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Ngonzi J, Birungi W, Byamukama O, Kamugisha A, Asiimwe J, Ntaro M, Nambozi G, Tibaijuka L, Tushabomwe-Kazooba C. Prevalence of and Factors Associated With Adverse Maternal Obstetrical Events Among Teenage Mothers Delivering in a Tertiary Referral Hospital in Southwestern Uganda. Cureus 2024; 16:e66168. [PMID: 39105202 PMCID: PMC11299131 DOI: 10.7759/cureus.66168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Many female teenagers in low-resource settings conceive, of which half are unplanned and end in many deaths in sub-Saharan Africa, accounting for the majority of the cases. Teenage pregnancy is associated sometimes with poor maternal, newborn, and child deaths. OBJECTIVES The aim of the study was to determine the prevalence, maternal obstetric outcomes, and factors associated with poor maternal obstetric outcomes among teenage mothers delivering at Mbarara Regional Referral Hospital. METHODS This was a cross-sectional study carried out in a maternity ward at Mbarara Regional Referral Hospital, where 9,200 mothers deliver annually. All the women coming in for the delivery of their babies were consecutively approached for inclusion in the study. The women were enrolled in the post-delivery ward after delivery and interviewed with pretested questionnaires to capture the sociodemographic, obstetric, and medical profiles of the mothers. Factors were significant if the p-value was <0.05. Results: Out of the 327 participants, the majority were rural dwellers (68.5%), married (75.8%), attained primary education (69.4%), had not used contraception (89%), and had had a planned pregnancy (63.3%). The prevalence of adverse maternal obstetrical events was 59.9%. The HIV-positive rate was 4.9%, and about half of the participants had delivered by cesarean section (41.6%). The participants' mean age was 18.4 years and SD 1.1. The mean number of antenatal care contacts attended was 4.59 and SD 1.9. The adverse maternal outcomes included episiotomy (30.9%), perineal tear (18.7%), premature rupture of membranes (10.1%), placenta abruption (5.2%), and pre-eclampsia/eclampsia (4%). Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants by 97% (adjusted odds ratio (aOR) (95% CI) of 0.03 (0.02-0.06), p-value<0.001). Having a prior history of a miscarriage was significantly associated with the occurrence of adverse maternal obstetrical events among the participants (aOR (95% CI) of 6.55 (1.46-29.42), p-value0.014). CONCLUSIONS Slightly more than half of the teenage mothers had adverse maternal obstetrical outcomes, and a history of a miscarriage in previous pregnancies was significantly associated with adverse maternal obstetrical outcomes. Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants. Teenage mothers are at a high risk of adverse maternal obstetrical outcomes, and close antepartum and intrapartum surveillance is recommended.
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Affiliation(s)
- Joseph Ngonzi
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Wilson Birungi
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Onesmus Byamukama
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Arnold Kamugisha
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Josephine Asiimwe
- Business Administration, Mbarara University of Science and Technology, Mbarara, UGA
| | - Moses Ntaro
- Community Health, Mbarara University of Science and Technology, Mbarara, UGA
| | - Grace Nambozi
- Nursing, Mbarara University of Science and Technology, Mbarara, UGA
| | - Leevan Tibaijuka
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
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Ngonzi J, Ainomugisha B, Byamukama O, Tumuhimbise W, Asiimwe J, Kamugisha A, Ntaro M, Nambozi G, Bebell L. Transition to Motherhood and Lived Experiences of Teenage Mothers Delivering in Kasese and Bundibugyo Districts, Western Uganda. Cureus 2024; 16:e63985. [PMID: 38974392 PMCID: PMC11227368 DOI: 10.7759/cureus.63985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction A large number of teenagers in low-resource settings experience pregnancy, with a significant number of these cases happening in sub-Saharan Africa. Teenage pregnancy is associated with unique physical and psychological experiences. Objective To explore the lived experiences of teenage mothers delivering at a tertiary referral hospital in southwestern Uganda. Methods This qualitative study used focus group discussions (FGDs) with teenage mothers in Kasese and Bundibugyo districts in Uganda. We purposively sampled 32 teenage mothers attending a tertiary referral hospital who had been pregnant at least once and had given birth. Sociodemographic information was obtained, and FGDs were conducted to capture the teenagers' experiences transitioning to motherhood. An inductive content analytic approach was used to analyze data. Results The mean age of the participants was 18.4 (standard deviation [SD], 1.2) years, with the majority (22, 68.8%) being rural dwellers, married (23, 71.9%), unemployed (21, 65.6%), and having attained primary education (23, 71.9%). Teenage mothers' lived experiences were characterized by shattered dreams, concerns about changes in their body size and shape, abandonment and neglect by family members and spouses, considerations of terminating the pregnancy, forced early marriages, family stereotypes, and engaging in sex for survival. The process of transitioning to motherhood occurred along with resilience post-pregnancy and supportive environments from their loved ones, which enabled them to accept reality and care for their children. Conclusions The lived experiences of teenage mothers demonstrated social pressures, fear of abandonment, and poverty as major influences on their mindset and behavior. Further research to gain a comprehensive understanding of the challenges encountered by teenage mothers will aid the development of culturally appropriate strategies to reduce teenage pregnancy and improve perinatal outcomes.
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Affiliation(s)
- Joseph Ngonzi
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Brenda Ainomugisha
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Onesmus Byamukama
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Wilson Tumuhimbise
- Information Technology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Josephine Asiimwe
- Business Administration, Mbarara University of Science and Technology, Mbarara, UGA
| | - Arnold Kamugisha
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Moses Ntaro
- Community Health, Mbarara University of Science and Technology, Mbarara, UGA
| | - Grace Nambozi
- Nursing, Mbarara University of Science and Technology, Mbarara, UGA
| | - Lisa Bebell
- Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Cluver L, Jochim J, Mapukata Y, Wittesaele C, Shenderovich Y, Mafuya S, Steventon Roberts K, Banougnin B, Sherr L, Toska E. Associations of formal childcare use with health and human capital development for adolescent mothers and their children in South Africa: A cross-sectional study. Child Care Health Dev 2024; 50:e13138. [PMID: 37287209 PMCID: PMC10952304 DOI: 10.1111/cch.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
AIM This study aims to investigate associations of formal childcare with maternal and child outcomes in a large sample of adolescent mothers. BACKGROUND Forty percent of adolescent girls in Africa are mothers. Increasing evidence shows positive impacts of formal childcare use for adult women, but no known studies in the Global South examine associations for adolescent mothers and their children. METHODS We interviewed 1046 adolescent mothers and completed developmental assessments with their children (n = 1139) in South Africa's Eastern Cape between 2017 and 2019. Questionnaires measured childcare use, maternal and child outcomes and socio-demographic background variables. Using cross-sectional data, associations between formal childcare use and outcomes were estimated in multivariate multi-level analyses that accounted for individual-level and family-level clustering. RESULTS Childcare use was associated with higher odds of being in education or employment (AOR: 4.01, 95% CIs: 2.59-6.21, p < .001), grade promotion (AOR: 2.08, 95% CIs: 1.42-3.05, p < .001) and positive future ideation (AOR: 1.58, 95% CIs: 1.01-2.49, p = .047) but no differences in mental health. Childcare use was also associated with better parenting on all measures: positive parenting (AOR: 1.66, 95% CIs: 1.16-2.38, p = .006), better parental limit-setting (AOR: 2.00, 95% CIs: 1.37-2.93, p < .001) and better positive discipline (AOR: 1.77, 95% CIs: 1.21-2.59, p = .003). For the children, there were no differences in temperament or illness, but a significant interaction showed stronger associations between childcare use and better cognitive, language and motor scores with increasing child age (AOR: 5.04, 95% CIs: 1.59-15.96, p = .006). CONCLUSIONS Adolescent mothers might benefit substantially from formal childcare, but causal links need to be explored further. Childcare use was also associated with improved parenting and better child development over time, suggesting positive pathways for children. At an average of $9 per month, childcare provisions for adolescent mothers may offer low-cost opportunities to achieve high returns on health and human capital outcomes in Sub-Saharan African contexts.
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Affiliation(s)
- Lucie Cluver
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
- Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| | - Janina Jochim
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | | | - Camille Wittesaele
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Yulia Shenderovich
- Wolfson Centre for Young People's Mental HealthUniversity of CardiffCardiffUK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
| | | | - Kathryn Steventon Roberts
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
- Institute for Global HealthUniversity College LondonLondonUK
| | - Bolade Banougnin
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
| | - Lorraine Sherr
- Institute for Global HealthUniversity College LondonLondonUK
| | - Elona Toska
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
- Department of SociologyUniversity of Cape TownCape TownSouth Africa
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Tesema GA, Teshale AB, Yeshaw Y, Angaw DA, Molla AL. Assessing the effects of duration of birth interval on adverse pregnancy outcomes in sub-Saharan Africa: a propensity score-matched analysis. BMJ Open 2023; 13:e062149. [PMID: 37015793 PMCID: PMC10083766 DOI: 10.1136/bmjopen-2022-062149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Unlike high-income countries, sub-Saharan African countries have the highest burden of adverse pregnancy outcomes such as abortion, stillbirth, low birth weight and preterm births. The WHO set optimal birth spacing as a key strategy to improve pregnancy outcomes. Estimating the impact of short and long birth intervals on adverse pregnancy outcomes based on an observational study like the Demographic and Health Survey (DHS) is prone to selection bias. Therefore, we used the propensity score-matched (PSM) analysis to estimate the actual impact of short and long birth intervals on adverse pregnancy outcomes. DESIGN A community-based cross-sectional study was conducted based on the DHS data. SETTING We used the recent DHS data of 36 sub-Saharan African countries. PARTICIPANTS A total of 302 580 pregnant women for stillbirth and abortion, 153 431 for birth weight and 115 556 births for preterm births were considered. PRIMARY OUTCOME MEASURES To estimate the impact of duration of birth interval (short/long) on adverse pregnancy outcomes, we used PSM analysis with logit model using psmatch2 ate STATA command to find average treatment effect on the population (ATE), treated and untreated. The quality of matching was assessed statistically and graphically. Sensitivity analysis was conducted to test the robustness of the PSM estimates using the Mantel-Haenszel test statistic. RESULTS The prevalence of short and long birth intervals in sub-Saharan Africa was 46.85% and 13.61%, respectively. The prevalence rates of abortion, stillbirth, low birth weight, macrosomia, and preterm births were 6.11%, 0.84%, 9.63%, 9.04%, and 4.87%, respectively. In the PSM analysis, the differences in ATE of short birth intervals on abortion, stillbirth, low birth weight, and preterm births were 0.5%, 0.1%, 0.2%, and 0.4%, respectively, and -2.6% for macrosomia. The difference in ATE among the treated group was 1%, 1%, and 1.1% increased risk of abortion, low birth weight, and preterm births, respectively, while there was no difference in risk of stillbirth between the treated and control groups. The ATEs of long birth intervals on abortion, stillbirth, low birth weight, macrosomia and preterm births were 1.3%, 0.4%, 1.0%, 3.4%, and 0.2%, respectively. The ATE on the treated group had 0.9%, 0.4%, 2.4%, 2.8%, and 0.2% increased risk of abortion, stillbirth, low birth weight, macrosomia, and preterm births, respectively. The estimates were insensitive to hidden bias and had a good quality of matching. CONCLUSION Short and long birth intervals had a significant positive impact on stillbirth, abortion, low birth weight, macrosomia and preterm births after matching treated and control groups by observed variables. These findings highlighted maternal and newborn healthcare programmes and policies to empower reproductive-aged women to exercise optimal birth spacing to reduce the incidence of stillbirth, abortion, low birth weight, macrosomia and preterm births.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Medical Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, Gondar University, Gondar, Ethiopia
| | - Ayenew Lakew Molla
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Mohammadian F, Nejadifard MM, Tofighi S, Garrosi L, Molaei B. Adverse Maternal, Perinatal, and Neonatal Outcomes in Adolescent Pregnancies: A Case-Control Study. J Res Health Sci 2023; 23:e00570. [PMID: 37571941 PMCID: PMC10422142 DOI: 10.34172/jrhs.2023.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Despite the increase in the age of marriage, early marriage and subsequent adolescent pregnancy remain a serious problem in many regions and societies. Due to low evidence in this regard, this study was conducted to determine the health consequences of adolescent pregnancy. STUDY DESIGN This was a case-control study. METHODS The present study was performed on pregnant women who were referred to Ayatollah Mousavi hospital of Zanjan for delivery in 2021. Pregnant women with gestational age less than 19 years were considered as the case group and those with gestational age between 19-35 years as the control group. The pregnancy outcomes on the mother and the neonate were obtained through the researcher-made checklist. Chi-square test and student's t-test were used to compare variables between the two groups. RESULTS In this study, 169 adolescent and 258 adult mothers were compared as the case and control groups, respectively. The mean age of cases and controls was 17.41±1.22 and 30.66±6.46 years, respectively. Cesarean delivery (34.5% vs. 23.67%, P=0.017) and anemia during pregnancy (16.28% vs. 10.7%, P=0.005) were significantly higher in the control group, while mood disorder after delivery was significantly higher in the case group (11.24% vs. 5.84%, P=0.04). The Apgar score 5 minutes after birth and birth weight were significantly higher in mothers of the control group (P<0.05). CONCLUSION The results demonstrated that adolescent mothers are more prone to postpartum depression, and babies born to these mothers are more prone to low birth weight and a low Apgar score. Therefore, adolescent pregnancy should be managed as a high-risk pregnancy.
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Affiliation(s)
- Farnaz Mohammadian
- Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Monireh Moharram Nejadifard
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Shabnam Tofighi
- Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Lida Garrosi
- Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Behnaz Molaei
- Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Envuladu EA, Issaka AI, Dhami MV, Sahiledengle B, Agho KE. Differential Associated Factors for Inadequate Receipt of Components and Non-Use of Antenatal Care Services among Adolescent, Young, and Older Women in Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054092. [PMID: 36901102 PMCID: PMC10001685 DOI: 10.3390/ijerph20054092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 05/10/2023]
Abstract
Nigerian women continue to die in childbirth due to inadequate health services such as antenatal care (ANC). Among other factors, the inadequate receipt or non-use of ANC appears to be associated with the age of women, remoteness, and poor households. This cross-sectional study aimed to compare the factors associated with inadequate receipt of the components and non-use of ANC among pregnant adolescents, and young and older women in Nigeria. Data for this study were from the 2018 Nigeria Demographic and Health Survey (NDHS) and covered a weighted total of 21,911 eligible women. Survey multinomial logistic regression analyses that adjusted for cluster, and survey weights were conducted to examine factors associated with adolescent, young, and older women. Adolescent women reported a higher prevalence of inadequate receipts and non-use of ANC than young and older women. Increased odds of inadequate receipt of the components of ANC were associated with residence in the North-East region and rural areas for all three categories of women. For adolescent women, the increased odds of inadequate receipt of the components of ANC were associated with delivering a baby at home and a big problem with distance to health facilities. Limited education or no schooling was associated with the increased odds of receiving inadequate ANC among older women. Implementing interventions to improve maternal and child health care should focus on the factors associated with the increased odds of receipt of inadequate or non-use of ANC services among Nigerian adolescent women, particularly those living in rural areas in the North-East region.
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Affiliation(s)
- Esther Awazzi Envuladu
- Department of Community Medicine, College of Health Sciences, University of Jos, Jos 930003, Nigeria
| | - Abukari Ibrahim Issaka
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Mansi Vijaybhai Dhami
- The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2571, Australia
| | - Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba 4540, Ethiopia
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2571, Australia
- African Vision Research Institute, Westville Campus, University of KwaZulu-Natal, Durban 3629, South Africa
- Correspondence: ; Tel.: +61-2-4620-3635
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Tembo CP, Portsmouth L, Burns SK. Mapping the contextual mental health interventions for perinatal adolescent mothers with self-reported common mental symptoms (anxiety and depression) in sub-Saharan African countries: a scoping review. J Child Adolesc Ment Health 2023; 35:147-164. [PMID: 38828874 DOI: 10.2989/17280583.2024.2323922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Introduction: Early preventive interventions may support adolescent mothers' mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub-Saharan African countries.Methods: The process was guided by the Joanna Briggs Institute's methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.
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Affiliation(s)
- Chimwemwe Pindani Tembo
- Saint John of God College of Health Sciences, Mzuzu Malawi
- Population Health, Curtin University, Perth, Australia
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Tesema GA, Wolde M, Tamirat KS, Worku MG, Fente BM, Tsega SS, Tadesse A, Teshale AB. Factors associated with short birth interval among reproductive-age women in East Africa. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231209879. [PMID: 37955253 PMCID: PMC10644753 DOI: 10.1177/17455057231209879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/26/2023] [Accepted: 09/28/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Child and maternal mortality continue as a major public health concern in East African countries. Optimal birth interval is a key strategy to curve the huge burden of maternal, neonatal, infant, and child mortality. To reduce the incidence of adverse pregnancy outcomes, the World Health Organization recommends a minimum of 33 months between two consecutive births. Even though short birth interval is most common in many East African countries, as to our search of literature there is limited study published on factors associated with short birth interval. Therefore, this study investigated factors associated with short birth intervals among women in East Africa. OBJECTIVE To identify factors associated with short birth intervals among reproductive-age women in East Africa based on the most recent demographic and health survey data. DESIGN A community-based cross-sectional study was conducted based on the most recent demographic and health survey data of 12 East African countries. A two-stage stratified cluster sampling technique was employed to recruit the study participants. METHODS AND ANALYSIS A total weighted sample of 105,782 reproductive-age women who had two or more births were included. A multilevel binary logistic regression model was fitted to identify factors associated with short birth interval. Four nested models were fitted and a model with the lowest deviance value (-2log-likelihood ratio) was chosen. In the multivariable multilevel binary logistic regression analysis, the adjusted odds ratio with the 95% confidence interval was reported to declare the statistical significance and strength of association between short birth interval and independent variables. RESULTS The prevalence of short birth interval in East Africa was 16.99% (95% confidence interval: 16.76%, 17.21%). Women aged 25-34 years, who completed their primary education, and did not perceive the distance to the health facility as a major problem had lower odds of short birth interval. On the contrary, women who belonged to the poorest household, made their own decisions with their husbands/partners or by their husbands or parents alone, lived in households headed by men, had unmet family planning needs, and were multiparous had higher odds of having short birth interval. CONCLUSION Nearly one-fifth of births in East Africa had short birth interval. Therefore, it is essential to promote family planning coverage, improve maternal education, and empower women to decrease the incidence of short birth intervals and their effects.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Maereg Wolde
- Department of Health Education and Behavioral Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aster Tadesse
- Department of Nursing, College of Health Sciences, Debre Markos University, Markos, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Parvin K, Talukder A, Mamun MA, Kalra S, Laterra A, Naved RT. A cluster randomized controlled trial for measuring the impact of a social norm intervention addressing child marriage in Pirgacha in Rangpur district of Bangladesh: study protocol for evaluation of the Tipping Point Initiative. Glob Health Action 2022; 15:2057644. [PMID: 35441566 PMCID: PMC9037192 DOI: 10.1080/16549716.2022.2057644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Child Marriage (CM) is one of the major developmental concerns in Bangladesh, reporting one of the highest rates of CM (59%) globally. To date, interventions to address CM in Bangladesh have failed to seriously engage with social norms that are important contributors to CM. This paper describes the evaluation design of the Tipping Point Initiative that aims to reduce CM through social norm change and increasing adolescent girls’ agency to voice their rights. The Tipping Point Initiative evaluation trial employs a mixed method design. The quantitative component includes a three-arm Cluster Randomized Controlled Trial design, where Arm 1 receives Tipping Point Program (TPP); Arm 2 receives Tipping Point Program Plus (TPP+), a social norms-enhanced version of TPP; and Arm 3 is the Control. The trial covers 51 clusters (villages) in Pirgacha, in Rangpur district, randomized into three study arms (17 per arms). From each cluster, a cohort of 25 adolescent girls aged 12–<16 years were selected randomly for participation in the survey and intervention. Further, a cross-section of adults (six males and six females) were randomly selected from each cluster for survey. Qualitative baseline data were collected from two purposively selected intervention villages in each intervention arm. Thirty In-Depth Interviews, eight Key Informant Interviews and 16 Focus Group Discussion were conducted with adolescent girls, boys, adult women and men. Same strategies have been followed at endline. The intervention was implemented from April 2019 to December 2020. The endline was conducted 10 months after the end of intervention. Intention-to-treat analysis approach will be used for impact assessment. Both narrative analysis and Grounded Theory approach will be employed in analysing qualitative data. The learnings are expected to inform programs and policies regarding what works and does not work to address CM in such social norms intervention in Bangladesh.
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Affiliation(s)
- Kausar Parvin
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Aloka Talukder
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Mahfuz Al Mamun
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
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Nambile Cumber S, Atuhaire C, Namuli V, Bogren M, Elden H. Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study. Glob Health Action 2022; 15:2067397. [PMID: 35762835 PMCID: PMC9246142 DOI: 10.1080/16549716.2022.2067397] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In Uganda, the uptake of maternal health services is very low, with only 41.1% of pregnant adolescent girls attending the eight antenatal visits that are recommended by the World Health Organisation. Uptake of maternal health services is essential in reducing the current level of adolescent pregnancies as well as its adverse effects on adolescent mothers and their babies, such as preterm deliveries, prolonged labour, death during pregnancy, and childbirth. No previous study has described pregnant adolescents' experiences with maternal health services in Uganda. OBJECTIVE This study aimed to describe the barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda. METHODS Data were collected in the Naguru Teenage Information and Health Centre in Uganda through individual interviews involving 31 pregnant adolescents. The transcribed interviews were inductively analysed through content analysis. RESULTS The pregnant adolescents described difficulty in reaching, as well as lack of financial support to visit, the Naguru Teenage Information and Health Centre, which is a clinic providing youth friendly services. Feelings of being discriminated against and disrespected by health workers, and lack of privacy when receiving health services was major barriers that hindered their access to maternal health services. Pregnant adolescents' access to these services can be enhanced by improving health workers' working conditions, accelerating community and health worker awareness on ways to mitigate these barriers, and developing policies that encourage men's involvement in maternal health services. CONCLUSION Adolescents in Uganda face considerable barriers to accessing improved and quality maternal health services. To mitigate these barriers, according to the adolescents, considerable efforts are required to tackle health workers' working conditions and sensitise the community on the importance of, as well as securing the availability of, maternal health services for pregnant adolescents. Future research should focus on pregnant adolescents who receive family support.
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Affiliation(s)
- Samuel Nambile Cumber
- Institute of Health and Care Sciences; The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Section for Epidemiology and Social Medicine; Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Vivian Namuli
- Section for Epidemiology and Social Medicine; Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Malin Bogren
- Institute of Health and Care Sciences; The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Helen Elden
- Institute of Health and Care Sciences; The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of obstetrics and gynaecology, Sahlgrenska University hospital, Gothenburg, Sweden
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11
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Pepito VCF, Amit AML, Tang CS, Co LMB, Aliazas NAK, De Los Reyes SJ, Baquiran RS, Tanchanco LBS. Exposure to family planning messages and teenage pregnancy: results from the 2017 Philippine National Demographic and Health Survey. Reprod Health 2022; 19:229. [PMID: 36544191 PMCID: PMC9769471 DOI: 10.1186/s12978-022-01510-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Teenage pregnancy is known to have physical, emotional, and psychosocial effects. Because of these risks, family planning and contraception messages have been disseminated in various forms of media, but their association with teenage pregnancy has not been studied previously in the Philippines. This study aims to examine the association between exposure to various family planning and contraception messages disseminated in various media channels and pregnancy among Filipino women aged 15-19. The study also intended to examine interactions between the different media channels where these family planning and contraception messages are being disseminated on their effect on teenage pregnancy. METHODS We used data from the individual recode of the 2017 Philippine National Demographic and Health Survey. We used logistic regression for survey data to study the association between exposure to family planning and contraception messages and teenage pregnancy. RESULTS Out of 5120 respondents, 44% of respondents have accessed information on contraception from the internet, 25% have heard information about contraception through the radio, 55% of respondents have heard about contraception via television, 15% have read about contraception in the newspapers and magazines, and only 6% have received information on contraception via short messaging service (SMS). There were 420 (8.56%) who have ever been pregnant. After adjusting for confounding variables, those who were exposed to family planning/contraceptive messages via the internet (aOR: 0.90; 95% CI: 0.59, 1.35) and newspapers/magazines (aOR: 0.78; 95% CI: 0.44, 1.41) have lower odds of teenage pregnancy, but no strong evidence of their effectiveness. On the other hand, exposure to family planning messages through the radio (aOR: 1.06; 95% CI: 0.71, 1.59), television (aOR: 1.09; 95% CI: 0.72, 1.65), and short messaging service (aOR: 1.29; 95% CI: 0.51, 3.22) marginally increase the risk of teenage pregnancy. We did not find any pairwise interactions between the different exposure variables. CONCLUSIONS Our results highlight the need to improve the content and key messages of contraceptive and family planning messages in the Philippines, especially those that are broadcasted online and in print media. There is also a need to increase the reach of these different family planning and contraception messages, especially by utilizing social media and other print and online media platforms commonly used by the youth.
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Affiliation(s)
- Veincent Christian F. Pepito
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Arianna Maever L. Amit
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines ,grid.11159.3d0000 0000 9650 2179National Clinical Trials and Translation Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Clinton S. Tang
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Luis Miguel B. Co
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Neil Andrew K. Aliazas
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Sarah J. De Los Reyes
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines ,Dr. Fe del Mundo Medical Center, Quezon, Philippines
| | - Raymundo S. Baquiran
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Lourdes Bernadette S. Tanchanco
- grid.443223.00000 0004 1937 1370School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines ,The Medical City, Pasig, Philippines ,MedMom Institute for Human Development, Mandaluyong, Philippines
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Pons-Duran C, Mombo-Ngoma G, Macete E, Desai M, Kakolwa MA, Zoleko-Manego R, Ouédragou S, Briand V, Valá A, Kabanywanyi AM, Ouma P, Massougbodji A, Sevene E, Cot M, Aponte JJ, Mayor A, Slutsker L, Ramharter M, Menéndez C, González R. Burden of malaria in pregnancy among adolescent girls compared to adult women in 5 sub-Saharan African countries: A secondary individual participant data meta-analysis of 2 clinical trials. PLoS Med 2022; 19:e1004084. [PMID: 36054101 PMCID: PMC9439219 DOI: 10.1371/journal.pmed.1004084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Malaria is among the top causes of death in adolescent girls (10 to 19 years) globally. Adolescent motherhood is associated with increased risk of adverse maternal and neonatal outcomes. The interaction of malaria, adolescence, and pregnancy is especially relevant in malaria endemic areas, where rates of adolescent pregnancy are high. However, data on burden of malaria among adolescent girls are limited. This study aimed at investigating whether adolescent girls were at a greater risk of experiencing malaria-related outcomes in pregnancy-parasitaemia and clinical disease-than adult women. METHODS AND FINDINGS An individual secondary participant-level meta-analysis was conducted using data from 5,804 pregnant women participating in 2 malaria prevention clinical trials in Benin, Gabon, Kenya, Mozambique, and Tanzania between 2009 and 2014. Of the sample, 1,201 participants were adolescent girls with a mean age of 17.5 years (standard deviation (SD) 1.3) and 886 (73.8%) of them primigravidae. Among the 4,603 adult women with mean age of 27.0 years (SD 5.4), 595 (12.9%) were primigravidae. Mean gestational age at enrolment was 20.2 weeks (SD 5.2) and 1,069 (18.4%) participants were HIV-infected. Women were followed monthly until the postpartum visit (1 month to 6 weeks after delivery). This study considered outcomes including clinical episodes during pregnancy, peripheral parasitaemia at delivery, and placental malaria. A 2-stage meta-analysis approach was followed by pooling single multivariable regression results into standard DerSimonian-Laird random-effects models. Adolescent girls were more likely than adult women to present with clinical malaria during pregnancy (incidence risk ratio (IRR) 1.70, 95% confidence interval (CI) 1.20; 2.39, p-value = 0.003, I2 = 0.0%, N = 4,092), peripheral parasitaemia at delivery (odds ratio (OR) 2.28, 95% CI 1.46; 3.55, p-value < 0.001, I2 = 0.0%, N = 3,977), and placental infection (OR 1.97, 95% CI 1.31; 2.98, p-value = 0.001, I2 = 1.4%, N = 4,797). Similar associations were observed among the subgroup of HIV-uninfected participants: IRR 1.72 (95% CI 1.22; 2.45, p-value = 0.002, I2 = 0.0%, N = 3,531) for clinical malaria episodes, OR 2.39 (95% CI 1.49; 3.86, p-value < 0.001, I2 = 0.0%, N = 3,053) for peripheral parasitaemia, and OR 1.88 (95% CI 1.06 to 3.33, p-value = 0.03, I2 = 34.9%, N = 3,847) for placental malaria. Among HIV-infected subgroups statistically significant associations were not observed. Similar associations were found in the subgroup analysis by gravidity. The small sample size and outcome prevalence in specific countries limited the inclusion of some countries in the meta-analysis. Furthermore, peripheral parasitaemia and placental malaria presented a considerable level of missing data-12.6% and 18.2% of participants had missing data on those outcomes, respectively. Given the original scope of the clinical trials, asymptomatic malaria infection was only assessed at the end of pregnancy through peripheral and placental parasitaemia. CONCLUSIONS In this study, we observed that adolescent girls in sub-Saharan Africa (SSA) are more prone to experience clinical malaria episodes during pregnancy and have peripheral malaria and placental infection at delivery than adult women. Moreover, to the best of our knowledge, for the first time this study disaggregates figures and stratifies analyses by HIV infection. Similar associations were found for both HIV-infected and uninfected women, although those for HIV-infected participants were not statistically significant. Our finding suggests that adolescent girls may benefit from targeted malaria prevention strategies even before they become pregnant.
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Affiliation(s)
- Clara Pons-Duran
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Clinics, Eberhard Karls University Tübingen, Tübingen, Germany.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & Dept. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eusebio Macete
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Meghna Desai
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Rella Zoleko-Manego
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Clinics, Eberhard Karls University Tübingen, Tübingen, Germany.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & Dept. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Smaïla Ouédragou
- Département de santé publique, Unité de formation en sciences de la santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.,Faculté de Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin
| | - Valérie Briand
- Université de Paris, MERIT, IRD, Paris, France.,IRD, Inserm, Université de Bordeaux, IDLIC team, UMR 1219, Bordeaux, France
| | - Anifa Valá
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | | | - Peter Ouma
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.,Department of Medical Laboratory Sciences, Maseno University School of Medicine, Kenya
| | | | - Esperança Sevene
- Manhiça Health Research Center (CISM), Manhiça, Mozambique.,Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Michel Cot
- Université de Paris, MERIT, IRD, Paris, France
| | - John J Aponte
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Laurence Slutsker
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.,PATH, Malaria and NTDs, Seattle, Washington, United States of America
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & Dept. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Clara Menéndez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Raquel González
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Manhiça Health Research Center (CISM), Manhiça, Mozambique
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Amoadu M, Hagan D, Ansah EW. Adverse obstetric and neonatal outcomes of adolescent pregnancies in Africa: a scoping review. BMC Pregnancy Childbirth 2022; 22:598. [PMID: 35896998 PMCID: PMC9327294 DOI: 10.1186/s12884-022-04821-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent pregnancy is a public health issue with well-defined causes and health risks with social and economic implications. Aim of this review was to examine adverse pregnancy outcomes and risk factors associated with adolescent pregnancy in Africa. METHOD PubMed Central, Science Direct and JSTOR were the main databases for the literature review. Other online sources and experts were consulted for relevant studies. In all, 11,574 records were identified and 122 were considered as full-text studies for evaluation after thorough screening and removal of duplicates. Finally, 53 studies were included in this review for thematic synthesis. RESULTS The 53 studies sampled 263,580 pregnant women, including 46,202 adolescents (< 20 years) and 217,378 adults (> 20 years). Adolescent pregnancy was associated with higher risks of adverse pregnancy outcomes. Factors of poor pregnancy outcomes included low socioeconomic and educational status, poor utilization of antenatal care, risky lifestyles such as alcohol consumption, and unattractive health care factors. Maternal health care utilization was identified as an important factor to improve pregnancy outcomes among adolescents in Africa. CONCLUSION To prevent adolescent pregnancy, stakeholders need to help lower socioeconomic inequalities, poor utilization of antenatal care, alcohol consumption, and improve adolescents' health care and their educational status. Issues such as child marriage, abortion, poor health care infrastructure and non-adolescent friendly health facilities need to be addressed.
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Affiliation(s)
- Mustapha Amoadu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
| | - Doris Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Edward W Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
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Vasconcelos A, Bandeira N, Sousa S, Machado MC, Pereira F. Adolescent pregnancy in Sao Tome and Principe: are there different obstetric and perinatal outcomes? BMC Pregnancy Childbirth 2022; 22:453. [PMID: 35642050 PMCID: PMC9153156 DOI: 10.1186/s12884-022-04779-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adolescent childbirth is a major public health problem in Sao Tome and Principe (STP). Adolescent pregnancy and childbirth can carry a risk of morbidity associated with the physiological and sociological characteristics of teenage girls. This study aims to identify the main adverse obstetric and perinatal outcomes for adolescent pregnancies in the Hospital Dr. Ayres de Menezes (HAM), the only hospital in STP. METHODS An institution-based cross-sectional study. Pregnant women ≤ 19 years of age (n = 104) were compared to non-adolescent women (n = 414). The obstetric and perinatal outcomes were compared between groups using the t test. Odds ratio (OR) were calculated through Cochran's and Mantel-Haenszel statistics test for odds ratio equal to 1, 95% confidence intervals (CI) and p values (p < 0.05) were considered significant. RESULTS The adverse perinatal outcomes imputable to adolescent births were foetal distress with low first minute Apgar score < 7 (OR 1.94, 95% CI 1.18-3.18, p = 0.009) and performance of neonatal resuscitation manoeuvres (OR 2.4, 95% CI 1.07-5.38, p = 0.032). Compared to older mothers, teenage girls were likely to have a non-statistically significant threefold higher risk of having an obstructed labour (OR 3.40, 95% CI 0.89-12.94, p = 0.07). Other perinatal outcomes as neonatal asphyxia, risk for cerebral palsy, premature birth, early neonatal infection, and neonatal death were identical between groups as well as maternal anaemia, mode of delivery or other obstetrical outcomes. CONCLUSION Adolescent pregnancies were associated with worse perinatal outcomes as foetal distress and higher need for neonatal resuscitation manoeuvres. This study may support STP health authorities in their efforts to make Sustainable Development Goals 3 (good health and wellbeing), 4 (quality education) and 5 (gender equality) a reality by 2030, since it identifies specific problems that need to be addressed to improve maternal adolescent health.
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Affiliation(s)
- Alexandra Vasconcelos
- Unidade de Clínica Tropical ‑ Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Nelson Bandeira
- Hospital Dr. Ayres de Menezes, República Democrática de São Tomé E Príncipe, Sao Tome, Sao Tome and Principe
| | - Swasilanne Sousa
- Hospital Dr. Ayres de Menezes, República Democrática de São Tomé E Príncipe, Sao Tome, Sao Tome and Principe
| | - Maria Céu Machado
- Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Filomena Pereira
- Unidade de Clínica Tropical ‑ Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, Lisbon, Portugal
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Budu E, Chattu VK, Ahinkorah BO, Seidu AA, Mohammed A, Tetteh JK, Arthur-Holmes F, Adu C, Yaya S. Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa. BMC Pregnancy Childbirth 2021; 21:834. [PMID: 34906105 PMCID: PMC8670119 DOI: 10.1186/s12884-021-04280-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Methods Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. Results Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. Conclusion Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.
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Affiliation(s)
- Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Vijay Kumar Chattu
- Department of Public Health, Saveetha Medical College and Hospitals, SIMATS, Saveetha University, Chennai, TN, 600077, India.,Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, MS, 442107, India
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia. .,Centre For Gender and Advocacy, Takoradi Technical University, P.O.Box 256, Takoradi, Ghana.
| | - Aliu Mohammed
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.,The George Institute for Global Health, Imperial College London, London, UK
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Chaura T, Mategula D, Gadama LA. Adolescent pregnancy outcomes at Queen Elizabeth Central Hospital, Malawi: a cross-sectional study. Malawi Med J 2021; 33:261-268. [PMID: 35291391 PMCID: PMC8892997 DOI: 10.4314/mmj.v33i4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Malawi has a growing population with a high Maternal Mortality Ratio (MMR) of 439 per 100,000 live births to which adolescents contribute 25%. Current data suggests adolescent pregnancies in low resource settings are at an increased risk of both maternal and neonatal morbidity. Objectives This study assessed the pregnancy outcomes amongst adolescents while using women from the early adulthood (20 - 24-year-old) and advanced maternal age (35 years old and above) groups as reference. Methods This was a cross-sectional study, carried out at the Chatinkha maternity (labour) and post-natal wards at QECH, and included all adolescents (10 - 19 years old) and women between 20 - 24 years old (early adulthood) and 35 years old or older (advanced maternal age), presenting in labor, at any gestational age ≥ 28 weeks or with a birth weight of 1000 grams or above. Results The study found the prevalence of adolescent pregnancy to be 20.4% (N=5035) out of all the deliveries during the recruitment period. Sexually transmitted infections were proportionally higher in the adolescent group, with 12% testing HIV seroreactive and 10% syphilis seroreactive. Neonatal outcomes of birth asphyxia (3.5%), low birth weight (5%), prematurity (4.3%) and early neonatal death (4.3%) were not statistically different from the outcomes of the older age groups. The major causes of maternal morbidity were determined to be a high caesarean section rate of 31.9% and intrapartum diagnosis of urinary tract infection (7.4%), malaria (7.4%) and hypertensive disorders (14.5%). Conclusions Adolescents are a significant proportion of the pregnant population in Malawi. These adolescents are at increased risk of some pregnancy and peripartum complications when compared to women of older age groups. However, our study determined that these outcomes appear to be more likely related to the peripartum care received and not solely specific to maternal age.
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Affiliation(s)
| | - Donnie Mategula
- Kamuzu University of Health Sciences, Malawi
- Malawi-Liverpool Wellcome Trust, Kamuzu University of Health Sciences, Malawi
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Mezmur H, Assefa N, Alemayehu T. Teenage Pregnancy and Its Associated Factors in Eastern Ethiopia: A Community-Based Study. Int J Womens Health 2021; 13:267-278. [PMID: 33664597 PMCID: PMC7924244 DOI: 10.2147/ijwh.s287715] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/04/2021] [Indexed: 11/28/2022] Open
Abstract
Background Teenage pregnancy is a global issue raising concerns for all who are interested in the health and well-being of young women and their children. It carries major health and social issues with unique medical and psychosocial consequences for both adolescents and society in general. This study aimed at assessing the prevalence and factors associated with teenage pregnancy in eastern Ethiopia. Methods A community-based cross-sectional study was conducted. Multi-stage simple random sampling procedure was used to select 2258 female teenagers. Interviewer-administered questionnaire was used for data collection. Data were entered into EpiData and analyzed using stata software. The Poisson regression model with robust variance estimation was used to examine the association of the independent variable with teenage pregnancy. An adjusted prevalence ratio (APR) with 95% confidence intervals (CI) was reported. Results The prevalence of teenage pregnancy was 30.2% (95% CI: 28.3, 32.1). Age 16–17 years old (APR=7.05; 95% CI: 4.15,11.96), 17–18 years old (APR=9.85; 95% CI: 5.72,16.98), not being in school (APR=2.83; 95% CI: 1.93,4.16), lack of formal education (APR=1.11; 95% CI: 1.03,1.19), being married (APR=3.59; 95% CI: 2.83,4.56), parental divorce (APR=1.24; 95% CI: 1.08,1.42), having elder sister who had a history of teenage pregnancy (APR=1.11; 95% CI: 1.02,1.21), and not knowing fertile period in menstrual cycle (APR=1.31; 95% CI: 1.16,1.47) were independently associated with teenage pregnancy. Conclusion One in three teenagers had been pregnant. Age, not being in school, lack of formal education, being married, parental divorce, having an elder sister who had a history of teenage pregnancy, and not knowing fertile period during the menstrual cycles were the factors associated with teenage pregnancy. In Ethiopia, further efforts are required in the prevention of teenage pregnancy, keeping girls in school and strengthening the policy of delaying child marriage, particularly in rural areas.
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Affiliation(s)
- Haymanot Mezmur
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Alemayehu
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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DeLong SM, Brooks MI, Aliou S, Lundgren R, Corneliess C, Johns NE, Challa S, Carter N, Lauro G, Silverman JG. Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence. PLoS One 2020; 15:e0231392. [PMID: 32282817 PMCID: PMC7153890 DOI: 10.1371/journal.pone.0231392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/23/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this analysis was to compare and contrast reproductive health (RH), gender equity attitudes, and intimate partner violence (IPV) among married very young adolescent (VYA) girls with married older adolescent girls and young women (AGYW) in rural Niger given limited literature on the topic. METHODS We conducted an exploratory analysis of baseline data from the Reaching Married Adolescents Trial in Dosso region, Niger. We report counts and percents, by age group (13-14 years (VYA), 15-16 years, 17-19 years), of AGYW's self-efficacy to use family planning (FP), accurate knowledge of FP, current use of modern FP, and unintended last pregnancy (UIP); lifetime reproductive coercion (RC), physical IPV, and sexual IPV; and gender equity attitudes. We also assess whether percents differ between VYA and older groups using Pearson's Chi-Square and Fisher's exact p-values. Results are stratified by parity. Finally, we use logistic regression to consider associations. RESULTS There were 49 VYA, 248 girls aged 15-16, and 775 AGYW aged 17-19 in our sample (n = 1072). Accurate knowledge of FP, self-efficacy to use FP, current use of modern FP, and UIP increased with age; all percents between VYA and AGYW 17-19 were marginally or statistically significantly different. We also saw VYA report higher lifetime RC and sexual IPV versus older groups, with sexual IPV statistically different between VYA and girls 17-19. Parous VYA reported a significantly higher percent of lifetime RC versus older AGYW. Among 17-19 year-olds, odds of current use of FP were higher among AGYW who reported physical IPV, and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity. CONCLUSIONS We observed differences in RH, RC, and sexual IPV among married VYA and older AGYW in rural Niger. VYA should be prioritized in research to confirm and further understand their RH needs.
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Affiliation(s)
- Stephanie M. DeLong
- University of California, San Diego, La Jolla, California, United States of America
| | - Mohamad I. Brooks
- Pathfinder International, Watertown, Massachusetts, United States of America
| | | | - Rebecka Lundgren
- University of California, San Diego, La Jolla, California, United States of America
| | - Caitlin Corneliess
- Pathfinder International, Watertown, Massachusetts, United States of America
| | - Nicole E. Johns
- University of California, San Diego, La Jolla, California, United States of America
| | - Sneha Challa
- University of California, San Diego, La Jolla, California, United States of America
| | - Nicole Carter
- University of California, San Diego, La Jolla, California, United States of America
| | - Giovanna Lauro
- Promundo–United States, Washington, DC, United States of America
| | - Jay G. Silverman
- University of California, San Diego, La Jolla, California, United States of America
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Malaria-Associated Factors among Pregnant Women in Guinea. J Trop Med 2019; 2019:3925094. [PMID: 31885633 PMCID: PMC6925697 DOI: 10.1155/2019/3925094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Malaria is the leading cause of consultation in Guinea health facilities. During pregnancy, it remains a major health concern causing considerable risks for mother, fetus, and newborn. However, little is known about the epidemiology of malaria among pregnant women in Guinea. We aimed to provide information on malaria-associated factors in parturients. Methods It was a cross-sectional survey in two regional hospitals and two district hospitals. 1000 parturients and their newborns were surveyed. All patients were interviewed, and thick and thin blood smears were examined. To determine the predictive factors of malaria in parturients, the Classification and Regression Tree (CART) was first performed by using peripheral and placental malaria as dependent variables and sociodemographic and antenatal characteristics as independent variables; then, explanatory profile variables or clusters from these trees were included in the logistic regression models. Results We found 157 (15.8%) and 148 (14.8%) cases of peripheral and placental malaria, respectively. The regular use of long-lasting insecticide-treated nets (LLINs) before delivery was 53.8%, and only 35.5% used sulfadoxine-pyrimethamine doses ≥3. Factors significantly associated with malaria were as follows: women from Forécariah and Guéckédou who did not regularly use LLINs and accomplished less than four antenatal care visits (ANC <4) and primigravid and paucigravid women who did not regularly use LLINs. Similarly, the odds of having malaria infection were significantly higher among women who had not regularly used LLINs and among primigravid and paucigravid women who had regularly used LLINs compared to multigravida women who had regularly used LLINs. Conclusion This study showed that pregnant women remain particularly vulnerable to malaria; therefore, strengthening antenatal care visit strategies by emphasizing on promoting the use of LLINs and sulfadoxine-pyrimethamine, sexual education about early pregnancies, and family or community support during first pregnancies might be helpful.
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Placental gene expression and antibody levels of mother-neonate pairs reveal an enhanced risk for inflammation in a helminth endemic country. Sci Rep 2019; 9:15776. [PMID: 31673046 PMCID: PMC6823435 DOI: 10.1038/s41598-019-52074-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023] Open
Abstract
In utero exposure to environmental factors can modify the development of allergies later in life whereby the mechanisms of the feto-maternal crosstalk still remain largely unknown. Murine studies revealed that inflammatory maternal signals elicited by chronic helminth infection within the placenta imprint a distinct gene expression profile related to the Vitamin-D-receptor (VDR)-inflammation-axis. We thus investigated whether pro- or anti- inflammatory immune responses as well as VDR and related gene expression within the placenta differ between women from helminth-endemic and non-endemic areas. A prospective pilot study was conducted in Munich, Germany (helminth non-endemic) and Lambaréné, Gabon (helminth-endemic). At delivery, clinical information alongside placenta tissue samples and maternal and cord blood were obtained for further laboratory analysis. Schistosoma haematobium infection was detected in 13/54 (23%) Gabonese women. RT PCR revealed significantly lower gene expression of VDR, Cyp27b1, Foxp3 and IL10 in Gabonese compared to German placentae as well as significantly lower levels of plasma IgG4 in newborns resulting in a significantly higher IgE/IgG4 ratio. These findings demonstrate that exposure in utero to different environments alters placental gene expression and thus possibly plays a role in the development and modulation of the immune system of the offspring.
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21
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Mekonnen T, Dune T, Perz J. Maternal health service utilisation of adolescent women in sub-Saharan Africa: a systematic scoping review. BMC Pregnancy Childbirth 2019; 19:366. [PMID: 31638927 PMCID: PMC6805384 DOI: 10.1186/s12884-019-2501-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/11/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Sub-Saharan Africa has the highest rate of adolescent pregnancy in the world. While pregnancy during adolescence poses higher risks for the mother and the baby, the utilisation of maternity care to mitigate the effects is low. This review aimed to synthesise evidence on adolescent mothers’ utilisation of maternity care in Sub-Saharan Africa and identify the key determinant factors that influence adolescent mothers’ engagement with maternity care. Method A systematic review of scholarly literature involving seven databases: ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit was conducted. Studies published in English between 1990 and 2017 that examined Sub-Saharan adolescent mothers’ experiences of utilising biomedical maternity care during pregnancy, delivery and the post-partum period were included. Results From 296 relevant articles 27 were identified that represent the experience of adolescent mothers’ maternal health service utilisation in Sub-Saharan Africa. The review indicates that maternal health service utilisation in the majority of Sub-Saharan African countries is still low. There is also a wide discrepancy in the use of maternity care services by adolescent mothers across countries in Sub-Saharan Africa. Conclusions The review reveals that a significant number of adolescents in Sub-Saharan Africa do not access and use maternity services during pregnancy. Several factors from individual to systemic levels contributed to low access and utilisation. This implies that interventions targeting the women, their partners, healthcare professionals, communities and the organisations (local to national) are necessary to improve adolescent mother’s engagement with maternity care in Sub-Saharan Africa.
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Affiliation(s)
- Tensae Mekonnen
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia.
| | - Tinashe Dune
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia.,School of Science and Health, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Janette Perz
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
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Wachamo TM, Bililign Yimer N, Bizuneh AD. Risk factors for low birth weight in hospitals of North Wello zone, Ethiopia: A case-control study. PLoS One 2019; 14:e0213054. [PMID: 30893344 PMCID: PMC6426181 DOI: 10.1371/journal.pone.0213054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 02/14/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Low birth weight at birth is an important underlying contributor for neonatal and infant mortality. It accounts for nearly half of all perinatal deaths. Identifying predictors of low birth weight is the first essential step in designing appropriate management strategies. Hence, this study aimed to identify risk factors for low birth weight in hospitals of northeastern Ethiopia. METHODS An institution based case-control study design was conducted from 10th April to 15th December 2016. Three hundred sixty mother-infant pairs (120 low birth weight babies as cases and 240 normal birth weights as controls) were included in the study. Data were collected by face-to-face interview. Univariable and multivariable logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 20.0. Variables with p-value <0.05 were considered statistically significant. RESULTS The mean (±SD) gestational age and birth weight (±SD) were 39.2 (±1.38) weeks and 2800 (±612), grams respectively. Partner's education/being illiterate (AOR: 4.09; 95% CI 1.45, 11.50), antenatal care visit at private health institutions (AOR: 0.13; 95% CI 0.02, 0.66), having history of obstetric complications (AOR: 5.70; 95% CI 2.38, 13.63), maternal weight during pregnancy (AOR: 4.04; 95% CI 1.50, 10.84) and gravidity (AOR: 0.36; 95% CI 0.18, 0.73) were significantly associated with low birth weight. Additionally, a site for water storage and water treatment were significant environmental factors. CONCLUSION Maternal weight during pregnancy, paternal education, previous obstetric complication and place of antenatal follow-up were associated with low birth weight. The risk factors identified in this study are preventable. Thus, nutritional counseling, health education on improvement of lifestyle and early recognition and treatment of complications are the recommended interventions.
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Affiliation(s)
- Tesfahun Mulatu Wachamo
- Department of Public Health, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Nigus Bililign Yimer
- Department of Midwifery, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Asmamaw Demis Bizuneh
- Department of Nursing, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
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Reyes Bravo DM, Muñoz de Rodriguez L. Valoración del servicio de enfermería por parte de adolescentes gestantes antes de una intervención en atención prenatal y después de esta. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2018. [DOI: 10.11144/javeriana.ie21-1.vsea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Introducción: Investigaciones sobre gestación en mujeres adolescentes han detectado ciertas necesidades, como sentirse escuchadas o apoyadas y recibir trato humanizado. Objetivo: Determinar cómo adolescentes gestantes valoraron el cuidado proporcionado por el servicio de enfermería antes de una intervención y después de esta, en una institución de salud de Bucaramanga, en 2015. Método: Estudio cuasi experimental pretest y postest en 39 adolescentes asistentes a atención prenatal. Para la valoración del cuidado se utilizó la Escala Profesional de Cuidado, organizada en las subescalas: sanador compasivo y competente. La valoración pretest se realizó después del control prenatal convencional, por enfermería, y la postest, después de la intervención de cuidado, fundamentada en la teoría de Swanson. Resultados: Aunque las valoraciones del cuidado fueron excelentes antes de la intervención, mejoraron posteriormente, lo que muestra un aumento de puntajes mínimos de 48 antes, a 57 después de la intervención, y en disminución de las desviaciones estándar 2,6704 y 0,6863, respectivamente. Estos cambios son notorios en el sanador compasivo referido a la relación afectuosa y de confianza que establece el enfermero(a) en la interacción de cuidado. Conclusiones: La teoría de Swanson permitió abordar a la adolescente en la atención prenatal, supliendo necesidades de escucha, trato humanizado y apoyo. Ello se evidencia en la valoración posterior.
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Maternal Anthropometric Measurements Do Not Have Effect on Birth Weight of Term, Single, and Live Births in Addis Ababa City, Ethiopia. J Pregnancy 2018; 2018:1982134. [PMID: 30622823 PMCID: PMC6304492 DOI: 10.1155/2018/1982134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/14/2018] [Accepted: 11/18/2018] [Indexed: 11/25/2022] Open
Abstract
Low birth weight is a global public health problem for mortality and morbidity in any age group. The objective of this study is to investigate the effect of maternal anthropometric measurements on birth weight. A cross-sectional study was conducted from Nov 25, 2012, to Feb 25, 2013, in maternity public hospitals in Addis Ababa city, Ethiopia. The effect is investigated using correlation, linear regression, independent sample T-test, one-way ANOVA, and finally multivariate linear regression analysis. A total of 605 women and their newborns took part in this study and prevalence of low birth weight is 8.3%. On adjusted multivariate linear regression analysis, maternal anthropometric measurements did not have an effect on birth weight. Since maternal mid-upper arm circumference ≤ 20 cm and body mass index ≤18.5kg/m2 are almost nil in this study, generalization is difficult to general population where undernourished women are common in the rural Ethiopia and similar study is recommended in those areas. Antenatal care visits, gestational age, and female sex of newborn had statistically significant effect in determining the risk of low birth weight. Women who were living with large family members had a heavier newborn than counterparts. This might be due to the fact that pregnant women have better care and social support in Ethiopian context, so advising pregnant women to live with family members should be considered to enhance social support during pregnancy in Ethiopia. Maternal anthropometric measurements have no significant effect in determining birth weight in the city and we recommend similar studies where undernourished women are common.
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Chikalipo MC, Nyondo-Mipando L, Ngalande RC, Muheriwa SR, Kafulafula UK. Perceptions of pregnant adolescents on the antenatal care received at Ndirande Health Centre in Blantyre, Malawi. Malawi Med J 2018; 30:25-30. [PMID: 29868156 PMCID: PMC5974383 DOI: 10.4314/mmj.v30i1.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Rates of adolescent pregnancies in Malawi remain high at 29%. Early childbearing is a major health issue because of its increased risk for adverse pregnancy outcomes compared to older women. Although antenatal care is believed not to directly reduce maternal mortality, comprehensive antenatal care, especially in developing countries, may promote safe motherhood as actual and potential problems related to pregnancy are identified and treated in a timely manner. While antenatal services in Malawi are meant to provide antenatal care for adolescents, much of the care provided seems to be limited. The purpose of this study was to explore views of pregnant adolescent girls about the antenatal care they received at Ndirande clinic. Understanding adolescents' views about the care they receive may provide an opportunity to identify gaps in the care and ultimately improve the care for pregnant adolescent girls. Methods We conducted a cross-sectional exploratory study on pregnant adolescent girls' perceptions of the antenatal care received at Ndirande Health Centre in Blantyre, Malawi, from 7 to 28 October 2011. We interviewed 15 purposively selected pregnant adolescents aged 14 to 19 years using a semi-structured interview guide. All the interviews were audiotaped, transcribed verbatim and translated from Chichewa into English. Data were analyzed using thematic content analysis. Findings Two major themes emerged from the findings: a) caring b) motivation for attending antenatal care. The findings indicate that pregnant adolescents view the establishment of a clinic as acceptable and feasible. However, the care was inadequate, as it did not meet the expected standards and the needs of the pregnant adolescents. Conclusion The antenatal care adolescent girls received at Ndirande clinic is inadequate as it does not meet their needs. Innovative models of care that embrace the principles of youth friendly services should be employed.
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Affiliation(s)
| | - Linda Nyondo-Mipando
- University of Malawi - School of Public Health and Family Medicine, College of Medicine
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26
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Rada S, Gamper J, González R, Mombo-Ngoma G, Ouédraogo S, Kakolwa MA, Zoleko-Manego R, Sevene E, Kabanywanyi AM, Accrombessi M, Briand V, Cot M, Vala A, Kremsner PG, Abdulla S, Massougbodgi A, Nhacolo A, Aponte JJ, Macete E, Menéndez C, Ramharter M. Concordance of three alternative gestational age assessments for pregnant women from four African countries: A secondary analysis of the MIPPAD trial. PLoS One 2018; 13:e0199243. [PMID: 30080869 PMCID: PMC6078285 DOI: 10.1371/journal.pone.0199243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/04/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND At times, ultrasound is not readily available in low resource countries in Africa for accurate determination of gestational age, so using alternative methods is pivotal during pregnancy. These assessments are used to aid the risk analysis for an infant and management strategies for premature delivery, if necessary. Currently, date of last menstrual period, fundal height measurements, and the New Ballard Score are commonly used in resource-limited settings. However, concordance of these measures is unknown for sub-Saharan Africa. We obtained data from an open-label randomized controlled trial, to assess the concordance of these alternative assessment methods. The purpose of our study was to determine the agreement between these alternative methods when used in sub-Saharan African populations. METHODS A total of 4,390 pregnant women from Benin, Gabon, Mozambique and Tanzania were included in our analysis. The assessment methods compared were: 1) reported last menstrual period, 2) symphysis-fundal height measurement, and 3) the New Ballard Score. The Bland-Altman method and intraclass correlation coefficient (ICC) were used to test the degree of agreement. Survival range gestational age, used as an inclusion criterion for further analysis, was from 22 to 44 weeks. FINDINGS Plots showed a lack of agreement between methods and the 95% limits of agreement too wide to be clinically useful. ICC = 0.25 indicated poor agreement. A post-hoc analysis, restricted from 32 to 42 weeks, was done to check for better agreement in this near-term population. The plots and ICC = 0.16 still confirmed poor agreement. CONCLUSION The alternative assessments do not result in comparable outcomes and discrepancies are far beyond the clinically acceptable range. Last menstrual period should not be used as the only estimator of gestational age. In the absence of reliable early ultrasound, symphysis-fundal height measurements may be most useful during pregnancy for fetal risk assessment and the New Ballard Score after delivery as a confirmation of these estimations and for further neonatal management. However, promotion of portable ultrasound devices is required for accurate assessment of gestational age in sub-Sahara Africa.
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Affiliation(s)
- Samantha Rada
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
- Institut für Medizinische Informationsverarbeitung Biometrie und Epidemiologie, Ludwig-Maximilians University, Munich, Germany
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Jutta Gamper
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Raquel González
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
- Department of Parasitology, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Smaïla Ouédraogo
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement (IRD), Paris, France
- Ministère de la Santé, Burkina Faso
| | | | - Rella Zoleko-Manego
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
- Ngounie Medical Research Centre, Fougamou, Gabon
| | | | | | - Manfred Accrombessi
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement (IRD), Paris, France
| | - Valérie Briand
- Institut de Recherche pour le Développement (IRD), Paris, France
- Université René Descartes, Paris, France
| | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Paris, France
- Université René Descartes, Paris, France
| | - Anifa Vala
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
| | | | - Achille Massougbodgi
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
| | | | - John J. Aponte
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Eusébio Macete
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Clara Menéndez
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Michael Ramharter
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
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Tamambang RF, Njim T, Njie AE, Mbuagbaw L, Mafuta A, Tchana M, Choukem SP. Adolescent deliveries in urban Cameroon: a retrospective analysis of the prevalence, 6-year trend and adverse outcomes. BMC Res Notes 2018; 11:469. [PMID: 30005713 PMCID: PMC6044024 DOI: 10.1186/s13104-018-3578-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 07/06/2018] [Indexed: 01/17/2023] Open
Abstract
Objective Adolescent deliveries remain a public health problem in most developing countries. The aim of our study was to determine the prevalence, trends and outcome of adolescent deliveries in an urban setting in Cameroon. We carried out a retrospective register analysis over a 6-year period (January 2010–December 2015) at the Saint Albert Le Grand hospital Douala. Results The overall prevalence of adolescent deliveries was 8.2% (662 out of 8056). There was a significant decrease over the 6-year period (p-trend: < 0.05). Adolescents were at higher risk of preterm deliveries (gestational age < 37 weeks; odds ratio [OR], 1.7; 95% confidence interval [CI]; 1.3–2.2; p < 0.01): low birth weight (defined as birth weight < 2650 g, OR; 1.7, CI 1.4–2.2, p < 0.01) and asphyxia at 1st minute (OR, 1.5; 95% CI 1.1–2.2; p = 0.02). There was no difference in delivery outcomes between early and late adolescents. Our results suggest that the prevalence of adolescent deliveries is lower in urban settings. Adolescent deliveries are more likely to result in adverse fetal outcomes than adult deliveries. Measures directed towards the prevention of adolescent pregnancies should be implemented to reduce neonatal morbidity and mortality. Electronic supplementary material The online version of this article (10.1186/s13104-018-3578-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rita F Tamambang
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Tsi Njim
- Health and Human Development (2HD) Research Network, Douala, Cameroon. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxfordshire, UK.
| | - Albertine E Njie
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Lawrence Mbuagbaw
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | | | - Mesack Tchana
- Obstetric and Gynecology Unit, Douala Laquintinie Hospital, Douala, Cameroon
| | - Simeon-Pierre Choukem
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Douala, Cameroon
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Arnaldo P, Rovira-Vallbona E, Langa JS, Salvador C, Guetens P, Chiheb D, Xavier B, Kestens L, Enosse SM, Rosanas-Urgell A. Uptake of intermittent preventive treatment and pregnancy outcomes: health facilities and community surveys in Chókwè district, southern Mozambique. Malar J 2018. [PMID: 29530044 PMCID: PMC5848514 DOI: 10.1186/s12936-018-2255-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Malaria in pregnancy leads to serious adverse effects on the mother and the child and accounts for 75,000–200,000 infant deaths every year. Currently, the World Health Organization recommends intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine–pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. This study aimed to assess IPTp-SP coverage in mothers delivering in health facilities and at the community. In addition, factors associated with low IPTp-SP uptake and malaria adverse outcomes in pregnancy were investigated. Methods A community and a health facility-based surveys were conducted in mothers delivering in Chókwè district, southern Mozambique. Social-demographic data, malaria prevention practices and obstetric history were recorded through self-report and antenatal records. For women delivering at health facilities, a clinical examination of mother and child was performed, and malaria infection at delivery was determined by rapid diagnostic test, microscopy, quantitative PCR and placental histology. Results Of 1141 participants, 46.6, 30.2, 13.5 and 9.6% reported taking ≥ 3, two, one and none SP doses, respectively. Low IPTp uptake (< 3 doses) was associated with non-institutional deliveries (AOR = 2.9, P < 0.001), first ANC visit after week 28 (AOR = 5.4, P < 0.001), low awareness of IPTp-SP (AOR = 1.6, P < 0.002) and having no or only primary education (AOR = 1.3, P = 0.041). The overall prevalence of maternal malaria (peripheral and/or placental) was 16.8% and was higher among women from rural areas compared to those from urban areas (AOR = 1.9, P < 0.001). Younger age (< 20 years; AOR = 1.6, P = 0.042) and living in rural areas (AOR = 1.9, P < 0.001) were predictors of maternal malaria at delivery. Being primigravidae (AOR = 2.2, P = 0.023) and preterm delivery (AOR = 2.6, P < 0.001) predicted low birth weight while younger age was also associated with premature delivery (AOR = 1.4, P = 0.031). Conclusion The coverage for two and ≥ 3 doses of IPTp-SP is moderately higher than estimates from routine health facility records in Gaza province in 2015. However, this is still far below the national target of 80% for ≥ 3 doses. Ongoing campaigns aiming to increase the use of malaria prevention strategies during pregnancy should particularly target rural populations, increasing IPTp-SP knowledge, stimulate early visits to ANC, improve access to health services and the quality of the service provided. Electronic supplementary material The online version of this article (10.1186/s12936-018-2255-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paulo Arnaldo
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.,Plataforma de Parasitologia Molecular, Instituto Nacional de Saúde, Maputo, Mozambique.,University of Antwerp, Antwerp, Belgium
| | - Eduard Rovira-Vallbona
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Jerónimo S Langa
- Plataforma de Parasitologia Molecular, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Crizolgo Salvador
- Plataforma de Parasitologia Molecular, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Pieter Guetens
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Driss Chiheb
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Bernardete Xavier
- Plataforma de Parasitologia Molecular, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Luc Kestens
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.,University of Antwerp, Antwerp, Belgium
| | - Sónia M Enosse
- Plataforma de Parasitologia Molecular, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Anna Rosanas-Urgell
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
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Decker MR, Kalamar A, Tunçalp Ö, Hindin MJ. Early adolescent childbearing in low- and middle-income countries: associations with income inequity, human development and gender equality. Health Policy Plan 2018; 32:277-282. [PMID: 28207067 DOI: 10.1093/heapol/czw121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 11/14/2022] Open
Abstract
Objective Reducing unwanted adolescent childbearing is a global priority. Little is known about how national-level economic and human development indicators relate to early adolescent childbearing. This ecological study evaluates associations of Gross Domestic Product (GDP), GINI index, Human Development Index (HDI) and Gender-related Development Index (GDI; i.e. the HDI adjusted for gender disparities) with early adolescent childbearing in 27 low- and middle-income countries (LMICs) across three time periods. Methods Among women ages 18–24, prevalence estimates for early birth (<16 years) were calculated by nation, and weighted linear regressions evaluated associations between national indicators and early childbearing. To examine temporal trends, analyses were stratified by year groupings. Findings Early adolescent childbearing declined over time, with the greatest change observed in Bangladesh (31.49% in 1996/7 to 19.69% in 2011). In adjusted models, GDI was negatively associated with early childbearing, i.e. early childbearing prevalence decreased as GDI increased. In the most recent time period, relative to the lowest GDI group, the average prevalence of early childbearing was significantly lower in the middle (-12.40, P < 0.00) and upper (-10.96, P = 0.03) tertiles after adjustment for the other indicators. These other indicators showed no consistent association with early childbearing. Conclusion As national-level GDI increased, early adolescent childbearing declined. The GDI, which reflects human development adjusted for gender disparities in educational and economic prospects, was more consistently related to early adolescent childbearing than the absolute development prospects as given by the HDI. While creating gender equality is an important goal in and of itself, the findings emphasize the potential for improved national-level gender equitable development as a means to improve adolescents’ sexual and reproductive health.
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Affiliation(s)
- Michele R Decker
- Johns Hopkins Bloomberg School of Public Health, Department of Population Family & Reproductive Health, Baltimore, MD, USA
| | - Amanda Kalamar
- Johns Hopkins Bloomberg School of Public Health, Department of Population Family & Reproductive Health, Baltimore, MD, USA
| | - Özge Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Michelle J Hindin
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Kesteman T, Randrianarivelojosia M, Rogier C. The protective effectiveness of control interventions for malaria prevention: a systematic review of the literature. F1000Res 2017; 6:1932. [PMID: 29259767 PMCID: PMC5721947 DOI: 10.12688/f1000research.12952.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 12/22/2022] Open
Abstract
Background: Thanks to a considerable increase in funding, malaria control interventions (MCI) whose efficacy had been demonstrated by controlled trials have been largely scaled up during the last decade. Nevertheless, it was not systematically investigated whether this efficacy had been preserved once deployed on the field. Therefore, we sought the literature to assess the disparities between efficacy and effectiveness and the effort to measure the protective effectiveness (PE) of MCI. Methods: The PubMed database was searched for references with keywords related to malaria, to control interventions for prevention and to study designs that allow for the measure of the PE against parasitemia or against clinical outcomes. Results: Our search retrieved 1423 references, and 162 articles were included in the review. Publications were scarce before the year 2000 but dramatically increased afterwards. Bed nets was the MCI most studied (82.1%). The study design most used was a cross-sectional study (65.4%). Two thirds (67.3%) were conducted at the district level or below, and the majority (56.8%) included only children even if the MCI didn’t target only children. Not all studies demonstrated a significant PE from exposure to MCI: 60.6% of studies evaluating bed nets, 50.0% of those evaluating indoor residual spraying, and 4/8 showed an added PE of using both interventions as compared with one only; this proportion was 62.5% for intermittent preventive treatment of pregnant women, and 20.0% for domestic use of insecticides. Conclusions: This review identified numerous local findings of low, non-significant PE –or even the absence of a protective effect provided by these MCIs. The identification of such failures in the effectiveness of MCIs advocates for the investigation of the causes of the problem found. Ideal evaluations of the PE of MCIs should incorporate both a large representativeness and an evaluation of the PE stratified by subpopulations.
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Affiliation(s)
- Thomas Kesteman
- Fondation Mérieux, Lyon, France.,Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Christophe Rogier
- Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.,Ecole doctorale Sciences de la vie et de l'environnement, Université d'Antananarivo, Antananarivo, Madagascar.,Institute for Biomedical Research of the French Armed Forces (IRBA), Brétigny-Sur-Orge , France.,Unité de recherche sur les maladies infectieuses et tropicales émergentes - (URMITE), Marseille, France
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Agbor VN, Mbanga CM, Njim T. Adolescent deliveries in rural Cameroon: an 8-year trend, prevalence and adverse maternofoetal outcomes. Reprod Health 2017; 14:122. [PMID: 28962649 PMCID: PMC5622552 DOI: 10.1186/s12978-017-0382-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/11/2017] [Indexed: 11/15/2022] Open
Abstract
Background Adolescent deliveries remain a global public health concern especially in low- and middle-income countries where 95% of these deliveries occur. In Cameroon, adolescent pregnancies have a high disease burden due to their association with adverse pregnancy outcomes. We sought to evaluate the prevalence, trend and adverse maternofoetal outcomes of adolescent deliveries in a rural community in Cameroon. Method We carried out a retrospective register analysis of 1803 singleton deliveries in two health facilities located in the Oku sub-division over an 8-year period (2009 to 2016). We excluded: records without maternal age, babies born before arrival, birthweights less than 1000 g, multiple deliveries and deliveries before 28 weeks gestation. Data analysis was done using Epi info 7.0.8.3. The Fisher’s exact test was used to compare categorical variables, while the chi-square test for trends was used to determine time trends. P-values below 5% were considered statistically significant. Results The 8-year prevalence of adolescent deliveries was 20.4% (95% CI = 18.6–22.4) with a significant, downward trend between 2009 and 2016 (P trend = 0.05). Second-fourth degree perineal tears were more likely to complicate adolescent (Age < 20 years) deliveries compared with their adult (Age ≥ 20 years) counterparts (OR = 2.9; 95% CI = 1.8–4.7; p < 0.001). Also, babies born to adolescent mothers were more likely to have a low birthweight (OR = 1.7; 95% CI = 1.1–2.6; p = 0.009) and be asphyxiated at the fifth minute of life (OR = 3.2; 95% CI = 1.9–5.5; p < 0.001). Over an eight-year period, the downward trend in the prevalence of adolescent deliveries was associated with a significant decrease in the trend of neonatal asphyxia at the fifth minute. Married adolescents and their babies were as likely to develop the complications of adolescent delivery such as second-fourth degree perineal tears (OR = 0.8; 95% CI = 0.4–1.6; p = 0.456), low birthweight (OR = 2.1; 95% CI = 0.9–4.7; p = 0.070) and fifth minute neonatal asphyxia (OR = 0.9; 95% CI = 0.4–2.0; p = 0.832) as single adolescents and their babies. Conclusion The prevalence of adolescent deliveries in this rural community is high with one of every five babies born to an adolescent mother. Despite the downward trend indicating a decrease in adolescent deliveries, our study demonstrates the need to reinforce and effectively apply existing government-based public health programme to target key indicators of adolescent pregnancy in Cameroon.
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Affiliation(s)
| | | | - Tsi Njim
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxfordshire, UK.,Health and Human Development Research Group (2HD), Douala, Cameroon
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Sámano R, Martínez-Rojano H, Chico-Barba G, Godínez-Martínez E, Sánchez-Jiménez B, Montiel-Ojeda D, Tolentino M. Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length. Nutrients 2017; 9:nu9101067. [PMID: 28953229 PMCID: PMC5691684 DOI: 10.3390/nu9101067] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 12/21/2022] Open
Abstract
Introduction: Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective: To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods: A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26–28 to three months postpartum (n = 168 mother–child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results: Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions: Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn.
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Affiliation(s)
- Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, 11000 Ciudad de México, Mexico.
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
- Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE) "Dr. Manuel Martínez Báez", Secretaría de Salud, 01480 Ciudad de México, Mexico.
| | - Gabriela Chico-Barba
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, 11000 Ciudad de México, Mexico.
| | - Estela Godínez-Martínez
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, 11000 Ciudad de México, Mexico.
| | - Bernarda Sánchez-Jiménez
- Subdirección de Investigación en Intervenciones Comunitarias del Instituto Nacional de Perinatología, Secretaría de Salud, 11000 Ciudad de México, Mexico.
| | - Diana Montiel-Ojeda
- Universidad del Valle de México, Chapultepec, 11810 Ciudad de México, Mexico.
| | - Maricruz Tolentino
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, 11000 Ciudad de México, Mexico.
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Efevbera Y, Bhabha J, Farmer PE, Fink G. Girl child marriage as a risk factor for early childhood development and stunting. Soc Sci Med 2017; 185:91-101. [DOI: 10.1016/j.socscimed.2017.05.027] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 05/04/2017] [Accepted: 05/10/2017] [Indexed: 11/28/2022]
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34
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Johnson CD, Jones S, Paranjothy S. Reducing low birth weight: prioritizing action to address modifiable risk factors. J Public Health (Oxf) 2017; 39:122-131. [PMID: 26888979 PMCID: PMC5409066 DOI: 10.1093/pubmed/fdv212] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Low birth weight (LBW) affects 6.9% of all UK births and has remained largely unchanged for many years. The United Nations and the World Health Assembly have set targets to substantially reduce global incidence. Understanding the contribution of modifiable risk factors to the burden of LBW is required to ensure appropriate interventions are in place to achieve this reduction. Methods Data from published studies on the risks from key modifiable factors were used alongside prevalence data from the Welsh population to calculate the population attributable risk for each factor individually and in combination. Results Fourteen risk factors accounted for nearly half of LBW births, and 60% of those to younger mothers (<25 years). Tobacco smoke exposure was the largest contributor. We estimated that smoking in pregnancy was a factor in one in eight LBW births, increasing to one in five for women aged under 25. Conclusions Risk factors are interrelated and inequitably distributed within the population. Exposure to one factor increases the likelihood of exposure to a constellation of factors further increasing risk. Action to address LBW must consider groups where the risk factors are most prevalent and address these risk factors together using multi-component interventions.
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35
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Manego RZ, Mombo-Ngoma G, Witte M, Held J, Gmeiner M, Gebru T, Tazemda B, Mischlinger J, Groger M, Lell B, Adegnika AA, Agnandji ST, Kremsner PG, Mordmüller B, Ramharter M, Matsiegui PB. Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon. BMC Public Health 2017; 17:130. [PMID: 28129759 PMCID: PMC5273856 DOI: 10.1186/s12889-017-4045-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 01/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa is undergoing an epidemiological transition from a predominance of infectious diseases to non-communicable and lifestyle related conditions. However, the pace of this transition and the pattern of disease epidemiology are uneven between affluent urban and rural poor populations. To address this question for a remote rural region located in the central African rainforest region of Gabon, this study was conducted to assess reasons for health care attendance and to characterize the epidemiology of malaria and other major infectious diseases for the department of Tsamba Magotsi. METHODS Major causes for health care attendance were collected from local hospital records. Cross sectional population based surveys were performed for the assessment of local malaria epidemiology. Pregnant women attending antenatal care services were surveyed as a sentinel population for the characterization of chronic viral and parasitic infections in the community. RESULTS Infectious diseases were responsible for 71% (7469) of a total of 10,580 consultations at the formal health care sector in 2010. Overall, malaria - defined by clinical syndrome - remained the most frequent cause for health care attendance. A cross sectional malaria survey in 840 asymptomatic individuals residing in Tsamba Magotsi resulted in a Plasmodium spp. infection prevalence of 37%. The infection rate in 2-10 year old asymptomatic children - a standard measure for malaria endemicity - was 46% (100 of 217) with P. falciparum as predominant species (79%). Infection with other plasmodial species (P. ovale and P. malariae) presented most commonly as coinfections (23.2%). Prevalence of HIV, HBV, and syphilis were 6.2, 7.3, and 2.5%, respectively, in cross-sectional assessments of antenatal care visits of pregnant women. Urogenital schistosomiasis and the filarial pathogens Loa loa and Mansonella perstans are highly prevalent chronic parasitic infections affecting the local population. CONCLUSIONS Despite major improvements in the accessibility of Tsamba Magotsi over the past decade the epidemiological transition does not appear to have majorly changed on the spectrum of diseases in this rural Gabonese population. The high prevalence of Plasmodium infection indicates a high burden of malaria related morbidity. Infectious diseases remain one of the most important health issues and further research activities in the field of tropical medicine and infectious diseases could help improve health care for the local population.
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Affiliation(s)
- R Zoleko Manego
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - G Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Département de Parasitologie-Mycologie, Université des Sciences de La Santé, Libreville, Gabon
| | - M Witte
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - J Held
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - M Gmeiner
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - T Gebru
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - B Tazemda
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
| | - J Mischlinger
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - M Groger
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - B Lell
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - A A Adegnika
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - S T Agnandji
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - P G Kremsner
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - B Mordmüller
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - M Ramharter
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon. .,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany. .,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
| | - P B Matsiegui
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
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Rahman A, Nisha MK, Begum T, Ahmed S, Alam N, Anwar I. Trends, determinants and inequities of 4 + ANC utilisation in Bangladesh. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:2. [PMID: 28086970 PMCID: PMC5237328 DOI: 10.1186/s41043-016-0078-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/23/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND The objectives of this study are to document the trend on utilisation of four or more (4+) antenatal care (ANC) over the last 22 years period and to explore the determinants and inequity of 4+ ANC utilisation as reported by the last two Bangladesh Demographic and Health surveys (BDHS) (2011 and 2014). METHODS The data related to ANC have been extracted from the BDHS data set which is available online as an open source. STATA 13 software was used for organising and analysing the data. The outcome variable considered for this study was utilisation of 4+ ANC. Trends of 4+ ANC were measured in percentage and predictors for 4+ ANC were measured through bivariate and multivariable analysis. The concentration index was estimated for assessing inequity in 4+ ANC utilisation. RESULTS Utilisation of 4+ ANC has increased by about 26% between the year 1994 and 2014. Higher level of education, residing in urban region and richest wealth quintile were found to be significant predictors. The utilisation of 4+ ANC has decreased with increasing parity and maternal age. The inequity indices showed consistent inequities in 4+ ANC utilisation, and such inequities were increased between 2011 and 2014. CONCLUSIONS In Bangladesh, the utilisation of any ANC rose steadily between 1994 and 2014, but progress in terms of 4+ ANC utilisation was much slower as the expectation was to achieve the national set target (50%: 4+ ANC utilisation) by 2016. Socio-economic inequities were observed in groups that failed to attend a 4+ ANC visit. Policymakers should pay special attention to increase the 4+ ANC coverage where this study can facilitate to identify the target groups whom need to be intervened on priority basis.
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Affiliation(s)
- Aminur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Tahmina Begum
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sayem Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nurul Alam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Iqbal Anwar
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9205016. [PMID: 28133615 PMCID: PMC5241487 DOI: 10.1155/2017/9205016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/26/2016] [Accepted: 12/05/2016] [Indexed: 12/03/2022]
Abstract
Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08–1.35]), foetal growth restriction (1.34 [1.21–1.48]), episiotomy (1.27 [1.21–1.34]), uterine revision (1.15 [1.06–1.25]), APGAR <7 at 1 min (2.42 [1.21–1.67]), cephalopelvic disproportion (1.26 [1.07–1.48]), and postpartum haemorrhage (1.42 [1.25–1.62]); however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70–0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10–1.17]), low urinary tract infection (1.10 [1.03–1.18]), pediculosis (2.42 [1.90–3.00]), anogenital condyloma (1.50 [1.04–2.17]), and trichomoniasis (1.74 [1.12–2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71), 0.90 (0.85–0.96), and 0.29 (0.20–0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.
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Yount KM, Crandall A, Cheong YF, Osypuk TL, Bates LM, Naved RT, Schuler SR. Child Marriage and Intimate Partner Violence in Rural Bangladesh: A Longitudinal Multilevel Analysis. Demography 2016; 53:1821-1852. [PMID: 27812927 PMCID: PMC5568420 DOI: 10.1007/s13524-016-0520-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Child marriage (before age 18) is a risk factor for intimate partner violence (IPV) against women. Worldwide, Bangladesh has the highest prevalence of IPV and very early child marriage (before age 15). How the community prevalence of very early child marriage influences a woman's risk of IPV is unknown. Using panel data (2013-2014) from 3,355 women first married 4-12 years prior in 77 Bangladeshi villages, we tested the protective effect of a woman's later first marriage (at age 18 or older), the adverse effect of a higher village prevalence of very early child marriage, and whether any protective effect of a woman's later first marriage was diminished or reversed in villages where very early child marriage was more prevalent. Almost one-half (44.5 %) of women reported incident physical IPV, and 78.9 % had married before age 18. The village-level incidence of physical IPV ranged from 11.4 % to 75.0 %; the mean age at first marriage ranged from 14.8 to 18.0 years. The mean village-level prevalence of very early child marriage ranged from 3.9 % to 51.9 %. In main-effects models, marrying at 18 or later protected against physical IPV, and more prevalent very early child marriage before age 15 was a risk factor. The interaction of individual later marriage and the village prevalence of very early child marriage was positive; thus, the likely protective effect of marrying later was negated in villages where very early child marriage was prevalent. Collectively reducing very early child marriage may be needed to protect women from IPV.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA.
| | - AliceAnn Crandall
- Department of Health Science, Brigham Young University, Provo, UT, USA
| | - Yuk Fai Cheong
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Theresa L Osypuk
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Lisa M Bates
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ruchira T Naved
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
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Kabwijamu L, Waiswa P, Kawooya V, Nalwadda CK, Okuga M, Nabiwemba EL. Newborn Care Practices among Adolescent Mothers in Hoima District, Western Uganda. PLoS One 2016; 11:e0166405. [PMID: 27855186 PMCID: PMC5113955 DOI: 10.1371/journal.pone.0166405] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/30/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Adolescent childbearing remains a major challenge to improving neonatal mortality especially in Sub Saharan countries which are still struggling with high neonatal mortality rates. We explored essential newborn care practices and associated factors among adolescent mothers in Western Uganda. METHODS Data were collected among 410 adolescent mothers with children aged one to six months in Hoima district. Three composite variables (appropriate neonatal breastfeeding, cord care and thermal protection) were derived by combining related practices from a list of recommended newborn care practices. Logistic regression analysis was conducted to identify factors independently associated with practice of essential newborn care. RESULTS Appropriate newborn feeding, optimal thermal protection and dry cord care were practiced by 60.5%, 67.2% and 31% of adolescent mothers respectively. Independent predictors' of cord care were: knowledge of cord care (AOR 5.34, 95% CI (1.51-18.84) and having delivered twins (AOR 0.04, 95% CI (0.01-0.22). The only predictor of thermal care was knowledge (AOR 25.15, 95% CI (7.01-90.20). Staying in a hospital for more than one day postpartum (AOR 2.45, 95%CI (1.23-4.86), knowledge of the correct time of breastfeeding initiation (AOR 14.71, 95% CI (5.20-41.58), predicted appropriate neonatal feeding, whereas; adolescent mothers who had had a caesarean delivery (AOR 0.19, 95% CI (I 0.04-0.96) and a male caretaker in the postnatal period (AOR 0.18, 95% CI (0.07-0.49) were less likely to practice the recommended newborn feeding. CONCLUSION Sub optimal essential newborn care practice was noted especially suboptimal cord care. Adolescent mothers should be a focus of strategies to improve maternal and neonatal health.
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Affiliation(s)
- Lydia Kabwijamu
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
| | - Peter Waiswa
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
- Centre of Excellence for Maternal and Newborn Health, Makerere University College of Health Sciences School of Public Health, Kampala, Uganda
- Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Vincent Kawooya
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
| | - Christine K. Nalwadda
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
| | - Monica Okuga
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
- Centre of Excellence for Maternal and Newborn Health, Makerere University College of Health Sciences School of Public Health, Kampala, Uganda
| | - Elizabeth L. Nabiwemba
- Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
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Tavares HDP, Tavares SBMP, Capingana DP, da Gama SGN, da Silva LGP. Obstetric, Sociodemographic, and Psychosocial Problems of Postpartum Adolescents of Huambo, Angola. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2016; 9:13-9. [PMID: 27226740 PMCID: PMC4874740 DOI: 10.4137/cmwh.s27161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 03/15/2016] [Accepted: 03/20/2016] [Indexed: 12/02/2022]
Abstract
This study aims to establish a profile of teenage pregnancy (<20 years) at a hospital in Huambo, Angola. Subjects were categorized into two age groups, 10-16 and 17-19 years. We interviewed 381 mothers in the postpartum maternity ward of the Central Hospital of Huambo. Statistical analysis then followed two stages, a descriptive analysis of the study population and analysis through a bivariate 2 × 2 table, using a chi-squared test to evaluate the hypothesis of homogeneity of proportions with a significance level of 5%. Comparing the two groups revealed a more frequent occurrence of problems among mothers under 17 years of age, including a higher frequency of involvement with unemployed parents, more often not living with parents, and fewer prenatal consultations.
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Affiliation(s)
| | | | - Daniel Pires Capingana
- Department of Physiological Sciences, Medical School of the Agostinho Neto University, Luanda, Angola
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Abu-Heija A, Al Haddabi R, Al Bash M, Al Mabaihsi N, Al-Maqbali NS. Early Teenage Pregnancy: Is it Safe? J Obstet Gynaecol India 2016; 66:88-92. [PMID: 27046961 DOI: 10.1007/s13224-014-0649-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/21/2014] [Indexed: 11/25/2022] Open
Abstract
AIM To compare obstetric and perinatal outcomes of early and late teenage pregnancies of Omani nulliparous women with singleton pregnancies cared for and delivered at a tertiary teaching hospital. METHOD In this retrospective study, we reviewed obstetric and perinatal outcomes of early teenage pregnancies (14-16 years), (n = 20) delivered at Sultan Qaboos University Hospital, Muscat, Oman, between 1 July 2006 and 30 June 2013 and compared their outcomes with outcomes of late teenage pregnancies (17-19 years), (n = 287) delivered at the same hospital during same period. RESULTS When compared with late teenage pregnant women, early teenagers were found to have no significant differences in prevalence of very preterm delivery <32 weeks (P = 0.62), preterm rupture of membranes (P = > 0.99), and anemia (P = 0.34). When compared to late teenagers, early teenagers had similar cesarean sections rates (P = >0.99), instrumental delivery rates (P = 0.56) and spontaneous vaginal delivery rates (P > 0.99). Both groups had similar birth weights (P = 0.87), low birth weights, (P = 0.55), and very low birth weights babies (P = 0.56 %). Perinatal mortality rate was similar in both groups. CONCLUSION We may conclude that early teenage pregnant Omani women are not at increased risk of obstetric and perinatal complication compared to older teenagers.
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Affiliation(s)
- Adel Abu-Heija
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Rahma Al Haddabi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Majeda Al Bash
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Nadia Al Mabaihsi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
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Kang G, Lim JY, Kale AS, Lee LY. Adverse effects of young maternal age on neonatal outcomes. Singapore Med J 2016; 56:157-63. [PMID: 25532516 DOI: 10.11622/smedj.2014194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Teenage pregnancy is associated with poor neonatal outcomes, which may burden the young mothers and their families. The aim of this study was to determine the effect young maternal age and single motherhood has on neonatal outcomes. METHODS We conducted a retrospective cohort study of 267 infants born to mothers aged ≤ 21 years in National University Hospital, Singapore, from January 2011 to December 2012. We compared the maternal demographics and neonatal outcomes of single mothers with those of married mothers. The neonatal outcomes of our study cohort were also compared to the hospital's birth cohort during the same period. RESULTS Unsatisfactory antenatal care was more prevalent among the young single mothers than among the young married mothers (odds ratio [OR] 2.90, 95% confidence interval [CI] 1.71-4.92, p < 0.01). The infants of the young single mothers had a lower mean birth weight (p = 0.01), with a significant proportion weighing < 2.5 kg (OR 2.91, 95% CI 1.35-6.37, p < 0.01). Young maternal age was linked to a higher incidence of prematurity (OR 1.70, 95% CI 1.18-2.43, p < 0.01), major congenital defects (OR 4.68, 95% CI 2.10-10.13, p < 0.01), and a perinatal mortality of 18.7 per 1,000 births (OR 3.76, 95% CI 1.26-10.32, p = 0.02). CONCLUSION Young single mothers were more likely to have unsatisfactory antenatal care and lighter infants. Young maternal age was associated with a higher risk of prematurity, major congenital malformations and perinatal mortality. More studies are needed to ascertain the cause of these adverse outcomes.
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Affiliation(s)
| | | | | | - L Y Lee
- Department of Neonatology, Level 12, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228.
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Francine N, Damien B, Anna F, Michael K, Christevy VJ, Felix KK. Characterization of asymptomatic Plasmodium falciparum infection and its risk factors in pregnant women from the Republic of Congo. Acta Trop 2016; 153:111-5. [PMID: 26477849 DOI: 10.1016/j.actatropica.2015.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 10/09/2015] [Accepted: 10/12/2015] [Indexed: 11/28/2022]
Abstract
Malaria in pregnancy remains a serious public health problem in the Republic of Congo despite the implementation of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) in 2006. The aim of this cross-sectional study was to characterize Plasmodium falciparum infections and determine possible risk factors in pregnant Congolese women attending an antenatal clinic in a periurban area of southern Brazzaville. This study was conducted from March 2012 to December 2013 in a site where several years ago, high malaria resistance to SP was reported. Pregnant women were enrolled during antenatal visits and the number of received IPTp-SP doses was recorded as well as individual sociodemographic data. Peripheral blood was collected and P. falciparum infection was checked by microscopy and by PCR targeting P. falciparum merozoite surface protein gene (msp2). Haemoglobin concentration was measured and P. falciparum positive samples were typed for msp2 allelic diversity. A total of 363 pregnant women were recruited. The prevalence of asymptomatic P. falciparum infection was 7% and 19% by microscopy and by PCR, respectively. More than one half (51.5%) of the pregnant women were anaemic. Multivariate analysis indicated that P. falciparum infection was associated with anaemia. It was also observed that women who have received IPTp-SP have significantly lower prevalence of infection. The administration of IPTp-SP did not influence the multiplicity of infection (MOI). This first study investigating asymptomatic malaria infection on pregnant women of the Republic of Congo shows that P. falciparum infections were clearly associated with maternal anaemia, and use of IPTp-SP reduced the risk of carrying asymptomatic infections.
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Affiliation(s)
- Ntoumi Francine
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, The Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
| | - Bakoua Damien
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo
| | - Fesser Anna
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo
| | - Kombo Michael
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo
| | | | - Koukouikila-Koussounda Felix
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, The Republic of Congo
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Hokororo A, Kihunrwa AF, Kalluvya S, Changalucha J, Fitzgerald DW, Downs JA. Barriers to access reproductive health care for pregnant adolescent girls: a qualitative study in Tanzania. Acta Paediatr 2015; 104:1291-7. [PMID: 25473729 PMCID: PMC4456338 DOI: 10.1111/apa.12886] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 09/17/2014] [Accepted: 12/01/2014] [Indexed: 11/29/2022]
Abstract
AIMS In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for adolescent girls are inaccessible and conducted this study to gain insights into their perceptions of sexually transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. METHODS We conducted nine focus groups among pregnant adolescents aged 15-20 years. Data were transcribed, translated and coded for relevant themes using NVivo10 software for qualitative data analysis. RESULTS Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs. They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, long waiting times, and lack of privacy in the clinics discouraged adolescent girls from seeking reproductive health care. CONCLUSION Reproductive health care for adolescent girls who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps.
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Affiliation(s)
- Adolfine Hokororo
- Department of Pediatrics and Child Health, Bugando Medical Centre, Box 1370,Mwanza, Tanzania
| | - Albert F. Kihunrwa
- Department of Obstetrics and Gynecology, Bugando Medical Centre, Box 1370,Mwanza, Tanzania
| | - Samuel Kalluvya
- Department of Internal Medicine, Bugando Medical Centre, Box 1370, Mwanza, Tanzania
| | - John Changalucha
- National Institute for Medical Research, Box 1460, Mwanza, Tanzania
| | - Daniel W Fitzgerald
- Center for Global Health, Weill Cornell Medical College, 402 E. 67 Street, Second Floor, New York, NY, 10065, USA
| | - Jennifer A. Downs
- Department of Internal Medicine, Bugando Medical Centre, Box 1370, Mwanza, Tanzania
- Center for Global Health, Weill Cornell Medical College, 402 E. 67 Street, Second Floor, New York, NY, 10065, USA
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Epidemiology of Human Herpes Virus 8 in Pregnant Women and their Newborns - A cross-sectional delivery survey in Central Gabon. Int J Infect Dis 2015; 39:16-9. [DOI: 10.1016/j.ijid.2015.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/03/2015] [Indexed: 11/18/2022] Open
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Mombo-Ngoma G, Mackanga JR, Basra A, Capan M, Manego RZ, Adegnika AA, Lötsch F, Yazdanbakhsh M, González R, Menendez C, Mabika B, Matsiegui PB, Kremsner PG, Ramharter M. Loa loa Infection in Pregnant Women, Gabon. Emerg Infect Dis 2015; 21:899-901. [PMID: 25897819 PMCID: PMC4412224 DOI: 10.3201/eid2105.141471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Hindin MJ. Adolescent childbearing and women's attitudes towards wife beating in 25 sub-Saharan African countries. Matern Child Health J 2015; 18:1488-95. [PMID: 24158508 DOI: 10.1007/s10995-013-1389-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Preventing unwanted adolescent pregnancy is key for keeping girls in school, leading to a more productive and healthier workforce in sub-Saharan Africa. Gender norms are an important indicator of the status of women and more conservative gender norms are associated with experiencing domestic violence, and poorer maternal and reproductive health care. This paper examines the association between adolescent childbearing and norms towards wife beating in sub-Saharan Africa, and the role of education in moderating this association. Data come from the most recent Demographic and Health Surveys-nationally representative cross-sectional surveys conducted every 5 years. Country-by-country multivariable logistic regressions were conducted in 25 countries, and country and regional estimates were obtained using meta-analytical techniques. More than half of sub-Saharan African adolescents have a child, with levels ranging from 23% in Rwanda to 69% in Niger. Between 12 and 87% of women believed wife beating is acceptable. In 20 of the 25 countries, women with a birth during adolescence were significantly more likely to believe wife beating is justified [OR = 1.39; 95% confidence interval (CI) 130-1.39]. After multivariate adjustment, the overall finding remains statistically significant [AOR = 1.09; 95% CI 105-1:13]. Education attenuates the observed association. Overall, the effects are strongest and most consistent in West Africa. Results suggest that women who have an adolescent birth more likely to hold more conservative attitudes. Working with adolescents to improve their attitudes on relationship expectations and the importance of furthering their education even after a pregnancy could be integrated into life skills and sexual education curricula.
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Affiliation(s)
- Michelle J Hindin
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E4546, Baltimore, MD, 21205, USA,
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Darnton-Hill I, Mkparu UC. Micronutrients in pregnancy in low- and middle-income countries. Nutrients 2015; 7:1744-68. [PMID: 25763532 PMCID: PMC4377879 DOI: 10.3390/nu7031744] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 02/09/2015] [Accepted: 02/26/2015] [Indexed: 11/21/2022] Open
Abstract
Pregnancy is one of the more important periods in life when increased micronutrients, and macronutrients are most needed by the body; both for the health and well-being of the mother and for the growing foetus and newborn child. This brief review aims to identify the micronutrients (vitamins and minerals) likely to be deficient in women of reproductive age in Low- and Middle-Income Countries (LMIC), especially during pregnancy, and the impact of such deficiencies. A global prevalence of some two billion people at risk of micronutrient deficiencies, and multiple micronutrient deficiencies of many pregnant women in LMIC underline the urgency to establishing the optimal recommendations, including for delivery. It has long been recognized that adequate iron is important for best reproductive outcomes, including gestational cognitive development. Similarly, iodine and calcium have been recognized for their roles in development of the foetus/neonate. Less clear effects of deficiencies of zinc, copper, magnesium and selenium have been reported. Folate sufficiency periconceptionally is recognized both by the practice of providing folic acid in antenatal iron/folic acid supplementation and by increasing numbers of countries fortifying flours with folic acid. Other vitamins likely to be important include vitamins B12, D and A with the water-soluble vitamins generally less likely to be a problem. Epigenetic influences and the likely influence of micronutrient deficiencies on foetal origins of adult chronic diseases are currently being clarified. Micronutrients may have other more subtle, unrecognized effects. The necessity for improved diets and health and sanitation are consistently recommended, although these are not always available to many of the world's pregnant women. Consequently, supplementation programmes, fortification of staples and condiments, and nutrition and health support need to be scaled-up, supported by social and cultural measures. Because of the life-long influences on reproductive outcomes, including inter-generational ones, both clinical and public health measures need to ensure adequate micronutrient intakes during pregnancy, but also during adolescence, the first few years of life, and during lactation. Many antenatal programmes are not currently achieving this. We aim to address the need for micronutrients during pregnancy, the importance of micronutrient deficiencies during gestation and before, and propose the scaling-up of clinical and public health approaches that achieve healthier pregnancies and improved pregnancy outcomes.
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Affiliation(s)
- Ian Darnton-Hill
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, NSW 2006, Australia.
- The Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA 021111, USA.
| | - Uzonna C Mkparu
- Columbia University Medical Center, Institute of Human Nutrition, New York, NY 10027, USA.
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Capan-Melser M, Mombo Ngoma G, Akerey-Diop D, Basra A, Würbel H, Groger M, Mackanga JR, Zoleko-Manego R, Schipulle U, Schwing J, Lötsch F, Rehman K, Matsiegui PB, Agnandji ST, Adegnika AA, Bélard S, González R, Kremsner PG, Menendez C, Ramharter M. Evaluation of intermittent preventive treatment of malaria against group B Streptococcus colonization in pregnant women: a nested analysis of a randomized controlled clinical trial of sulfadoxine/pyrimethamine versus mefloquine. J Antimicrob Chemother 2015; 70:1898-902. [PMID: 25722300 DOI: 10.1093/jac/dkv041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/31/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Streptococcus agalactiae constitutes an important cause of neonatal infections in sub-Saharan Africa. Sulfadoxine/pyrimethamine-the current intermittent preventive treatment of malaria in pregnancy (IPTp)-has proven in vitro activity against group B Streptococcus (GBS). Because of specific drug resistance to sulfadoxine/pyrimethamine, mefloquine-an antimalarial without in vitro activity against GBS-was evaluated as a potential alternative. This study assessed the potential of sulfadoxine/pyrimethamine-IPTp to reduce the prevalence of GBS colonization in pregnant women in Gabon when compared with the inactive control mefloquine-IPTp. METHODS Pregnant women participating in a randomized controlled clinical trial evaluating mefloquine-IPTp versus sulfadoxine/pyrimethamine-IPTp were invited to participate and recto-vaginal swabs were collected at delivery for detection of GBS colonization. Prevalence of recto-vaginal GBS colonization was compared between IPTp regimens and risk factor and birth outcome analyses were computed. RESULTS Among 549 participants, 106 were positive for GBS colonization at delivery (19%; 95% CI = 16%-23%). Prevalence of maternal GBS colonization showed no significant difference between the two IPTp regimens (mefloquine-IPTp: 67 of 366 women = 18%; 95% CI = 14%-22%; sulfadoxine/pyrimethamine-IPTp: 39 of 183 women = 21%; 95% CI = 15%-27%). Risk factor analysis for GBS colonization demonstrated a significant association with illiteracy (adjusted OR = 2.03; 95% CI = 1.25-3.30). GBS colonization had no impact on birth outcome, anaemia at delivery, gestational age and birth weight. CONCLUSIONS Sulfadoxine/pyrimethamine did not reduce colonization rates when used as the IPTp drug during pregnancy. Illiteracy was associated with GBS colonization.
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Affiliation(s)
- Mesküre Capan-Melser
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Ghyslain Mombo Ngoma
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany Département de Parasitologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Daisy Akerey-Diop
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Arti Basra
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Heike Würbel
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Mirjam Groger
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Jean R Mackanga
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Rella Zoleko-Manego
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany Ngounie Medical Research Centre, Fougamou, Gabon
| | - Ulla Schipulle
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Julia Schwing
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Felix Lötsch
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Khalid Rehman
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Selidji T Agnandji
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Ayôla A Adegnika
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Sabine Bélard
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Raquel González
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), IS Global, Barcelona, Spain
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Clara Menendez
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), IS Global, Barcelona, Spain
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
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Al-Haddabi R, Al-Bash M, Al-Mabaihsi N, Al-Maqbali N, Al-Dhughaishi T, Abu-Heija A. Obstetric and perinatal outcomes of teenage pregnant women attending a tertiary teaching hospital in oman. Oman Med J 2015; 29:399-403. [PMID: 25584155 DOI: 10.5001/omj.2014.108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 12/02/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To study the obstetrical and perinatal outcomes of teenage Omani girls with singleton pregnancies at a tertiary teaching hospital. METHODS This is a retrospective case control study. We reviewed obstetric and perinatal outcomes of teenage nulliparous pregnant Omani girls with singleton pregnancies aged 14 to 19 years, delivered at Sultan Qaboos University Hospital, between 1 July 2006 and 30 June 2013. We compared their outcomes with outcomes of pregnant nulliparous Omani women with singleton pregnancies aged 20 to 25 years old delivered at the same hospital during the same period. RESULTS When compared with pregnant women (n=307), teenage pregnant girls (n=307) were found to have higher proportion of preterm delivery <32 weeks (7% vs. 3%, p=0.040), preterm pre-labor rupture of membranes (PPROM) (19% vs. 11%, p=0.005) and anemia (58% vs. 44%, p=0.005). Cesarean section rate was higher in women than teenager girls (20% vs. 10%, p=0.001). Teenager girls had lighter babies (mean weight ± standard deviation 2,750±690 vs. 2,890±480, p=0.020), incidence of very low birth weight babies (<1,500g) was higher in teenagers (3.9% vs. 0.3%, p=0.003), but perinatal mortality rate was similar in the two groups. CONCLUSION Teenage pregnant Omani women are at increased risk of preterm delivery before 32 weeks gestation, PPROM, anemia, and delivering very low birth weight babies.
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Affiliation(s)
- Rahma Al-Haddabi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Majeda Al-Bash
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Nadia Al-Mabaihsi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Najla Al-Maqbali
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | | | - Adel Abu-Heija
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
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