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Mezmur H, Assefa N, Alemayehu T. An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study. Glob Pediatr Health 2021; 8:2333794X21999154. [PMID: 33748345 PMCID: PMC7940719 DOI: 10.1177/2333794x21999154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference (P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.
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Baş EK, Bülbül A, Uslu S, Baş V, Elitok GK, Zubarioğlu U. Maternal Characteristics and Obstetric and Neonatal Outcomes of Singleton Pregnancies Among Adolescents. Med Sci Monit 2020; 26:e919922. [PMID: 32087083 PMCID: PMC7055197 DOI: 10.12659/msm.919922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Adolescent pregnancy remains a global public health issue with serious implications on maternal and child health, particularly in developing countries The aim of this study was to investigate maternal characteristics and obstetric and neonatal outcomes of singleton pregnancies among adolescents. Material/Methods A total of 241 adolescent women who gave birth to singletons between January 2015 and December 2015 at our hospital were included in this descriptive cross-sectional study. Data on maternal sociodemographic and obstetric characteristics as well as neonatal outcome were recorded. Results Primary school education (66.0%), lack of regular antenatal care (69.7%), religious (36.7%) and consanguineous (37.0) marriage, Southeastern Anatolia hometown (34.9%) and Eastern Anatolia hometown (21.2%) were noted in most of the adolescent pregnancies, while 95% were desired pregnancies within marriage. Pregnancy complications were noted in 19.5% (preeclampsia in 5.8%) and cesarean delivery was performed in 44.8% of adolescent pregnancies. Preterm delivery rate was 27.0% (20.3% were in >34 weeks). Overall, 13.3% of neonates were admitted to neonatal intensive care unit (NICU) in the postpartum period (prematurity in 28.1%), while 25.3% were re-admitted to NICU admission in the post-discharge 1-month (hyperbilirubinemia in 55.7%). Adolescent pregnancies were associated considerably high rates of fetal distress at birth (28.7%), preterm delivery (26.9%), and re-admission to NICU after hospital discharge (25.3%). Conclusions In conclusion, our findings indicate that along with considerably high rates of poor antenatal care, maternal anemia and cesarean delivery, adolescent pregnancies were also associated with high rates for fetal distress at birth, preterm delivery, and NICU re-admission within post-discharge 1-month.
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Affiliation(s)
- Evrim Kiray Baş
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Vedat Baş
- Department of Pediatrics, Istanbul Arel University, Istanbul, Turkey
| | - Gizem Kara Elitok
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Umut Zubarioğlu
- Department of Neonatology, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
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Abstract
Early marriages/child marriages, defined as formal marriages or informal unions before age 18, have been studied within other adolescence issues in Turkey. Adolescence pregnancies resulting from early marriages in Turkey should not be evaluated without considering the socio-cultural context. This is because this problem occurs mostly under the marriage structure even if it is too early (under the age of 18) and families approve of such marriages. The purpose of this study is to discuss adolescent pregnancies as a result of early marriages in Turkey in accordance with the socio-cultural context pertaining to the social structure of Turkey.
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Yuce T, Aker SS, Seval MM, Kalafat E, Soylemez F. Obstetric and neonatal outcomes of adolescent pregnancy. North Clin Istanb 2015; 2:122-127. [PMID: 28058352 PMCID: PMC5175089 DOI: 10.14744/nci.2015.86158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/09/2015] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE We performed a retrospective study to evaluate adolescent pregnancies as for gestational complications, and prinatal outcomes. METHODS We evaluated 341 pregnants whose data we could reach regarding gestational, and perinatal complications. RESULTS In our study group anemia (35.4%), preeclampsia/eclampsia (1.45%), premature membrane rupture (1.4%), intrauterine growth retardation (3.81%), and instrumental delivery (0.3%) were seen in indicated incidence rates. CONCLUSION In our retrospective study, we found lower our complication rates in adolescent age group when compared with the adult age group, and other studies performed in adolescents. Since our hospital is a tertiary health care institute, and we monitorized our patients closely, our incidence rates can be better than those cited in the literature. As long as proper antenatal surveillance is employed, adolescent mothers do not seem to have increased risk for most of obstetric complications.
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Affiliation(s)
- Tuncay Yuce
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seda Sahin Aker
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Murat Seval
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erkan Kalafat
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Feride Soylemez
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
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Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J OBSTET GYNAECOL 2014; 33:346-50. [PMID: 23654312 DOI: 10.3109/01443615.2013.767786] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of the study was to analyse and compare demographic characteristics and clinical outcomes of pregnancies in adolescent, advanced age and normal reproductive age women. All completed pregnancies in a 6-month period, registered by the family practitioners in Denizli province, were included into the study. A face-to-face questionnaire was used to gather information. Participants were asked for demographic information, pregnancy outcome and obstetric history, obstetric and neonatal problems. Overall 5,882 pregnancies in different age groups: 296 (5%) adolescent (< 20-years-old); 4,957 (84.3%) normal reproductive age (20-35-years-old) and 629 (10.7%) advanced age (> 35-years-old ) (group III), were included into the study. Adolescent women had a lower educational status (p < 0.01), and family played a major role in decision of marriage (p < 0.01). Birth weight of the baby was lower in adolescents (p < 0.01). While adolescents tended to deliver vaginally (OR = 1.9, p < 0.01), elderly women were more prone to operative delivery (OR = 1.2, p < 0.05). Risk of caesarean section rate was higher in elderly nulliparous women (OR = 2.2, p 0.01). The number of spontaneous and induced abortions were increased with age (p < 0.01). Antenatal problems were seen least frequently in normal reproductive age women. Both antenatal (OR = 1.7, p < 0.01) and neonatal problems (OR = 1.5, p < 0.05), were significantly higher in advanced age pregnancy. It was concluded that with sufficient antenatal care, adolescent pregnancy is not associated with an increase in adverse pregnancy outcome, except low birth weights. Advanced maternal age is more likely to be associated with increased obstetric, maternal and neonatal complications.
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Affiliation(s)
- A Karabulut
- Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.
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Uzun AK, Orhon FS, Baskan S, Ulukol B. A comparison between adolescent mothers and adult mothers in terms of maternal and infant outcomes at follow-ups. J Matern Fetal Neonatal Med 2012; 26:454-8. [PMID: 23020604 DOI: 10.3109/14767058.2012.733748] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the risk factors of adolescent pregnancies and to ascertain the effects of this condition on the maternal and infant outcomes. METHODS The study was carried out on 100 adolescent mothers less than 20 years of age and on a same number of adult mothers between 22 and 32 years of age and their infants. A socio-demographic attributes questionnaire form, a pregnancy follow-up and birth history form, and a mother and infant follow-up form were used. RESULTS The mean age of the adolescent mothers was 17.8 ± 0.7 years and that of the adult mothers was 26 ± 0.3 years. Income level of 83% of the families of adolescent mothers and 69% of the families of adult mothers was below the poverty line (p < 0.05). Dropout rate (i.e. rate of those not attending any school) was 36% in the adolescent group and 21% in the adult group. Rate of exclusively breastfeeding during the first 2 months was 40% in adolescents and 62% in adults (p < 0.01). Higher rates of adolescent mothers felt themselves inadequate infant care and with 7% of them experiencing problems in accessing a healthcare institution. CONCLUSIONS Properly following up adolescent pregnancies during prenatal and postnatal periods may be helpful for preventing the negative impacts on mother and infant health.
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Affiliation(s)
- Aysun Kara Uzun
- Department of Pediatrics, Etlik Zubeyde Hanim Gynecology and Obstetrics Education and Research Hospital, Ankara, Turkey
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Kuo CP, Lee SH, Wu WY, Liao WC, Lin SJ, Lee MC. Birth outcomes and risk factors in adolescent pregnancies: results of a Taiwanese national survey. Pediatr Int 2010; 52:447-52. [PMID: 19863752 DOI: 10.1111/j.1442-200x.2009.02979.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study explores birth outcomes and determinants in adolescent pregnancies, using subjects drawn from the Taiwan Birth Cohort Study (TBCS) from 2005. METHODS Through completed interviews and surveys with mothers or other family members, differences in birth outcomes and personal, pregnancy and social profiles of mothers were analyzed. RESULTS A total of 533 adolescent mothers (<20 years old) and 9347 adult mothers (20-34 years old) were included in our study. There was a significantly higher incidence of low birthweight (LBW) (<2500 g, 10.2% vs 5.6%) and premature birth (<37 weeks, 14.8% vs 8.6%) in the adolescent group. When adjusted for covariates in the multiple-variable model, youth remained a risk factor for LBW (OR = 1.50, 95%CI 1.09, 2.07) and premature delivery (OR = 1.42, 95%CI 1.07, 1.89). Age, prenatal care and weight gain during pregnancy are important predictors of LBW and premature birth. CONCLUSION Adolescent pregnancy carries a high-risk of LBW and premature birth. Inadequate prenatal care and weight gain during pregnancy are contributing factors that could be improved through strategies of health education, family support and case management.
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Affiliation(s)
- Ching-Pyng Kuo
- School of Nursing, Institute of Medicine, Chun Shan Medical University, Taichung, Taiwan
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Rocha RCL, de Souza E, Soares EP, Nogueira ES, Chambô Filho A, Guazzelli CAF. Prematurity and low birth weight among Brazilian adolescents and young adults. J Pediatr Adolesc Gynecol 2010; 23:142-5. [PMID: 19822446 DOI: 10.1016/j.jpag.2009.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 08/25/2009] [Accepted: 08/25/2009] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To compare the incidence of preterm birth and low birth weight infants in young and older primiparous adolescents versus young adults. DESIGN Cross-sectional study. SETTING Maternity hospital in Vitória, ES, Brazil. PARTICIPANTS During a 5-year period, young primiparous women who delivered a singleton liveborn infant over 22 weeks were interviewed while in the postpartum ward. INTERVENTIONS A single investigator performed all the individual interviews to collect sociodemographic variables and obtained gestational age and birth weight from the patients' charts before discharge. MAIN OUTCOME MEASURES Participants were divided into 3 groups according to age: young adolescents (10-15 years), older adolescents (16-19 y) and young adults (20-24 y). The chi(2) test was used to compare the rate of preterm birth and low birth weight between the groups and analyze differences in sociodemographic characteristics between the 3 groups. P<0.05 was considered significant. RESULTS A total of 1124 participants were included: 164 young adolescents, 537 older adolescents and 423 adults. The rate of preterm birth was similar in the 3 groups: 4.3%, 3.5% and 4.5%, for young adolescents, older adolescents and adults, respectively (P=0.48). The rate of low birth weight was significantly higher among young adolescents (9.7%) compared to older adolescents (6.1%) and young adults (3.5%) (P=0.012). CONCLUSIONS The rate of preterm birth was similar in adolescents and young adults. Adolescent mothers under 16 years of age have a significantly higher incidence of low birth weight infants.
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Affiliation(s)
- Ricardo C L Rocha
- Department of Obstetrics and Gynecology, Santa Casa de Misericórdia de Vitória Medical School, Espirito Santo, Brazil.
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Briggs MM, Hopman WM, Jamieson MA. Comparing Pregnancy in Adolescents and Adults: Obstetric Outcomes and Prevalence of Anemia. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2007; 29:546-555. [PMID: 17623567 DOI: 10.1016/s1701-2163(16)32506-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterize the obstetric outcome and prevalence of anemia in primiparous adolescents and compare them with those in older primiparas. METHODS We conducted a retrospective chart review of 207 adolescents (<or19 years old) and 415 adults (>or20 years old) whose prenatal care was provided by a single obstetrician in Kingston, Ontario, and who had a live singleton birth at >or24 weeks gestation between 1996 and 2004. RESULTS The mean age of the adolescents (T) was 17.5 years and of the adults (A) 27.3 years. More than 95% of the women were Caucasian. Mean gestational age at delivery was similar in the two groups (T 39.4 weeks, A 39.6 weeks, P = 0.25). Adolescents were more likely to have a preterm delivery (T 12.6%, A 7.5%, P = 0.038), although smoking rather than young maternal age was an independent risk factor for preterm delivery (odds ratio [OR] 3.2; 95% confidence intervals [CI] 1.47.5). A significantly lower proportion of adolescents delivered by Caesarean section (CS) (T 12.1%, A 27.7%, P < 0.001). Older maternal age, higher pre-pregnancy BMI, increased weight gain during pregnancy, and pre-delivery anemia were all independent risk factors for CS. Smoking was the most influential factor in predicting infant birth weight. Adolescents had significantly more low birth weight infants (< 2500 g) than adults (T 10.1% vs. A 4.3%, P = 0.008). Gestational age rather than young maternal age was the most significant risk factor for low birth weight (OR 3.3; 95% CI 1.95.7). After controlling for smoking status, adolescents were 2.5 times more likely than adults to be anemic at 26 to 35 weeks gestation and pre-delivery. CONCLUSION Our results suggest that primiparous adolescents have significantly different obstetric outcomes from primiparous adults. Smoking and anemia are significant risk factors for poor obstetric outcomes and are potentially modifiable.
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Affiliation(s)
- M Martha Briggs
- Department of Obstetrics and Gynaecology, Kingston General Hospital Queen's University, Kingston ON
| | - Wilma M Hopman
- Clinical Research Centre, Kingston General Hospital and Department of Community Health and Epidemiology, Queen's University, Kingston ON
| | - Mary Anne Jamieson
- Department of Obstetrics and Gynaecology, Kingston General Hospital Queen's University, Kingston ON
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