Issues materno-fœtales des grossesses non suivies à Lubumbashi, République Démocratique du Congo

INTRODUCTION: Unattended pregnancies are characterized by significant morbidity maternal and morbidity and mortality fetal. This study aims to determine the frequency of unattended pregnancies, to describe the socio-demographic profile and to assess the maternal and fetal outcomes during childbirth among women who did not attend antenatal care (ANC) in the city of Lubumbashi. METHODS: It was an analytical cross-sectional study of maternal pregnancy from December 2013 to May 2014 in 10 maternity hospitals in Lubumbashi. Women who did not receive ANC were compared to women who had followed them (ANC≥4). Maternal socio-demographic parameters, maternal and perinatal morbidity and mortality were analyzed. RESULTS: We found that the frequency of no pregnancy monitoring was 21.23% and the mean number of antenatal visits was 2.6 ± 1.9. An analysis of the relationship between ANC and socio-demographic characteristics of women who were delivered shows that the lack of follow-up was 2.29 times higher for adolescent girls than for adult women (OR=2.29 [1.54-3.41]), 4 times higher for women living alone than for women living in unions (OR=4.00 [2.05-7.79]) and 4.08 times higher for women with low levels of education (illiterate or primary) than among those with a high level of education (OR=4.08 [3.08-5.40]). Compared to those who followed them well, we did not find that women who did not attend ANC had a high risk of obstetric emergency (OR = 1.90 [1.26-2.95]), rupture of membranes fetal admission (OR=1.31 [1.02-1.68]), fetal mal presentation (OR=1.89 [1.03-3.44]), caesarean delivery (OR=1.78 [1.21-2.63]), eclampsia (OR=3.00 [1.09-8.70]), uterine rupture (OR=4.76 [1.00-47.19]) and anemia (OR=2.33 [1.06-5.13]). Rates of preterm birth (OR = 1.93 [1.33-2.80]), post-maturity (OR=1.47 [1.00-2.30]), low birth weight (OR=2.33 [1.56-3.46]), neonatal depression (OR=3.89 [2.52-6.02]), neonatal transfer (OR=1.60 [1.11-2.32]) and perinatal mortality (OR=2.70 [1.59-4.57]) were significantly higher in neonates from women with prenatal consultations than in those with well followed. CONCLUSION: Our study shows that the lack of follow-up of ANC is associated with high maternal morbidity and high perinatal morbidity and mortality in our environment.