Study on utilization of antenatal care and outcome of pregnancy in a medical college & hospital of Kolkata, West Bengal

• 'Be good to your baby before it is born'.
• This aphorism serves to emphasize the
importance of medical care during
pregnancy. The care is so important
because, the fetal organs are actively
developing during the first 12 weeks of
pregnancy.

 The embryo is highly susceptible to external insults
during this time, so that any damage can lead to
crippling birth defects.1
• WHO defines ante natal care as ‘A care which
includes recording medical history, assessment of
individual needs, advice and guidance on pregnancy
and delivery, screening tests, education on self-care
during pregnancy, identification of conditions
detrimental to health during pregnancy, first-line
management and referral if necessary.’

•So Antenatal care is the systemic medical
supervision of women during pregnancy. It
preserves the physiological aspect of
pregnancy and labor and to prevent or
detect, as early as possible, all that is
pathological.1
•The primary aim of antenatal care is to
achieve, at the end of pregnancy, a healthy
mother and baby.

•The quality of care is more important
than the quantity.2 It is the care that
mother had received during pregnancy
which included IFA tablets, TT, blood,
urine tests and ultrasonographic
investigations.1
•According to SRS (2012) the IMR is 44
per 1000 live birth which was attributed to
primarily low birth weight, severe anemia,
high birth rate and low spacing4.

• Low birth weight and preterm
deliveries in turn are related to adolescent
pregnancies and short spacing. The
Neonatal mortality rate in West Bengal in
2010 was 24 per 1000 live birth and 19 per
1000 live birth in urban area.
•The infant mortality rate in West Bengal
in 2010 was 32 per 1000 live birth in rural
area and 25 per 1000 live birth in urban
area.4 The Maternal mortality rate (MMR)
in West Bengal in 2010 was 212 per
100,00 women of reproductive age group.

•A very important aspect of antenatal
care is to offer information and advice
to women about pregnancy and the
related complications. It also informs
about the care a mother should take for
herself and the possible curative
measures on early detection of
complications and its management.

•Antenatal care also plays a critical role for
preparing a woman and her families for child
birth by establishing confidence, further
antenatal visits raise the awareness about the
need for care during delivery.3
•Most maternal death to pregnancy related
complication can be prevented if pregnant
women have access to good quality antenatal
care & if certain harmful birth practices are
avoided.4

•In West Bengal 51.1% women take more
than 3 antenatal visits, 47% practice
institutional deliveries and 46.6% take 100
IFA tablets.4
•High maternal mortality can also be
reduced by early registration of pregnancy,
taking at least 4 antenatal visits,
prevention and treatment of complications
like – eclampsia, malpresentations,
diabetes and hypertension.

Primary aims of antenatal care-
 To achieve at the end of the
pregnancy a healthy mother & a
healthy baby.
 To promote, protect & maintain
the health of mother during
pregnancy.
 To foresee complications &
prevent them.

To reduce maternal & infant mortality
rate.
 To teach the mother elements of
child care, nutrition, personal hygiene,
environmental sanitation & family
planning.
These can be achieved through
a well planned package of antenatal
services provided at different health
facilities. The desired outcome is having a
healthy child out of a healthy mother.

AIMS & OBJECTIVES
To assess sociodemographic profile of
mother admitted in postnatal ward of CNMCH.
To find out antenatal care services utilized by
them.
To determine the outcome of pregnancy.
To assess the association of
sociodemographic profile & antenatal care
utilization with the outcome of pregnancy, if
any.

Type of Study – Observational, Descriptive, Hospital Based Study.
Study Design – Cross-sectional .
Place of study – Post-natal ward of Calcutta National Medical College &
Hospital, Kolkata.
 Study Population – Mothers admitted in postnatal ward of Calcutta
National Medical College & Hospital.

 Study Duration – 23rd May 2013 to 19th June 2013 →28 Days
 1st week-
Topic Selection
Discussion
Schedule preparation
2nd week-
•Data Collection
3rd week-
•Data Entry
•Data Analysis
4th week-
•Report writing
•Presentation

Sampling Technique –
Complete enumeration – All the mothers admitted in the postnatal
ward during the period of data collection were included in the study.
 Exclusion criteria –
Those mothers who didn’t give consent to participate.
Those mothers who were severely ill.
 Sample Size –
 Thus the total sample size was160.
Study Technique -
Interview method – of the patients.
Record review method – Review of all the prescriptions & ANC
Cards with investigation reports.

 Study Tools –
 A pretested, predesigned, semi-structured
schedule.
Antenatal Card
 Bed Head Tickets with special investigation
reports
 Prescription (if available.)

Variables included in the study -
 Age .
 Religion.
 Residence.
 Education of patients &
their husbands.
 Occupation of patients and
their husbands.
 Socio-economic status.
 Type of family.
 Parity
 Number of living children.
 Number of ANC visits.
 Time of registration for ANC.
 Investigations done.
 Prophylaxis given.
 Advices given.
 Practices during pregnancy.
 Outcome of pregnancy.

♦ Study Procedure ♦
The topic was chosen &
Discussed.
Schedule was prepared with
the help of teachers.
Pretesting of the schedule
was done on 10 subjects &
necessary corrections done.
After taking informed consent from
the patients study was conducted by
interviewing the mothers admitted in
the postnatal ward. Additional
information were noted after
consulting the necessary records.
The data thus collected, were
compiled & analysed using
MS Excel & Word.
Report was prepared &
presented.

Table 1 : Distribution of study population according
to age (n= 160)
Age (yrs) Number percentage
<20 27 16.87
20-25 93 58.13
26-30 32 20.00
>30 8 5.00
Total 160 100
 COMMENT : Majority of the study population were within the age
group of 20 to 25 years.

0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
<20 20-25 26-30 >30
Distribution of study population according
to age
percentage

to RELIGION. (n= 160)
Religion Number Percentage
Hindu 80 50.00
Muslim 76 47.50
Christian 4 2.50
Total 160 100
 COMMENT : Most of the study population (50%) are Hindus.

to residence . (n=160)
Residence Number Percentage
Rural 100 62.50
Urban 60 37.50
Total 160 100
 COMMENT : 62.50 % of the study population belong to the rural area.

Table 4: Distribution of study population according to
Education of husband and wife.
(n=160 )
Education Wife
[No.(%)]
Husband
[No.(%)]
Illiterate 16 (10.00) 16 (10.00)
Just literate 16 (10.00) 15 (9.37)
Primary 42 (26.25) 36 (22.50)
Mid School 43 (26.87) 37 (23.12)
Secondary 32 (20.00) 27 (16.88)
Higher secondary 7 (4.38) 20 (12.50)
Graduate & Above 4 (2.50) 9 (5.63)
Total 160 (100) 160 (100)
 COMMENT : Most of the study population (53.12%) & their husbands
(45.62%) were educated up to Mid school & primary level.

Table 5 : Distribution Of Study Population According
to Patients Occupation. (n = 160)
OCCUPATION Number %
SERVICE 1 0.63
SKILLED WORKER 3 1.87
UNSKILLED WORKER 6 3.75
HOME MAKER 150 93.75
TOTAL 160 100
 COMMENTS – Majority (93.75%) were home makers.

OCCUPATION Number %
SERVICE 6 3.75
SMALL BUSINESS 33 20.62
SKILLED WORKER 48 30.00
UNSKILLED WORKER 72 45.00
UNEMPLOYED 1 0.63
TOTAL 160 100
 COMMENTS – Majority were unskilled workers.

SOCIOECONOMIC
STATUS
Number %
UPPER MIDDLE 10 6.25
LOWER MIDDLE 39 24.38
POOR 84 52.50
VERY POOR 27 16.87
TOTAL 160 100
 COMMENTS – Majority of the study population (52.5%)were poor,
whereas people from high & upper high class were not
found during the study.

TYPE OF FAMILY Number %
JOINT 85 53.13
NUCLEAR 75 46.87
TOTAL 160 100
 COMMENTS – Most of the study population were from joint families.

TABLE 9 : Distribution of Study population according
to parity. (n = 160)
Parity Number %
1 109 68.12
2 44 27.50
≥3 7 4.38
TOTAL 160 100
 COMMENT : Majority (68.12%) of the study population are primi Para.

TABLE 10 : Distribution of Study Population According
to spacing from last child birth. (n = 51)
SPACING (in years) Number %
< 3 45 88.24
≥3 6 11.76
TOTAL 51 100
 COMMENT : Majority ( 88.24%) of the multipara mothers were
pregnant within 3 years of last child birth.
(109 patients were primi para)

time of registration. (n= 160)
Time of registration Number Percentage
≤ 12 Weeks 128 80.00
> 12 Weeks 32 20.00
TOTAL 160 100
 COMMENT : Majority (80%) of the study population have registered
within 12 weeks.

Distribution of study population according to time of
registration.
≤ 12 Weeks
> 12 Weeks

Table 12: Distribution of study population according
to place of visit. (n= 160)
Place of visit Number Percentage
Government
Sub-Centre 17 10.63
Primary Health Centre 39 24.38
Govt. Hospitals 95 59.38
Private 14 8.75
 COMMENT : Most of the study population visited Govt. institution
for their antenatal care.

Table 13: Distribution of study population according to utilization of
antenatal care. (n=160)
Antenatal Care Utilization Number Percentage
I. No. of antenatal visit
1 3 1.88
2 11 6.87
3 30 18.74
4 37 23.13
>4 79 49.38
II. No. of time BP measured
0 3 1.88
1 8 5.00
2 14 8.75
3 38 23.75
≥4 97 60.62
III. No. of time weight measured
0 4 2.50
1 6 3.75
2 19 11.87
3 28 17.50
≥ 4 103 64.38

 COMMENT : Majority (72.51%) of study population took 4 or more
antenatal visits. Weight & blood pressure was measured 4
times or more in 64.38% and 60.25% of the study
population respectively.

Table 14 : Distribution of study population according to
different types of blood investigations done.
(n=160)
Investigations Done Results
Frequency Percentage
Hb% 137 85.63
VDRL 92 57.50
HIV 88 55.00
HbsAg 79 49.37
ABO group 131 81.87
Rh typing 131 81.88
Sugar 86 53.75
 Comment : Majority of study population had done investigations of Hb%,
ABO grouping, Rh typing ; whereas in around 50% cases
VDRL, HIV, Sugar testing were done .

different other investigations done . (n=160)
Investigations done Results
Urine
RE
C&S
Frequency Percentage
27 16.86
4 2.50
Stool 5 3.12
USG 149 93.12
 Comment : In majority of cases USG was done, while frequency
of doing other investigations were low .

iron & folic acid tablet intake (n=160)
No. Of Tablets taken Frequency Percentage
< 100 72 45.00
100 – 200 70 43.75
> 200 2 1.25
Nil 16 10.00
Total 160 100
 Comment : 45.00% subjects have taken less than 100 tablets, while
10% subjects did not take anything .

history of tetanus toxoid. (n=160)
Tetanus Toxoid Frequency Percentage
Only TT1 2 1.25
TT1 & TT2 154 96.25
Booster 2 1.25
Nil 2 1.25
Total 160 100
 Comment : Majority of study population has received both TT1 and TT2 ,
whereas 1.25% cases does not receive any dose of toxoid .

TABLE 18: Distribution of study population on the basis
of the advices given. (n=160)
ADVICES GIVEN FREQUENCY PERCENTAGE
REST 145 90.63
DIET 150 93.75
PLACE OF DELIVERY 123 76.88
BREAST FEEDING 143 89.38
CONTRACEPTION 47 29.38
PERSONAL HYGINE 139 86.88
ADDICTION 101 63.13
DRUG ADVICE 109 68.13
COUNTING FOETAL
MOVEMENTS
124 77.50
 COMMENT – Most of the mothers were given advices on rest, diet, breast
feeding & place of delivery. Only 30% of the study population was
given advice regarding contraception.

ADVICES GIVEN ( DANGER SIGNS) FREQUENCY PERCENTAGE
GEN. SWELLING 99 61.88
BLEEDING P.V. 88 55.00
HEADACHE 93 58.13
BLURRING OF VISION 75 46.88
PAIN ABDOMEN 98 61.25
CONVULSION 88 55.00
WATERY DISCHARGE P.V. 80 50.00
PALPITATION 86 53.75
BREATHLESSNESS 102 63.75
REDUCED FOETAL MOVEMENT 70 43.75
 COMMENT– Around 60% of the study population were given advices
on BREATHLESSNESS, Gen. Swelling and PAIN ABDOMEN. Rest
of the danger signs were informed to about 50% of the study population.
TABLE 19: Distribution of study population on the basis of
advices regarding Danger Signs. (n=160)

dietary practice during pregnancy. (n=160)
Dietary practice Number Percentage
Increased 74 46.25
Same 53 33.12
Reduced 33 20.63
Total 160 100
 Comment : Most of the population have increased diet during their
pregnancy period.

Table 21: Distribution of study population according
to activity during pregnancy. (n=160)
Strenuous activity Number Percentage
Yes 31 19.38
No 129 80.62
Total 160 100
 Comment : Majority of the population (80.62%) did not perform
any strenuous activity during pregnancy .

to addiction during pregnancy. (n= 160)
Addiction Number Percentage
Yes 5 3.12
No 155 96.88
Total 160 100
 Comment : Majority of the population (96.88%) didn’t have
any addiction history during pregnancy .
(The main addiction was tobacco chewing.)

outcome of pregnancy. (n= 160 )
Outcome Number %
Live birth
NBW 104 65.00
LBW 53 33.13
Still birth 3 1.87
Total 160 100
 COMMENT – 1. Majority of the study population gave birth to normal
birth weight baby.
2. Around 33% had low birth weight baby.

Education Live birth Still birth
[No.(%)]
Total
[No.(%)]
Normal birth
weight
[No.(%)]
Low Birth
Weight
[No.(%)]
Illiterate 6 (37.50) 10(62.50) 16 (100)
Just literate 10(62.50) 6(37.50) 16(100)
Primary 24(57.14) 15(35.71) 3(7.15) 42 (100)
Mid school 29(67.44) 14(32.56) 43 (100)
Secondary 26(81.25) 6(18.75) 32 (100)
H.S & Above 9(81.82) 2(18.18) 11 (100)
Total 104 53 3 160
Table 24 : Distribution Of Study Population according to
Educational Status & outcome of pregnancy.
(n =160)
 COMMENT – Occurrence of low birth weight is much higher among
the illiterate population.

SOSCIOECONOMIC
STATUS
LIVE BIRTH STILL
BORN
[No.(%)]
TOTAL
[No.(%)]
Normal birth
weight
[No.(%)]
Low Birth
Weight
[No.(%)]
UPPER MIDDLE 10(100) - - 10(100)
LOWER MIDDLE 32(82.05) 7(17.95) - 39(100)
POOR 45(53.57) 37(44.05) 2(2.38) 84(100)
VERY POOR 17(62.97) 9(33.33) 1(3.70) 27(100)
Total 104 53 3 160
COMMENTS – Adverse outcomes of pregnancy (Low Birth weight, Still
Birth) were more common in poor & very poor families.

SPACING LIVE BIRTH STILL
BIRTH
[No.(%)]
TOTAL
[No.(%)]
Normal
birth weight
[No.(%)]
Low Birth
Weight
[No.(%)]
<3 30(66.67) 15(33.33) 0 45(100)
≥3 5(83.33) 1(16.67) 0 6(100)
Total 35 16 0 51
TABLE 26: Distribution Of Study Population according to
spacing from last child birth and pregnancy
outcome. (n =51)
 COMMENT : Proportion of normal birth weight babies was more in cases
where spacing from the last child birth was more than 3 years.

PARITY LIVE BIRTH STILL
BIRTH
[No.(%)]
TOTAL
[No.(%)]
Normal
birth weight
[No.(%)]
Low Birth
Weight
[No.(%)]
1
69(63.30) 37(33.95) 3(2.75) 109(100)
2
31(70.45) 13(29.55) 0 44
≥3
4(57.14) 3(42.86) 0 7
TOTAL
104 53 3 160
TABLE 27 : Distribution of study population according to
parity & pregnancy outcome. (n = 160)
 COMMENT :Proportion of low birth weight babies were more in parity 3
or more

IFA tablet taken Outcome of pregnancy
Live birth Still birth
[No.(%)]
Total
[No.(%)]
Normal
Birth weight
[No.(%)]
Low birth
weight
[No.(%)]
Iron and
folic
acid
tablets
Nil 9(56.25) 7(43.75) 16(100)
<100 45(62.50) 25(34.72) 2(2.78) 72(100)
≥100 50(69.44) 21(29.17) 1(1.39) 72(100)
Total 104 53 3
 COMMENT : Most of the study population who have taken <100 IFA tablets
gave birth low birth weight baby, 1 having neonatal death.

Inj. TT taken and outcome of pregnancy.
(n=160)
Inj. TT taken Outcome of pregnancy
Live birth Still birth
[No.(%)]
Total
[No.(%)]
Normal
Birth weight
[No.(%)]
Low birth
weight
[No.(%)]
Nil/Only TT1 1(25) 2(50) 1(25) 4(100)
TT2/Booster 103(66.03) 51(32.69) 2(1.28) 156(100)
Total 104 53 3 160

Table 30: Distribution of study population according to ANC
utilization and outcome of pregnancy. (n=160)
ANC Utilization Outcome Of Pregnancy
Live Birth Still
Birth
[No.(%)]
Total
[No.(%)]
Normal Birth
weight
[No.(%)]
Low Birth
weight
[No.(%)]
No. of visit
<4 21 (47.73) 21 (47.73) 2(4.54) 44(100)
≥4 83 (71.55) 32 (27.59) 1(0.86) 116(100)
Time of
Registration
In weeks
≤12 84(65.63) 42 (32.81) 2(1.56) 128 (100)
>12 20(62.50) 11 (34.38) 1(3.12) 32 (100)

 COMMENT:
1. 47.73% of study population gave birth to normal birth weight baby
& had attended <4 ANC visits.
>4 ANC visits.
and had registered in <12 weeks.
and had registered in >12 weeks

PRACTICES DURING
PREGNANCY
LIVE BIRTH STILL BORN
NO(%)
TOTAL
NO(%)
Normal birth
weight
[No.(%)]
Low Birth Weight
[No.(%)]
1.DIET DURING
PREGNANCY:-
a. Increased 58(78.38) 13(17.57) 3(4.05) 74(100)
b. Same 27(50.94) 26(49.06) - 53(100)
c. Decreased 19(57.58) 14(42.42) - 33(100)
2.ANY STRENUUS
ACTIVITY DURING
PREGNANCY:-
a. Yes* 22(70.97) 7(22.58) 2(6.45) 31(100)
b. No* 82(63.57) 46(35.66) 1(0.77) 129(100)
3.ADDICTION:-
a. Yes 3(60.00) 2(40.00) - 5(100)
Table 31 : Distribution Of Study Population According to
Practices During Pregnancy & Outcome of
Pregnancy. (n=160)

PRACTICES
DURING
PREGNANCY
LIVE BIRTH STILL BORN
NO(%)
TOTAL
NO(%)Normal birth
weight
[No.(%)]
Low Birth Weight
[No.(%)]
3.ADDICTION:-
a. Yes 3(60.00) 2(40.00) - 5(100)
b. No 101(65.16) 51(32.90) 3 (1.94) 155(100)
COMMENT –
1. Majority of mothers(78.38%) who have taken increased diet during pregnancy
gave birth to normal birth weight babies.
2. 63.57% of mothers who have not done any strenuous activity during pregnancy
gave birth to normal birth weight babies.
3. 65.16% mothers who have no addiction gave birth to normal birth weight babies.

 A descriptive, observational, Cross Sectional study with the title of “THE
UTILIZATION OF ANTE NATAL CARE AND OUTCOME OF PREGNANCY”
had been undertaken on the mothers admitted in the postnatal ward of CNMC&H
from 28th May to 19th June, in 2013.
 The objectives of the study were :
 To assess sociodemographic profile of postnatal mother admitted in CNMCH.
 To find out antenatal care services utilized by them.
 To determine the outcome of pregnancy.
 To assess the association of sociodemographic profile & antenatal care
utilization with the outcome of pregnancy, if any.
The data were collected interviewing all the mothers (160) after taking their
informed consent and also by reviewing records.
 Findings of the study were as follows :
 . Majority of the study population were within the age group of 20 to 25 years.

 Majority of study population (50%) were Hindus & belong to rural area(62.5%)
 Most of the study population (53.12%) & their husbands(45.62%) were
educated up to Mid school & primary level.
 Majority of them were home makers &their husbands were unskilled workers.
 Majority were from joint families with poor socioeconomic status
 Majority (68.12%) of the study population are primi Para :
 88.24% of the multipara mothers were pregnant within 3 years of last child
birth.
 Majority (75%) have registered within 12 weeks & 94 % visited Govt.
institution for their antenatal care.

 Majority of study population took 4 or more antenatal visits. Weight & blood
pressure was measured 4 times or more in 64.38% and 60.25% of the study
population respectively:
 42.55 % of study population who had visited <4 times to antenatal care unit
had low birth weight babies .
 57.6% of study population who had registered after 12 weeks had low birth
weight babies
 Most of study population had done investigation of Hb%, ABO grouping, Rh
typing ; whereas in around 50% cases VDRL, HIV, Sugar testing are done . : In
majority of cases USG is done :
 45% subjects had taken ≥100 IFA tablets, while 10% subjects did not take any
tablet Majority of study population has received both TT1 and TT2 or TT booster.
 Most of the mothers were given advices on rest, diet, breast feeding & place of
delivery.

 Only 30% of the study population was given advice regarding contraception &
around 50-60% of the study population were given advices on different danger signs
 Majority(65%) of the study population have normal birth weight baby & 32% had
low birth weight babies .
 Regarding practice , majority of the population have increased diet & did not
perform any strenuous activity during their pregnancy period
 Adverse outcomes of pregnancy (Low Birth weight-33%, Abortion, Still Birth,
Neonatal death) were quite common in poor & very poor families and among
illiterates and mothers with spacing <3 years from last child.
 51% of mothers who have taken increased diet & 63% of mothers who have not
done any strenuous activity during pregnancy gave birth to babies having normal
birth weight .

Analyzing the data collected during the study it is observed that
outcome of pregnancy is indeed related to ANC taken by the mother during
pregnancy. From the study, it is concluded that –
1. Antenatal Care utilization is not up to the mark (i.e. delayed
registration, <4 ANC visits, <100 IFAs intake), which is seen in
considerable no. of mothers. The outcome of pregnancy also have
shown adverse results in some cases where ANC is not up to the mark.
2. Though majority of the mothers were pregnant within 3 years of last
child birth, it was observed that most of them received 2 doses of TT
instead of Booster dose.
3. Mothers who had good practice during pregnancy have shown better
outcome.
4. SES & literacy level also play an important role in the study as it is
observed that adverse outcomes of pregnancy were more common in
poor and very poor family & among illiterates.

Hence, from the study it is observed that SES of the parents, their
general awareness about the maternal health & ANC utilization – all contribute
to the outcome of pregnancy. So, to improve the total picture, these areas should
be looked upon to be improved.

1) Outcome of pregnancy can be improved by improving educational status
of the mothers.
2) To educate the community by the village level workers like ASHA,
AWW regarding early registration of pregnancy, adequate number of
ANC visits.
3) Counseling of mothers in each antenatal visit regarding rest, diet, danger
signs, institutional delivery, taking iron and FA, TT by the Antenatal Care
providers.
4) Counseling on contraception should be done for proper birth spacing.
5) Improvement of the facility for investigations like VDRL, Hep.B, HIV
testing etc. by proper implementation of RCH II Programme.
6) The study can be improved by increasing the sample size & study
duration

 The study has following limitations :
1. The sample size was small due to shortage of time.
2. Proper documents were not available.

We heartily thank all the patients of the post natal ward for their fine co-
operation for providing us all the necessary information for smooth
conduction of our project.
We acknowledge our respected HOD of community Medicine, Prof. (Dr.)
Salil Kumar Bhattacharcharya and all the teachers of the department. We
thank our guides Dr. Sharmila Mallik, Dr. Soma Chakrabarti and Dr. Manufa
Bilkis for their huge help in completing this project. And finally we would
like to acknowledge our Principal Prof. Dr. Samir Chandra Ghosh Roy.
We extend our acknowledgement to HOD of GYNAECOLOGY &
OBSTRETICS, Prof. (Dr.) Arati Biswas and other teachers of the department
for their help in conducting the project.

REFERENCES
1. Dr. Manjula G. Kadapatti, Dr. A.H.M. Vijayalaxmi, Antenatal Care the Essence of
New Born Weight and Infant Development, International Journal of Scientific and
Research Publications, Volume 2, Issue 10, October 2012 1 ISSN 2250-3153.
2. C.S.Metgud*,S.M.Katti, M.D.Mallapur and A.S.Wantamutte, Utilization Patterns of
Antenatal Services Among Pregnant Women: A Longitudinal Study in Rural Area of
North Karnataka, Al Ameen J Med Sci (2009)2 (1 ) : 58 – 62.
3. Nomita Chandhiok, Balwan S Dhillon, Indra Kambo, Nirakar C Saxena,
Determinants of antenatal care utilization in rural areas of India : A cross-sectional
study from 28 districts (An ICMR task force study), J Obstet Gynecol India Vol. 56,
No. 1 : January/February 2006 Pg 47-52
4. K. Park, Textbook of Preventive and Social Medicine, 22e (2013)

INTRODUCTION
SNEHA DASGUPTA(101) & SUDIP RAY(97)
METHODOLOGY
SUMAN BISWAS (96)
TABLE NO. – 1,2,3,4
SWAGATO ROY (94)
TABLE NO. – 5,6,7,8
SOURAV NASKAR (95)
TABLE NO. – 9,10,11
SUDIPTA NASKAR (93)
TABLE NO. – 12,13,14
SUMANA BISWAS (100)
TABLE NO. – 14,15,16,17
SUBHASISH PATHAK (148)
TABLE NO. – 18,19
SHIBASIS GHOSH ()

TABLE NO. – 20,21,22
SUPARNA SAHU (102)
TABLE NO. – 28,29
RITUPRIYA CHOWDHURY (150)
TABLE NO. – 1, 2,
SOURAV MANDAL (98)
SUMMARY
SARBANI GHOSAL (99)
CONCLUSION
SHIBASIS GHOSH (149)
RECOMMENDATION
SOURAV MANDAL (98)
ACKNOWLEDGEMENT & REFERENCES
MD. IMRAN ANSARI (134)
LIMITATIONS
MIZAAN AHMED (147)

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