Prenatal Consultation Associated with Maternal and Fetal Complications During Delivery in Military Hospital of Soavinandriana Madagascar
Maternal and fetal complications represent a public health problem. The aim of this study is to identify the effects of prenatal consultation (PNC) in pregnant women to the maternal and fetal complications of deliveries in Military hospital of Soavinandriana (CENHOSOA). This is an analytical study using "Historical Cohort" comparing two groups of population, one group have done PNC or "PNC+" and the other group without PNC or "PNC-".The study was conducted in the CENHOSOA over a period of 13 months from 01 May 2012 to May 31, 2013. During the study period, we have include 296 (23.2%) belonged to the group of PNC- and 982 (76.8%) to the PNC+. The proportion of term birth is lower in PNC- than PNC+ (80.4% versus 93.3%, p<10-6). The cesarean section was high in the PNC- group in comparison with the "PNC+" (32.1% versus 24.1% p<10-2). Group of PNC- have a relative risk RR = 6.64, 95% CI [1.22 – 36.05] of dyspnea. Infections and phlebitis are non significant in the two groups. Concerning fetal complication, PNC- group had RR=1.99, 95% CI [1.13 – 3.52] to have APGAR score<7 and RR=2.65, 95% CI [1.58 – 4.47] of weight <2,000mg. Concerning complications conducting in deaths, mother with PNC- had RR=3.32, 95% CI [0.21 – 52.88] of maternal death and newborns had RR=2.65, 95% CI [0.72 – 9.82] to intrauterine fetal death. In brief, maternal and fetal complications have been more frequent among women who have not had PNC. The state should promote the practice of adequate and well-conducted PNC for the good of the mother and the baby.