World Health Organization. Geneva: WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience: Summary. 2016. Available from: https://www.who.int/publications/i/item/9789241549912. [Last accessed on 2025 May 12].

Perry SE, Hockenberry MJ, Cashion K, Alden KR, Olshansky E, Lowdermilk DL. Maternal Child Nursing Care. 7th ed. St. Louis: Elsevier; 2023.

Health Data Center. Ministry of Public Health of Thailand. Nonthaburi: Percentage of pregnant women who initiate antenatal care within 12 weeks; 2023. Available from: https://dashboard.anamai.moph.go.th/surveillance/default/index?year=2023. [Last accessed on 2025 May 06].

Pervin J, Rahman SM, Rahman M, Aktar S, Rahman A. Association between antenatal care visit and preterm birth: A cohort study in rural Bangladesh. BMJ Open 2020;10:e036699.

Puthussery S, Tseng P. Risk of low birthweight and late antenatal care initiation in an ethnically diverse maternal cohort. Eur J Public Health 2023;33:ckad160.934.

Izuka EO, Obiora‑Izuka CE, Asimadu EE, Enebe JT, Onyeabochukwu AD, Nwagha UI. Effect of late antenatal booking on maternal anemia and fetal birth weight on parturient in Enugu, Nigeria: An analytical cross‑sectional study. Niger J Clin Pract 2023;26:558‑65.

Puthussery S, Tseng PC, Sharma E, Harden A, Griffiths M, Bamfo J, et al. Disparities in the timing of antenatal care initiation and associated factors in an ethnically dense maternal cohort with high levels of area deprivation. BMC Pregnancy Childbirth 2022;22:713.

Dibaba B, Bekena M, Dingeta T, Refisa E, Bekele H, Nigussie S, et al. Late initiation of antenatal care and associated factors among pregnant women attending antenatal clinic at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: A cross‑sectional study. Front Glob Womens Health 2024;5:1431876.

Tadele F, Getachew N, Fentie K, Amdisa D. Late initiation of antenatal care and associated factors among pregnant women in Jimma Zone Public Hospitals, Southwest Ethiopia, 2020. BMC Health Serv Res 2022;22:632.

Tesfaye M, Dessie Y, Demena M, Yosef T. Late antenatal care initiation and its contributors among pregnant women at selected public health institutions in Southwest Ethiopia. Pan Afr Med J 2021;39:264.

Gbene J, Takase MA, Ayangba V, Azumah Abanga W, Hamza SA, Alechana JA, et al. Predictors of late antenatal care initiation: A multicentre cross‑sectional study in Ghana. SAGE Open Nurs 2024;10:23779608241299345.

Al‑Mamun M, Kalam A, Uzzal NI. Factors affecting maternal health and antenatal care services of working mothers in Southwestern Coastal Bangladesh: A cross‑sectional study. Ann Med Surg (Lond) 2025;87:487‑96.

Warri D, George A. Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study. BMC Pregnancy Childbirth 2020;20:70.

Nyando M, Makombe D, Mboma A, Mwakilama E, Nyirenda L. Perceptions of pregnant women on antenatal care visit during their first trimester at area 25 health center in Lilongwe, Malawi‑A qualitative study. BMC Womens Health 2023;23:646.

Crosby R, Noar SM. What is a planning model? An introduction to PRECEDE‑PROCEED. J. Public Health Dent 2011;71(Suppl 1):S7‑15.

Pattanasombutsook M, Siriphan S, Chantarasiriput B, Bunlap P, Niha S, Mama J, et al. The reasons for late initiation of antenatal care and self‑care experiences without receiving antenatal care by pregnant women in Yala province: Qualitative descriptive research. PNUJR 2024;16:20‑42.

Junngam P, Suwannasan A. Factors related to the delay of the first antenatal care in Chumphae Hospital, Khon Kaen Province, Thailand. J Prev Med Assoc Thailand 2023;12:373‑88.

Yamane T. Statistics: An Introductory Analysis. 2nd ed. New York: Harper and Row; 1967.

Bloom BS. Learning for Mastery. Los Angeles: University of California; 1968.

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q 1988;15:175‑83.

Schaefer C, Coyne JC, Lazarus RS. The health‑related functions of social support. J Behav Med 1981;4:381‑406.

Battu GG, Kassa RT, Negeri HA, Kitawu LD, Alemu KD. Late antenatal care booking and associated factors among pregnant women in Mizan‑Aman town, South West Ethiopia, 2021. PLOS Glob Public Health 2023;3:e0000311.

Shinyawani RS, Malwela TN, Maputle MS. Midwives' voices on early initiation of antenatal care following a positive gravindex test: A qualitative study. Iran J Nurs Midwifery Res 2023;28:673‑8.

Wong Shee A, Frawley N, Robertson C, McKenzie A, Lodge J, Versace V, et al. Accessing and engaging with antenatal care: An interview study of teenage women. BMC Pregnancy Childbirth 2021;21:693.

Ambaye E, Regasa ZW, Hailiye G. Early initiation of antenatal care and its associated factors among pregnant women attending antenatal care at public health centres in Bahir Dar Zuria zone, Northwest Ethiopia, 2021: A cross‑sectional study. BMJ Open 2023;13:e065169.

Girma N, Abdo M, Kalu S, Alemayehu A, Mulatu T, Hassen TA, et al. Late initiation of antenatal care among pregnant women in Addis Ababa city, Ethiopia: A facility based cross‑sectional study. BMC Womens Health 2023;23:13.


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