Sociodemographic factors influencing antenatal booking time at antenatal clinic of mother and child hospital, Akure, Ondo State, Nigeria

Background: Early initiation of antenatal care (ANC) is crucial for optimal maternal and fetal outcomes. The World Health Organization (WHO) 2016 model recommends the first contact during the first trimester, and at least eight contacts overall. Nigeria continues to experience high maternal mortality, with 512 deaths per 100,000 live births reported in the 2018 NDHS. Methods: A cross-sectional study was conducted at Mother and Child Hospital, Akure, between June 2023 and April 2024. Systematic random sampling recruited 1,043 pregnant women presenting for booking. Data on age, parity, education, occupation, spouse characteristics, and religion were collected via structured questionnaire. Gestational age at booking was categorized by trimester. Chi-square tests examined associations (p<0.05). Results: Mean age was 32.0±4.93 years. Booking distribution: first trimester 20.6% (n=215), second trimester 62.4% (n=651), third trimester 17.0% (n=177). Maternal age was significantly associated with booking time (χ²=54.926, p=0.018): women aged 15-25 years had the highest first-trimester booking (28.6%) versus 20.1% for 26-35 years and 18.1% for 36-45 years. Parity was also significant (χ²=17.980, p=0.008): nulliparous women booked earliest (25.3% first trimester), while grand-multiparous women had the lowest (16.7%) and highest third-trimester booking (66.7%, standardized residual +2.99, p<0.01). Maternal education, spouse education, maternal occupation, spouse occupation, and religion showed no statistically significant association. Conclusions: Only one in five women booked in the first trimester. Younger age and nulliparity predicted earlier booking, while grand-multiparity predicted severe delay. Interventions must target experienced mothers who may underestimate risk.