Sociodemographic and Clinical Characteristics of Pregnant Women Seeking Antenatal Care in Beni-Suef Governorate

___________________________________________________ Pregnancy is an important time to prepare women and their families psychologically and emotionally for parenthood. Antenatal care (ANC) is defined as the care provided by skilled health-care providers to pregnant women to ensure the best health conditions for both mother and baby during pregnancy. Objective: is to study the sociodemographic and clinical characteristics of pregnant women seeking antenatal care in Beni-Suef Governorate. Methodology: A descriptive cross-sectional study conducted over a

https://ejmr.journals.ekb.eg/ group 20-35 (78.6%), had preuniversity and university education (34.3%) and (30.0%), respectively. Three quarters of the pregnant women had a complicated previous pregnancy with abortion (73.9%), around one-half of them had previously delivered by cesarean section (48.2%). Pregnant women seeking ANC were mainly in the third trimester (53%), most of them had a planned pregnancy (68%) and the largest percentage of the studied women were multigravida (59.4 %) with a mean equal 2.9 ±1.8 SD.
Conclusion and Recommendation: There should be proper health care programs for pregnant women with health education about ANC services all through the gestation period.

Introduction
Pregnancy is an extraordinarily complex process with important morphological, metabolic, physiological and immunological changes involving three interacting systems, the woman, the placenta and the fetus; which maintain a complex crosstalk simultaneously aimed at maintaining women homeostasis, promote fetal growth and maturation , as well as preparing the mother for labor and lactation [1]. Pregnancy has three trimesters, each of which is marked by specific fetal developments. A pregnancy is considered fullterm at 40 weeks; infants delivered before the end of week 37 are considered premature. The following explain different physiological changes of pregnancy: First Trimester (0 to 13 Weeks): The first trimester is the most crucial to the baby's development. During this period, the fetus body structure and organ systems develop. Most miscarriages and birth defects occur during this period [2].

Second Trimester (14 to 26 Weeks):
Somewhere between 16 weeks and 20 weeks, the pregnant woman may feel her baby's first fluttering movements [2].

Third Trimester (27 to 40 Weeks):
The stage of final stretch of pregnancy and almost many women are probably very excited and anxious for the birth of the baby.
The average weight gain throughout pregnancy of 20 to 30 lb. (9.1 to 13.6 kg), most of the weight gain after week 20 [3].
Antenatal care (ANC) can be defined as the care provided by skilled health-care providers to pregnant women and adolescent girls in order to ensure the best health conditions for both mother and baby during pregnancy [4].
Antenatal care is one of the -four pillars‖ of https://ejmr.journals.ekb.eg/ safe motherhood initiatives to promote and establish good health during pregnancy and the early postpartum period [5]. Good quality antenatal care services improve the survival and health of mothers as well as babies.
Antenatal care also provides an opportunity for women to communicate with their healthcare provider and increases the chances of their using a skilled birth attendant [6].
Previously the World Health Organization (WHO) recommended 4 antenatal visits for uncomplicated pregnancies. The first of these took place within 12 weeks of gestational age [7]. However, in a recently published document, WHO now recommends a minimum of 8 visits to improve neonatal outcomes and to provide a more positive [4].
For instance, the focused antenatal care model of WHO emphasizes on screening and treating anemia, malaria, HIV/AIDS, and also be immunized against tetanus [8].

Subjects and Methods
Population Frame: The study was designed as a cross-sectional study conducted on pregnant women.
Inclusion criteria: pregnant women (in the first, second and third trimesters) attending for their routine antenatal checkups during pregnancy in Beni-Suef Governorate.

Duration of the study:
The study was carried out over a period of ten months (from April 2021 to January 2022).

Sample Size:
Using Epi info stat-calc, the sample size for the population survey was calculated at 95% confidence level, 5% acceptable margin of error

B) Data Collection:
During this phase, data was collected from pregnant women attending for their routine antenatal care by a self-structured questionnaire prepared in Arabic language (Owing to a low level of literacy among some participants, the researcher read out the questionnaire and noted their responses).

C) Data management and analysis:
According to the type of the collected data, they were managed as follows: o They were assured that their personal information will be kept confidential.

Discussion:
In the current study concerning Sociodemographic Characteristics of the participants utilizing ANC services: The largest percentage of the studied pregnant women was in the age group 20-35 (78.6%) similar to [9], the highest prevalence of participants were aged 21-30 years (86.9%).
Pregnant women with higher educational levels preuniversity and university education (34.3%) and (30.0%) respectively, similarly had a greater confidence to take actions regarding their own health and they had awareness on advantage of utilizing health services compared to women who had no education [10,11] Most of the pregnant women were housewives (65.9 %) and this is similar to a study in which over a third of participants were high school graduates though over 90% were not working [12].
Regarding the medical and obstetric history of the pregnant women seeking ANC: The largest percentage of the studied women were multigravida (2-4): (59.4 %) with a mean equal 2.9 ±1.8 SD.
We found that women knowing of antenatal care (multigravida) were more likely to utilize antenatal care services as compared to the ones who did not know about ANC services (primigravida).
Having knowledge about health enables women to be aware of their health status in order to seek appropriate health services [13].  [14].
In the current study, most of the participating pregnant women were in the third trimester (53%), the possible explanation might be related to the closeness to delivery and the need for reassurance and close follow up, in contrary to the study [9] in which most of them were in the first trimester (41.8%) and only (3.2%) of women were in the third trimester.
Most of the pregnant women had a planned pregnancy (68%) that is similar to some estimates showing that women whose pregnancies were planned were more likely to receive antenatal care. This is supported by studies conducted in other https://ejmr.journals.ekb.eg/ countries [15,16,17]. In addition to a study conducted in Kenya indicated that women who reported planned pregnancy were more likely to receive antenatal care while those who reported unplanned pregnancy were less likely to receive antenatal care [17]. It is possible that women whose pregnancies were unintended may fear the social ramifications of an unplanned pregnancy and so may avoid health services.

Limitations of the study:
-Some of the participants were not cooperative with the researcher.
-A cross-sectional study design in which causality and effect relationship cannot be built.