Antenatal Care in Sao Tome and Principe: Beyond the Number of Visits

Abstract Background: Newborn mortality in Sao Tome and Principe (STP) is overwhelmingly high and the antenatal healthcare (ANC) is one of the strategies to achieve its reduction. This study aimed to know which antenatal screenings are done in STP and which antenatal problems are detected. Methods: A retrospective study in which 518 pregnant women antenatal cards were reviewed between July 2016 and November 2018. Information analysed included clinical factors, laboratory tests, ultrasounds, results, and treatment. Results: Mothers’ mean age was 26.6 (SD=7.1) years old. At least one ANC visit occurred in 98.6% pregnant women and 38.7% had 8 or more. Regarding laboratory screenings, blood group was done in 64.4%, haemoglobin tested in 62.5% (first trimester) and in 29.3% (second trimester) and, urine once in 57.1% and twice in 12.2%. Antenatal problems identified in the pregnant women studied were: i) a RhD-negative phenotype (5.8%); 2) anaemia 1st trimester (36.4%) and 2nd trimester (35.5%); 3) bacteriuria (43.2%); 4) intestinal parasites (55.5%); 5) sickle cell solubility test positive (13%). Overall, 161 (53.7%) out of the 300 ultrasounds were done before the 20th week. Conclusion: In Sao Tome and Principe many pregnant women do not have access to the full spectrum of ANC recommended screenings. Maternal anaemia and bacteriuria are the main health problems that should be urgently addressed to prevent newborn morbidity and mortality in the country. Other preventive interventions as anthelmintic drugs should be debated as intestinal parasites were diagnosed in more than half of the women. Alloimmunization to RhD is also a concern due to the unaffordability of anti-D immunoglobulin in the country.