Impact of Early and Delayed Registration of Antenatal Cases on the Outcome of Pregnancy Among Postnatal Mothers in A Tertiary Care Hospital in Central Karnataka

Introduction - Antenatal care is central to reducing maternal and perinatal morbidity and mortality. The WHO recommends registration of pregnancy within the first trimester, yet delayed registration remains common in India, potentially compromising early detection and management of complications.

Objectives: To assess outcome of pregnancy with the time of registration and to associate early and delayed antenatal registration with maternal and fetal outcome. Methods: This hospital-based cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Chitradurga, from October 2024 to March 2025. A total of 330 postnatal mothers aged 18–40 years were enrolled using systematic random sampling. Data on sociodemographic profile, antenatal registration timing, and pregnancy outcomes were collected using a pretested semi-structured questionnaire and hospital records. Participants were classified as early (≤12 weeks) or delayed (>12 weeks) registrants. Chi-square test and logistic regression were used for analysis, with odds ratios (OR) and 95% confidence intervals (CI) reported.

Results: Of the 330 mothers, 42.4% registered early and 57.6% registered late. Delayed registration was significantly associated with higher rates of anemia (51.6% vs. 30.0%, OR 2.49), PIH/preeclampsia (17.9% vs. 8.6%, OR 2.32), preterm labor (21.1% vs. 10.0%, OR 2.40), and PROM (14.7% vs. 6.4%, OR 2.52) among maternal outcomes. Fetal/neonatal outcomes—low birth weight (44.2% vs. 21.4%, OR 2.91), preterm birth (24.2% vs. 11.4%, OR 2.48), NICU admission (30.5% vs. 14.3%, OR 2.64), IUGR (16.8% vs. 7.9%, OR 2.38), and low APGAR score (12.6% 5.0%, OR 2.75)—were also significantly higher in the delayed group. Vaginal delivery was more common with early registration (60.0% vs. 48.4%).

Conclusion: Delayed antenatal registration is associated with a 2–3 fold higher risk of adverse maternal and fetal outcomes. Strengthening community awareness and promoting first-trimester registration through frontline health workers are essential to improve pregnancy outcomes.