Perinatal Outcomes Among Booked and Unbooked Mothers: A Comparative Analysis from a Teaching Hospital in the Niger Delta Region of Nigeria

Abstract

Perinatal morbidity and mortality remain high in many low-resource settings, particularly among women without antenatal care. Understanding the impact of booking status on perinatal outcomes is crucial for improving feto-maternal health indices. We compared perinatal outcomes between booked and unbooked mothers who delivered at the Delta State University Teaching Hospital (DELSUTH). This was a retrospective comparative study that reviewed the case files of mothers who delivered at DELSUTH. Socio-demographic, obstetric, and perinatal data were extracted. Chi square tests evaluated group differences, while logistic regression identified independent predictors of perinatal outcomes. Perinatal mortality rate (PMR) was calculated using stillbirths and early neonatal deaths per 1000 live births. Booked mothers were significantly younger, more educated, and most resided in urban areas (p < 0.05). Unbooked women had higher rates of labour complications. Unbooked mothers also recorded higher rates of stillbirth (8.5% vs. 2.2%), neonatal asphyxia (27.1% vs. 6.9%), NICU admission (30.5% vs. 11.2%), and early neonatal death (5.1% vs. 0.9%) (all p < 0.01). PMR was statistically significantly higher among unbooked mothers (148.1 vs. 30.9 per 1000 live births). Unbooked status was a strong independent predictor of adverse perinatal outcome (AOR = 8.12; 95% CI: 3.04–21.67) and Emergency caesarean section and assisted vaginal delivery also significantly increased risk. Unbooked pregnancies are associated with poorer perinatal outcomes, emphasizing the vital importance of improved antenatal care in our setting. Strengthening community awareness, improving access to care, and promoting early booking are essential in reducing adverse perinatal outcomes in the region.