Prevalence of early antenatal care visit and its associated factors among pregnant women attending at Selam Health Center in 2025 Addis Ababa, Ethiopia

Abstract

Abstract Background: Antenatal care (ANC) is a cornerstone of maternal health services and plays a critical role in reducing pregnancy-related complications and improving maternal and neonatal outcomes. The World Health Organization recommends that the first ANC visit should occur before 12 weeks of gestation to enable timely screening, preventive interventions, and birth preparedness. Despite improvements in overall ANC coverage in Ethiopia, early initiation of ANC remains low. Limited facility-level evidence, particularly in urban settings such as Selam Local Health Center (LHC), constrains the development of targeted strategies to improve early ANC utilization. Objective: To determine the prevalence of early first ANC initiation and identify associated factors among pregnant women attending Selam LHC ANC Outpatient Department in Addis Ababa over a one-year period. Methods: A facility-basedcross-sectional study was conducted at Selam Local Health Center ANC Outpatient Department in Addis Ababa, Ethiopia, using records from August 1, 2024, to July 31, 2025. A total of 422 pregnant women who initiated their first ANC visit during the study period were selected using systematic random sampling from ANC registration logbooks. Data were extracted using a structured checklist and entered into SPSS version 27 for analysis. Descriptive statistics were used to estimate the prevalence of early ANC initiation. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with early ANC initiation. Adjusted Odds Ratios (AOR) with 95% Confidence Intervals (CI) were calculated, and a p-value of less than 0.05 was considered statistically significant. Results: Among the 422 pregnant women included in the study, only 118 (27.3%) initiated ANC early (≤12 weeks of gestation), while 304 (72.7%) initiated ANC late. In the multivariable logistic regression analysis, pregnancy intention, history of pregnancy complications, known medical condition and Age were identified as independent predictors of early ANC initiation. Conclusion: The prevalence of early ANC initiation at Selam Local Health Center was low. Pregnancy intention, previous pregnancy complications and knownmedical conditionswere key determinants of early ANC initiation. Strengthening family planning services, improving female education, and providing targeted counseling for women without prior obstetric complications may enhance timely ANC uptake and improve maternal health outcomes. Keywords: Early antenatal care, ANC initiation, pregnancy intention, maternal health, Addis Ababa, Ethiopia