ปัจจัยสาเหตุของการฝากครรภ์ครั้งแรกล่าช้าของหญิงตั้งครรภ์วัยรุ่นในชุมชนDeterminants of late start of antenatal care among pregnant teenagers in community

Abstract

A case-control study was designed to address the purpose of the study:  to identify determinants of late start of antenatal care among pregnant teenagers who living in community. Theory of Triadic Influence was used as a theoretical framework.  Participants consisted of 220 pregnant adolescents aged less than 20 years old having first ANC visit within the first 12 weeks of gestation in Nakornprathom province. The subjects were divided into two groups. There were 110 of case group who received antenatal care after 12 weeks of gestation and there were 110 of control group who received antenatal care services during 12 weeks of gestation. The research instrument included the following questionnaires: personal information, Intention of Pregnancy, Perceived Self-efficacy for ANC, Knowledge of ANC, Attitude toward Pregnancy and ANC, and  Approval of Partner, Family and Community, with acceptable Cronbach's alpha coefficients were  between 0.70-0.97.  Scale of ANC Knowledge with Kruder-Richardson -20 was  0.81.  Binary Logistic Regression at 95% confidence level was used for data analysis. 

The results revealed that  the significant determinants of  late start of antenatal care  at  95 % confident  interval were   perceived  self-efficacy for ANC  (OR_adj = 9.15, 95% CI = 3.02-27.72) ,  knowledge of ANC  (OR_adj  = 11.81, 95%CI= 11.81, 95% CI = 4.16 – 33.50) , attitude toward pregnancy and ANC (OR_adj = 4.54, 95% CI = 1.51–13.63),  approval of family (OR_adj = 15.37, 95% CI = 5.27-44.80) , and  community approval  (OR_adj = 18.00, 95%CI= 5.12-63.27). The results show that community nursing practitioners should be proactive: focusing accurate information and awareness of early antenatal care among adolescents, family and community.