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Fikre R, Gerards S, Teklesilasie W, Gubbels J. Correlates of adverse outcomes of adolescent pregnancy in Sidama region, Ethiopia. An unmatched case-control study. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 41:100986. [PMID: 38815452 DOI: 10.1016/j.srhc.2024.100986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Adolescent pregnancy has received little attention, despite being it is the leading cause of maternal mortality and morbidity in low-income countries, including Ethiopia. Sidama regional state is one of the regions in Ethiopia that has high rates of adolescent pregnancy. This study aimed to identify factors related to adverse outcomes of adolescent pregnancy, in the Sidama region, Ethiopia. METHODS A hospital-based unmatched case-control study was conducted among 120 cases and 240 controls of pregnant adolescents. Structured interviews and patient record reviews were used to examine the potential correlates and adverse outcomes of adolescent pregnancy. Using binary logistic analysis, adjusted odds ratio (AOR) with 95% confidence intervals, were computed to identify factors related to adverse outcomes of adolescent pregnancies. RESULTS A monthly income below the poverty level (AOR: 3.40; 95% CI, 1.21-9.58), lack of antenatal care follow-up (AOR: 4.22; 95% CI, 1.97-9.04), experiencing gender-based violence (AOR: 2.03; 95% CI, 1.16-3.57), and referral to a specialized health facility (AOR: 2.79; 95% CI,1.39, 5.62) were associated with higher odds of adverse pregnancy outcomes. CONCLUSION Several socio-economic and health care system-related determinants are associated with adverse outcomes of adolescent pregnancy. Therefore, it is crucial to improve free and accessible maternal health care services for adolescents, focusing on education, challenging social norms that condone gender-based violence as well as enhancing the referral system to lessen the burden of adverse outcomes of adolescent pregnancy.
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Affiliation(s)
- Rekiku Fikre
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism; Department of Health Promotion; Faculty of Health, Medicine & Life Sciences, the Netherlands; Hawassa University, College of Medicine and Health Sciences, Department of Midwifery, Ethiopia.
| | - Sanne Gerards
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism; Department of Health Promotion; Faculty of Health, Medicine & Life Sciences, the Netherlands.
| | - Wondwosen Teklesilasie
- Hawassa University, College of Medicine and Health Sciences, Department of Midwifery, Ethiopia.
| | - Jessica Gubbels
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism; Department of Health Promotion; Faculty of Health, Medicine & Life Sciences, the Netherlands.
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Mekonen EG. Pooled prevalence and associated factors of teenage pregnancy among women aged 15 to 19 years in sub-Saharan Africa: evidence from 2019 to 2022 demographic and health survey data. Contracept Reprod Med 2024; 9:26. [PMID: 38778418 PMCID: PMC11112827 DOI: 10.1186/s40834-024-00289-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Teenage pregnancy is becoming one of the most common social and public health problems worldwide, with the highest prevalence in sub-Saharan Africa. Health risks and adverse outcomes of pregnancy and childbirth among adolescent girls are the commonest cause of the global burden of maternal morbidity and mortality. This study is intended to determine the pooled prevalence and determinants of teenage pregnancy in sub-Saharan Africa using the most recent demographic and health survey data (2019-2022). METHODS A cross-sectional study was conducted using data from the most recent demographic and health surveys of four countries (Kenya, Tanzania, Gabon, and Cameroon) in sub-Saharan Africa conducted between 2019 and 2022. A total weighted sample of 12,829 teenagers aged 15 to 19 years was included in the study. Data extracted from demographic and health survey data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value ≤ 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS The pooled prevalence of teenage pregnancy among women aged 15 to 19 years was 18.15% (95% CI: 17.49, 18.83). Teenage pregnancy was positively associated with the respondent's age [AOR = 2.97; 95% CI (2.55, 3.46)], educational status [AOR = 2.21; 95% CI (1.62, 3.03)] and [AOR = 1.80; 95% CI (1.54, 2.12)], wealth status [AOR = 2.61; 95% CI (2.12, 3.22)] and [AOR = 1.65; 95% CI (1.33, 2.05)], relation to the household head [AOR = 2.09; 95% CI (1.60, 2.72)], and unmet need for contraception [AOR = 14.3; 95% CI (11.5, 17.8)]. On the other hand, it was negatively associated with marital status [AOR = 0.08; 95% (0.07, 0.10)], working status [AOR = 0.75; 95% CI (0.64, 0.88)], age at first sex [AOR = 0.68; 95% CI (0.58, 0.80)], contraceptive use [AOR = 0.25; 95% CI (0.20, 0.30)], contraceptive knowledge [AOR = 0.27; 95% CI (0.19, 0.40)], and community contraceptive utilization [AOR = 0.85; 95% CI (0.73, 0.99)]. CONCLUSION In the current study, one out of six young women aged 15 to 19 experienced teenage pregnancy. Therefore, addressing unmet needs for family planning, improving women's educational status, and giving special attention to teenagers with low educational and economic status are recommended.
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Affiliation(s)
- Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Kassa G, Batchelder A, Gross D. Prevalence and determinants of postpartum depression among adolescent and adult mothers in Northwest Ethiopia. Res Nurs Health 2024; 47:125-140. [PMID: 38095115 DOI: 10.1002/nur.22362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/25/2023] [Accepted: 12/03/2023] [Indexed: 03/25/2024]
Abstract
Postpartum depression (PPD) is a common mental health issue in resource-limited settings that negatively affects the well-being of mothers and children. However, PPD often remains untreated, leading to long-term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest Ethiopia. Data were collected from 374 adolescent (10-19 years) and 760 adult (20-34 years) mothers 6 weeks after childbirth. Data were analyzed using binary and multiple logistic regression. Adolescent mothers had a significantly higher proportion of PPD (37.4%) than adult mothers (20.1%) and were more likely to report low self-esteem (13.1% vs. 8.2%) and low social support (28.3% vs. 23.3%). Factors associated with PPD differed between adolescent and adult mothers. Adolescent mothers with PPD were more likely to report household food insecurity, low self-esteem, low knowledge of postpartum complications, and working in agriculture or professional/technical occupations. For adult mothers, factors associated with PPD included distance to the nearest health facility, medium social support, inadequate dietary diversity, and food insecurity. Results suggest that targeted interventions by age group are needed to reduce the burden of PPD in Ethiopia.
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Affiliation(s)
- Getachew Kassa
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anne Batchelder
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deborah Gross
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Tesfaye A, Tamiru D, Belachew T. Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial. Sci Rep 2024; 14:5070. [PMID: 38429426 PMCID: PMC10907709 DOI: 10.1038/s41598-024-55709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Tesfaye A, Gerbaba M, Tamiru D, Belachew T. Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study. Sci Rep 2024; 14:2871. [PMID: 38311634 PMCID: PMC10838914 DOI: 10.1038/s41598-024-53467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Mulusew Gerbaba
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Tesfaye A, Wondimagegne YA, Tamiru D, Belachew T. Exploring dietary perception, beliefs and practices among pregnant adolescents, their husbands and healthcare providers in West Arsi, Central Ethiopia: a phenomenological study. BMJ Open 2023; 13:e077488. [PMID: 38070937 PMCID: PMC10729068 DOI: 10.1136/bmjopen-2023-077488] [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: 07/08/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The two most physically active stages of life, pregnancy and adolescence, put the pregnant adolescent under a lot of stress. Adolescence is a crucial era in women's nutrition that is frequently overlooked. OBJECTIVE This study aimed to explore dietary perceptions, beliefs and practices among pregnant Adolescents in West Arsi, Central Ethiopia. DESIGN A qualitative method, specifically, a phenomenological research design, was carried out from February to March 2023. SETTINGS This study was conducted in the West Arsi zone, Oromia, Ethiopia, in four randomly selected districts. PARTICIPANTS Thirty participants, 12 pregnant adolescents, 8 husbands of pregnant adolescents and 10 healthcare providers were purposefully selected and participated. METHODS In-depth and key informant interviews were conducted. To create relevant codes, subthemes and themes, ATLAS.ti V.7.1 software was used. An inductive qualitative data analysis approach was used. The results were presented using respondents' clear verbatim and thematic analysis. RESULTS The findings were organised into four major themes: (1) low nutritional awareness, (2) poor dietary practice, (3) barriers to good dietary practice and (4) facilitators for good dietary practice. A low perceived severity (one's belief of the seriousness) of undernutrition and low perceived benefits (one's belief of the benefits) of balanced nutrition have been reported. A monotonous diet (one type food usually cereal based), no change in dietary practices during pregnancy, and low intake of animal food sources (meat, egg and milk) were found under dietary practices. One of the most striking findings to emerge from this study is the Alliance for Development (AFD), the former Women Development Army, which can be a great facilitator of good dietary practice. Husbands' involvement in nutrition education and specific nutrition training for healthcare providers are the other facilitators identified in this study. The lack of nutrition education, misconceptions and economic problems are barriers to dietary practices. CONCLUSION This study found a low nutritional awareness and poor dietary practices. Further experimental studies are recommended to assess whether AFD is capable of delivering effective nutrition interventions that improve dietary practice of pregnant.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Yohanness Addisu Wondimagegne
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Mina MN, Nuruzzaman M, Habib MN, Rahman M, Chowdhury FM, Ahsan SN, Ahmed FF, Azizi S, Mubin N, Kibria AHMG, Shuchi FA. The Effectiveness of Adequate Antenatal Care in Reducing Adverse Perinatal Outcomes: Evidence From a Low- or Middle-Income Country. Cureus 2023; 15:e51254. [PMID: 38283425 PMCID: PMC10822035 DOI: 10.7759/cureus.51254] [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: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Background and aim Antenatal care (ANC) is universally acknowledged as an essential intervention for enhancing the well-being of both mothers and children. The World Health Organization advises a minimum of four ANC visits. The objective of this study is to assess the effectiveness of adequate ANC in mitigating adverse perinatal outcomes. Methods This cross-sectional study was done at the Department of Obstetrics and Gynecology, Delta Medical College & Hospital, Bangladesh, from March 2023 to August 2023. A total of 226 mothers who gave birth at the hospital during this period were enrolled in the study. Results More than 87% of the participants received adequate (≥4 visits) antenatal care from a registered physician. More than 84% of the mothers gave birth via cesarean section. Among the mothers who received inadequate ANC, the proportion of adverse perinatal outcomes was higher (69.0%) than that of those who received adequate ANC (32.0%). A significant association (p<0.05) was noted between inadequate antenatal care and adverse perinatal outcomes. Pregnant women receiving adequate antenatal checkups were 79% less likely to experience adverse perinatal outcomes compared to those receiving inadequate ANC. Conclusion Adequate ANC is a very efficient and economical strategy for mitigating adverse perinatal outcomes.
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Affiliation(s)
| | - Mostafa Nuruzzaman
- Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | | | - Mahin Rahman
- Obstetrics and Gynaecology, Delta Medical College & Hospital, Dhaka, BGD
| | - Faiza Mehrab Chowdhury
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Syeda Nafisa Ahsan
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Fabliha Fyrose Ahmed
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Shajeda Azizi
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Nazirum Mubin
- Radiotherapy, Dhaka Medical College Hospital, Dhaka, BGD
| | - A H M Golam Kibria
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Ferdous Ara Shuchi
- Obstetrics and Gynaecology, Delta Medical College & Hospital, Dhaka, BGD
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SUMIATI TATI, SABARINAH, KUSUMAYATI AGUSTIN. Nurturing care among adolescent mothers. J Public Health Afr 2023; 14:2606. [PMID: 37942061 PMCID: PMC10628793 DOI: 10.4081/jphia.2023.2606] [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: 03/15/2023] [Accepted: 06/01/2023] [Indexed: 11/10/2023] Open
Abstract
Many studies show the impact of adolescent mothers on child development. To prevent the impact of adolescent pregnancy, nurturing care is needed to support optimal children's development. This study aims to identify comprehensive nurturing care among adolescent mothers. This study used secondary data in the integration of the 2018 National Socioeconomic Survey and Basic Health Survey. To measure nurturing care, 5 components were used: health, adequate nutrition, security and safety, responsive caregiving, and opportunities for early learning with latent class analysis. The results of the analysis showed that 62% of adolescent mothers provided uncompleted nurturing care. About 21% of adolescent mothers need assistance in improving nurturing care related to adequate nutrition and learning opportunities, and 17% need assistance to improve health, nutrition, responsive caregiving, and opportunities for early learning. Adolescent mothers are in need of comprehensive nurturing care for their children. Practice is needed in order to enhance nurturing care initiatives, particularly for teenage mothers.
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Affiliation(s)
- TATI SUMIATI
- Public Health Department, Faculty of Health Science, Muhammadiyah Maluku Utara University
| | - SABARINAH
- Faculty of Health Science, University of Indonesia, Indonesia
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Dessie AM, Anley DT, Zemene MA, Gebeyehu NA, Adella GA, Kassie GA, Mengstie MA, Seid MA, Abebe EC, Gesese MM, Tegegne KD, Anteneh RM, Solomon Y, Moges N, Bantie B, Feleke SF, Dejenie TA, Geremew H. Trend, determinants, and future prospect of child marriage in the Amhara region, Ethiopia: a multivariate decomposition analysis. Front Public Health 2023; 11:1132148. [PMID: 37780428 PMCID: PMC10537212 DOI: 10.3389/fpubh.2023.1132148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 08/16/2023] [Indexed: 10/03/2023] Open
Abstract
Background Child marriage is a harmful traditional practice, which compromises children of their childhood and threatens their lives and health. In Ethiopia, 58% of women and 9% of men get married before the age of 18 years. Surprisingly, parents in the Amhara region make marriage promises of their children before they are even born, which will hinder the region from attaining the Sustainable Development Goal of ending child marriage. Thus, this study aimed to assess the trends, determinants, and future prospects of child marriage in the Amhara region of Ethiopia. Methods A repeated cross-sectional study was conducted using four consecutive nationally representative Ethiopian demographic and health surveys (2000-2016). A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in child marriage over time. Statistical significance was declared at a p-value of < 0.05. The child marriage practice in the Amhara region by the year 2030 was also predicted using different forecasting features of Excel. Results The trend of child marriage over the study period (2000-2016) decreased from 79.9% (76.7, 82.8) to 42.9% (39.1, 46.9), with an annual average reduction rate of 2.9%. Approximately 35.2% of the decline resulted from an increase in the proportion of women who attained secondary and above-secondary education over the two surveys. A decrease in the proportion of rural women and a change in the behavior of educated and media-exposed women also contributed significantly to the decline in child marriage. The prevalence of child marriage in the Amhara region by the year 2030 was also predicted to be 10.1% or 8.8%. Conclusion Though there has been a significant decline in child marriage in the Amhara region over the past 16 years, the proportion is still high, and the region is not going to eliminate it by 2030. Education, residence, and media exposure were all factors associated with the observed change in child marriage in this study. Therefore, additional efforts will be required if child marriage is to be eliminated by 2030, and investing more in education and media access will hasten the region's progress in this direction.
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Affiliation(s)
- Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Physiology, Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Rahel Mulatie Anteneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yenealem Solomon
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Moges
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
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Aynalem BY, Melesse MF, Bitewa YB. Cultural Beliefs and Traditional Practices During Pregnancy, Child Birth, and the Postpartum Period in East Gojjam Zone, Northwest Ethiopia: A Qualitative Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:415-422. [PMID: 37645589 PMCID: PMC10460962 DOI: 10.1089/whr.2023.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/31/2023]
Abstract
Introduction Many countries invest in interventions to minimize maternal and neonatal morbidity and mortality but the progress has been slow, in developing countries, especially in Africa. Traditional taboos and malpractices like home deliveries owing to cultural beliefs and traditional practices during pregnancy, childbirth, and the postpartum period increase maternal and neonatal complications. Although there are different researches in Ethiopia, the reasons for practicing such traditional activities in the East Gojjam zone in northwest Ethiopia are not well understood. Ethical clearance was obtained from the research committee of Debre Markos University. Objective This study aimed to explore cultural beliefs and traditional practices during pregnancy, childbirth, and the postpartum period in East Gojjam Zone, Northwest Ethiopia. Materials and Methods Purposive and snowball nonprobability sampling techniques were used to select the study participants. Data were collected through in-depth interviews and focused group discussions until the information was saturated and it was categorized and analyzed after the interviews were completed. The translated text file was analyzed using thematic analysis using codes and terms to create themes. Information from the interview consists of the women's descriptions and explanations of their cultural practices during pregnancy, childbirth, and the postnatal period. Result Respondents report many examples of cultural, traditional, and religious practices experienced by the community in East Gojjam Zone during pregnancy, childbirth, and postpartum period, whether they are beneficial or harmful for the mother and the fetus. Drinking holy water, praying to God and Mary, taking herbal medicine, food taboo, making a confinement period in a dark room, and other cultural ceremonies are among commonly experienced cultural, traditional, and religious practices in the study area. Conclusion Traditional, cultural, and religious practices during pregnancy, childbirth, and the postpartum period are still popular among the community in the East Gojjam Zone. It is critical to identify the harmful practices and reinforce the positive healthy practices to make pregnancy, childbirth, and postpartum periods healthy and joyful.
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Baraki SG, Thupayagale-Tshweneagae GB. Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia. Afr J Prim Health Care Fam Med 2023; 15:e1-e10. [PMID: 37526559 PMCID: PMC10476444 DOI: 10.4102/phcfm.v15i1.3865] [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: 10/07/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks. AIM To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia. SETTING The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia. METHODS A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied. RESULTS Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents. CONCLUSION Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.
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Affiliation(s)
- Semere G Baraki
- Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa.
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Osmundo Junior GDS, Cabar FR, Peres SV, Waissman AL, Galletta MAK, Francisco RPV. Adverse Perinatal Outcomes among Adolescent Pregnant Women Living with HIV: A Propensity-Score-Matched Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085447. [PMID: 37107729 PMCID: PMC10138774 DOI: 10.3390/ijerph20085447] [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: 01/21/2023] [Revised: 03/03/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
HIV infection and adolescent pregnancy are known to increase the risk of adverse perinatal outcomes. However, data are limited concerning the outcomes of pregnancies among adolescent girls living with HIV. This retrospective propensity-score matched study aimed to compare adverse perinatal outcomes in adolescent pregnant women living with HIV (APW-HIV-positive) with HIV-negative adolescent pregnant women (APW-HIV-negative) and adult pregnant women with HIV (PW-HIV). APW-HIV-positive were propensity-score matched with APW-HIV-negative and PW-HIV. The primary endpoint was a composite endpoint of adverse perinatal outcomes, comprising preterm birth and low birth weight. There were 15 APW-HIV-positive and 45 women in each control group. The APW-HIV-positive were aged 16 (13-17) years and had had HIV for 15.5 (4-17) years, with 86.7% having perinatally acquired HIV. The APW-HIV-positive had higher rates of perinatally acquired HIV infection (86.7 vs. 24.4%, p < 0.001), a longer HIV infection time (p = 0.021), and longer exposure to antiretroviral therapy (p = 0.034) compared with the PW-HIV controls. The APW-HIV-positive had an almost five-fold increased risk of adverse perinatal outcomes compared with healthy controls (42.9% vs. 13.3%, p = 0.026; OR 4.9, 95% CI 1.2-19.1). The APW-HIV-positive and APW-HIV-negative groups had similar perinatal outcomes.
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Affiliation(s)
- Gilmar de Souza Osmundo Junior
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
- Correspondence: ; Tel.: +55-11-2661-6209
| | - Fábio Roberto Cabar
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Stela Verzinhasse Peres
- Divisao de Clinica Obstetrica, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Adriana Lippi Waissman
- Divisao de Clinica Obstetrica, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Marco Aurélio Knippel Galletta
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
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Diabelková J, Rimárová K, Dorko E, Urdzík P, Houžvičková A, Argalášová Ľ. Adolescent Pregnancy Outcomes and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4113. [PMID: 36901128 PMCID: PMC10002018 DOI: 10.3390/ijerph20054113] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
One of the major social and public health problems in the world is adolescent pregnancy. Adolescent pregnancy is strongly associated to less favorable results for both the mother and the newborn. We conducted this research to ascertain the impact of teenage age on neonatal outcomes and also observed the lifestyles of pregnant teenage girls. We conducted a study of 2434 mothers aged ≤19 years (n = 294) or 20-34 years (n = 2140) who gave birth in 2019-2020 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. The data on mothers and newborn infants have been reported from the reports on mothers at childbirth. Women between the ages of 20 and 34 served as the reference group. The teenage mothers were more likely to become pregnant if they were unmarried (OR = 14.2; 95% CI = 9.3-21.6; p < 0.001) and had a basic education or lack of education (OR = 16.8; 95% CI = 11.5-24.6; p < 0.001). Additionally, they were more likely to smoke when pregnant (OR = 5.0; 95% CI = 3.8-6.6; p < 0.001). Low birth weight was more common in newborns born to adolescent mothers than in those born to adult mothers (p < 0.001). Our findings showed that infants of teenage mothers often had lower birth weights (-332.6 g, p < 0.001). Adolescent mothers were associated with lower Apgar scores at the first minute (p = 0.003). As compared with the control group, pregnant teenage girls had a greater prevalence of preterm deliveries in our research (p = 0.004). This study finds significant age-related disparities in neonatal outcomes between mothers. These results might be used to identify vulnerable groups who need special assistance and actions to reduce the probability of negative outcomes for such groups.
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Affiliation(s)
- Jana Diabelková
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Erik Dorko
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Peter Urdzík
- Department of Gynaecology and Obstetrics, Medical Faculty, Louis Pasteur University Hospital, University of Pavol Jozef Šafárik, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Andrea Houžvičková
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Ľubica Argalášová
- Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Špitálska 24, 813 72 Bratislava, Slovakia
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Shongwe ZB. Implementation of maternal guidelines for gravid teenagers with hypertensive disorders in KwaZulu-Natal. Curationis 2023; 46:e1-e7. [PMID: 36744473 PMCID: PMC9982488 DOI: 10.4102/curationis.v46i1.2395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/14/2022] [Accepted: 11/15/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The worldwide phenomenon of teenage pregnancy among 13-9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy. OBJECTIVE The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers. METHODS As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics. RESULTS Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives. CONCLUSION Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP).Contribution: This study contributed to facilitating adherence to guidelines improving healthcare of teenagers in government facilities.
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Affiliation(s)
- Zwelihle B. Shongwe
- Department of Health, KwaZulu-Natal College of Nursing, Empangeni, South Africa,Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa
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Ursache A, Lozneanu L, Bujor I, Cristofor A, Popescu I, Gireada R, Mandici CE, Găină MA, Grigore M, Matasariu DR. Epidemiology of Adverse Outcomes in Teenage Pregnancy-A Northeastern Romanian Tertiary Referral Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1226. [PMID: 36673977 PMCID: PMC9859398 DOI: 10.3390/ijerph20021226] [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: 10/25/2022] [Revised: 12/18/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
Background: Despite being a very well-documented subject in the literature, there are still conflicting results regarding teenage pregnancies and their fetal outcomes. Methods: We conducted a retrospective, comparative cohort study that included 1082 mothers aged less than 18 years, compared to 41,998 mothers aged over 18 years, who delivered in our tertiary referral center between January 2015 and December 2021. To check for significant differences between the two groups, the chi-qquared or Fisher’s test for categorical variables were used. Results: We detected statistically significant higher rates of fetal malformation, premature birth, FGR and SGA fetal growth conditions, preeclampsia, condylomatosis and vaginal infection with E. coli in our cohort of teenagers. In this subpopulation of teenagers, the rate for premature birth at less than 32 weeks of gestation was 3.26-fold higher and 3.25-fold higher for condylomatosis, and these results referred to the cohort of adult patients (>18 years old) that gave birth in the same interval of time. Conclusions: Teenage pregnancies still remain a major health problem that burdens all countries worldwide regardless of their income. It needs solutions initially to prevent pregnancy in this young age segment and last but not least to improve both maternal and fetal outcomes.
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Affiliation(s)
- Alexandra Ursache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Ludmila Lozneanu
- Department of Morpho-Functional Sciences I—Histology, Pathology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Iuliana Bujor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Alexandra Cristofor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Ioana Popescu
- Department of Dermatology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Roxana Gireada
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Cristina Elena Mandici
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Marcel Alexandru Găină
- Psychiatry, Department of Medicine III, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Mihaela Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Daniela Roxana Matasariu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
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Odongkara B, Nankabirwa V, Ndeezi G, Achora V, Arach AA, Napyo A, Musaba M, Mukunya D, Tumwine JK, Thorkild T. Incidence and Risk Factors for Low Birthweight and Preterm Birth in Post-Conflict Northern Uganda: A Community-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12072. [PMID: 36231374 PMCID: PMC9564590 DOI: 10.3390/ijerph191912072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Annually, an estimated 20 million (13%) low-birthweight (LBW) and 15 million (11.1%) preterm infants are born worldwide. A paucity of data and reliance on hospital-based studies from low-income countries make it difficult to quantify the true burden of LBW and PB, the leading cause of neonatal and under-five mortality. We aimed to determine the incidence and risk factors for LBW and preterm birth in Lira district of Northern Uganda. METHODS This was a community-based cohort study, nested within a cluster-randomized trial, designed to study the effect of a combined intervention on facility-based births. In total, 1877 pregnant women were recruited into the trial and followed from 28 weeks of gestation until birth. Infants of 1556 of these women had their birthweight recorded and 1279 infants were assessed for preterm birth using a maturity rating, the New Ballard Scoring system. Low birthweight was defined as birthweight <2.5kg and preterm birth was defined as birth before 37 completed weeks of gestation. The risk factors for low birthweight and preterm birth were analysed using a multivariable generalized estimation equation for the Poisson family. RESULTS The incidence of LBW was 121/1556 or 7.3% (95% Confidence interval (CI): 5.4-9.6%). The incidence of preterm births was 53/1279 or 5.0% (95% CI: 3.2-7.7%). Risk factors for LBW were maternal age ≥35 years (adjusted Risk Ratio or aRR: 1.9, 95% CI: 1.1-3.4), history of a small newborn (aRR: 2.1, 95% CI: 1.2-3.7), and maternal malaria in pregnancy (aRR: 1.7, 95% CI: 1.01-2.9). Intermittent preventive treatment (IPT) for malaria, on the other hand, was associated with a reduced risk of LBW (aRR: 0.6, 95% CI: 0.4-0.8). Risk factors for preterm birth were maternal HIV infection (aRR: 2.8, 95% CI: 1.1-7.3), while maternal education for ≥7 years was associated with a reduced risk of preterm birth (aRR: 0.2, 95% CI: 0.1-0.98) in post-conflict northern Uganda. CONCLUSIONS About 7.3% LBW and 5.0% PB infants were born in the community of post-conflict northern Uganda. Maternal malaria in pregnancy, history of small newborn and age ≥35 years increased the likelihood of LBW while IPT reduced it. Maternal HIV infection was associated with an increased risk of PB compared to HIV negative status. Maternal formal education of ≥7 years was associated with a reduced risk of PB compared to those with 0-6 years. Interventions to prevent LBW and PBs should include girl child education, and promote antenatal screening, prevention and treatment of malaria and HIV infections.
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Affiliation(s)
- Beatrice Odongkara
- Department of Paediatrics and Child Health, Faculty of Medicine, Gulu University, Gulu P.O. Box 166, Uganda
- Centre for International Health, University of Bergen, 5020 Bergen, Norway
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Victoria Nankabirwa
- School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Grace Ndeezi
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Vincentina Achora
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Gulu University, Gulu P.O. Box 166, Uganda
| | - Anna Agnes Arach
- Department of Midwifery, Lira University, Lira P.O. Box 1035, Uganda
| | - Agnes Napyo
- Department of Public Health, College of Health Sciences, Busitema University, Mbale P.O. Box 1460, Uganda
| | - Milton Musaba
- Department of Public Health, College of Health Sciences, Busitema University, Mbale P.O. Box 1460, Uganda
| | - David Mukunya
- Department of Public Health, College of Health Sciences, Busitema University, Mbale P.O. Box 1460, Uganda
| | - James K. Tumwine
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Tylleskar Thorkild
- Centre for International Health, University of Bergen, 5020 Bergen, Norway
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Mabrouk A, Abubakar A, Too EK, Chongwo E, Adetifa IM. A Scoping Review of Preterm Births in Sub-Saharan Africa: Burden, Risk Factors and Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10537. [PMID: 36078258 PMCID: PMC9518061 DOI: 10.3390/ijerph191710537] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Preterm births (PTB) are the leading cause of neonatal deaths, the majority of which occur in low- and middle-income countries, particularly those in Sub-Saharan Africa (SSA). Understanding the epidemiology of prematurity is an essential step towards tackling the challenge of PTB in the sub-continent. We performed a scoping review of the burden, predictors and outcomes of PTB in SSA. We searched PubMed, Embase, and three other databases for articles published from the database inception to 10 July 2021. Studies reporting the prevalence of PTB, the associated risk factors, and/or its outcomes were eligible for inclusion in this review. Our literature search identified 4441 publications, but only 181 met the inclusion criteria. Last menstrual period (LMP) was the most commonly used method of estimating gestational age. The prevalence of PTB in SSA ranged from 3.4% to 49.4%. Several risk factors of PTB were identified in this review. The most frequently reported risk factors (i.e., reported in ≥10 studies) were previous history of PTB, underutilization of antenatal care (<4 visits), premature rupture of membrane, maternal age (≤20 or ≥35 years), inter-pregnancy interval, malaria, HIV and hypertension in pregnancy. Premature babies had high rates of hospital admissions, were at risk of poor growth and development, and were also at a high risk of morbidity and mortality. There is a high burden of PTB in SSA. The true burden of PTB is underestimated due to the widespread use of LMP, an unreliable and often inaccurate method for estimating gestational age. The associated risk factors for PTB are mostly modifiable and require an all-inclusive intervention to reduce the burden and improve outcomes in SSA.
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Affiliation(s)
- Adam Mabrouk
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
- Department of Public Health, Pwani University, Kilifi P.O. Box 195-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7FZ, UK
| | - Ezra Kipngetich Too
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya
| | - Esther Chongwo
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya
| | - Ifedayo M. Adetifa
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Department of Paediatrics, College of Medicine, University of Lagos, Idi-Araba, Lagos 100254, Nigeria
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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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Maheshwari MV, Khalid N, Patel PD, Alghareeb R, Hussain A. Maternal and Neonatal Outcomes of Adolescent Pregnancy: A Narrative Review. Cureus 2022; 14:e25921. [PMID: 35844352 PMCID: PMC9282583 DOI: 10.7759/cureus.25921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
Adolescent pregnancy is the pregnancy of girls aged 10-19 years, leading to many maternal and neonatal adverse effects. These pregnancies have been a global concern for many decades and yet are still prevailing. This article has reviewed the significant determinants of adolescent pregnancy and various maternal adverse effects, including preeclampsia, preterm premature rupture of the membrane (PPROM), maternal anemia, sexually transmitted diseases, postpartum depression, and maternal deaths, and adverse neonatal outcomes, including low birth weight (LBW), prematurity, stillbirths, early neonatal demise, and low Apgar score. Various pathophysiologic events that lead to such adverse consequences have been briefly discussed in the article and how such occurrences can be overcome. This article has also emphasized the need to implement various modalities such as sex education, availability of contraceptives, and bringing community-level awareness to lower the prevalence of adolescent pregnancy.
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Muwema M, Kaye DK, Edwards G, Nalwadda G, Nangendo J, Okiring J, Mwanja W, Ekong EN, Kalyango JN, Nankabirwa JI. Perinatal care in Western Uganda: Prevalence and factors associated with appropriate care among women attending three district hospitals. PLoS One 2022; 17:e0267015. [PMID: 35639711 PMCID: PMC9154186 DOI: 10.1371/journal.pone.0267015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Perinatal mortality remains high globally and remains an important indicator of the quality of a health care system. To reduce this mortality, it is important to provide the recommended care during the perinatal period. We assessed the prevalence and factors associated with appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region, Uganda. Results from this study provide valuable information on the perinatal care services and highlight areas of improvement for better perinatal outcomes. Methods A cross sectional survey was conducted among postpartum mothers attending care at three district hospitals in Bunyoro. Following consent, a questionnaire was administered to capture the participants’ demographics and data on care received was extracted from their antenatal, labour, delivery, and postpartum records using a pre-tested structured tool. The care received by women was assessed against the standard protocol established by World Health Organization (WHO). Poisson regression with robust standard errors was used to assess factors associated with appropriate postpartum care. Results A total of 872 mothers receiving care at the participating hospitals between March and June 2020 were enrolled in the study. The mean age of the mothers was 25 years (SD = 5.95). None of the mothers received appropriate antenatal or intrapartum care, and only 3.8% of the participants received appropriate postpartum care. Factors significantly associated with appropriate postpartum care included mothers being >35 years of age (adjusted prevalence ratio [aPR] = 11.9, 95% confidence interval [CI] 2.8–51.4) and parity, with low parity (2–3) and multiparous (>3) mothers less likely to receive appropriate care than prime gravidas (aPR = 0.3, 95% CI 0.1–0.9 and aPR = 0.3, 95% CI 0.1–0.8 respectively). Conclusions Antenatal, intrapartum, and postpartum care received by mothers in this region remains below the standard recommended by WHO, and innovative strategies across the continuum of perinatal care need to be devised to prevent mortality among the mothers. The quality of care also needs to be balanced for all mothers irrespective of the age and parity.
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Affiliation(s)
- Mercy Muwema
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- * E-mail:
| | - Dan K. Kaye
- Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace Edwards
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda
| | - Gorrette Nalwadda
- Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joanita Nangendo
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jaffer Okiring
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Elizabeth N. Ekong
- Department of Nursing, Faculty of Health Sciences, Uganda Christian University, Uganda
| | - Joan N. Kalyango
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pharmacy, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joaniter I. Nankabirwa
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
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21
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Jackson-Gibson M, Zash R, Mussa A, Caniglia EC, Diseko M, Mayondi G, Mabuta J, Morroni C, Mmalane M, Lockman S, Makhema J, Shapiro RL. High risk of adverse birth outcomes among adolescents living with HIV in Botswana compared to adult women living with HIV and adolescents without HIV. BMC Pregnancy Childbirth 2022; 22:372. [PMID: 35490225 PMCID: PMC9055710 DOI: 10.1186/s12884-022-04687-y] [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: 07/18/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Adolescent girls are three times more likely to be living with HIV than boys of the same age. Prior studies have found associations between adolescent pregnancies and increased maternal morbidity and infant mortality, but few studies have assessed the impact of HIV infection on maternal and infant outcomes in adolescents. Methods The Tsepamo Study abstracts maternal and infant data from obstetric records in government maternity wards in Botswana. We assessed maternal complications and adverse birth outcomes for all singleton pregnancies from August 2014 to August 2020 at eighteen Tsepamo sites among adolescents (defined as 10–19 years of age) and adults (defined as 20–35 years of age), by HIV status. Univariate and multivariate logistic regression using a complete case analysis method were used to evaluate differences in outcomes. Results This analysis included 142,258 singleton births, 21,133 (14.9%) to adolescents and 121,125 (85.1%) to adults. The proportion of adults living with HIV (N = 22,114, 22.5%) was higher than adolescents (N = 1593, 7.6%). The proportion of most adverse birth outcomes was higher in adolescents. Among adolescents, those with HIV had increased likelihoods of anemia (aOR = 1.89, 95%CI 1.66, 2.15) and cesarean sections (aOR = 1.49, 95%CI 1.3,1.72), and infants with preterm birth (aOR = 1.15, 95%CI 1.0, 1.32), very preterm birth (aOR = 1.35, 95%CI 1.0,1.8), small for gestational age (aOR = 1.37, 95%CI 1.20,1.58), and very small for gestational age (aOR = 1.46, 95%CI 1.20, 1.79). Conclusions Adolescent pregnancy and adolescent HIV infection remain high in Botswana. Adolescents have higher risk of adverse maternal and infant birth outcomes than adults, with the worst outcomes among adolescents living with HIV. Linking HIV prevention and family planning strategies for this age group may help minimize the number of infants with poor birth outcomes among this already vulnerable population.
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Affiliation(s)
- Maya Jackson-Gibson
- Feinberg School of Medicine Northwestern University, Chicago, Illinois, USA.
| | - Rebecca Zash
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Aamirah Mussa
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Ellen C Caniglia
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Modiegi Diseko
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Gloria Mayondi
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Judith Mabuta
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Chelsea Morroni
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, Scotland
| | - Mompati Mmalane
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Shahin Lockman
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Joseph Makhema
- Botswana-Harvard Partnership AIDS Institute, Gaborone, Botswana
| | - Roger L Shapiro
- Harvard T. H Chan School of Public Health, Boston, Massachusetts, USA
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22
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Workineh YA, Workie HM. Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study. Glob Pediatr Health 2022; 9:2333794X221084070. [PMID: 35355940 PMCID: PMC8958707 DOI: 10.1177/2333794x221084070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Adverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors. Method Institutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data. Results In this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes. Conclusions The adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.
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23
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Dasa TT, Okunlola MA, Dessie Y. Effect of Grand Multiparity on the Adverse Birth Outcome: A Hospital-Based Prospective Cohort Study in Sidama Region, Ethiopia. Int J Womens Health 2022; 14:363-372. [PMID: 35300284 PMCID: PMC8923638 DOI: 10.2147/ijwh.s350991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background Adverse birth outcome is associated with grand multiparity and is still a major public health problem in developing countries. There is limited information that investigates the effect of grand multiparity on perinatal outcomes in a prospective follow-up design in Ethiopia. Therefore, this study was aimed to investigate the effect of grand multiparity on the occurrence of adverse perinatal outcomes in the Sidama Region of Ethiopia. Methods We conducted a prospective follow-up study among 837 women who gave birth in selected public hospitals of the Sidama Region from January 1 to August 31, 2021. Data were collected using a structured questionnaire and medical record review. A modified Poisson regression model with robust standard errors was applied to estimate the adjusted risk ratio and its 95% CI of the risk factors for adverse perinatal outcomes to examine the association of the multi-parities with the adverse birth outcome. STATA Version 14 was used for analysis. Results The overall cumulative incidence of adverse perinatal outcomes was 33% (95% CI: 29.9%, 36.4%). After adjusted for confounders, women with grand multiparity gave birth to babies with a higher risk of stillbirth (ARR = 1.6; 95% CI: 1.01–2.51), macrosomia (ARR = 1.6; 95% CI: 1.23–2.07), and preterm birth (ARR = 1.3; 95% CI: 1.1–1.66) compared to their counterparts. Conclusion High incidences of adverse perinatal outcomes occurred among women with grand multiparity. We recommend that the region and districts health bureau should give close monitoring for pregnant women with high parity throughout their prenatal, intrapartum, and postpartum periods.
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Affiliation(s)
- Tamirat Tesfaye Dasa
- Department of Reproductive Health Sciences, Life and Earth Sciences Institute (Including Agriculture and Health), Pan African University, Ibadan, Nigeria.,Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Michael A Okunlola
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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24
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Yildiz MS, Cimsir MT. Comparison of obstetric and neonatal outcomes between Syrian adolescent refugees and local Turkish adolescent citizens. J OBSTET GYNAECOL 2022; 42:1092-1096. [PMID: 35023800 DOI: 10.1080/01443615.2021.2003308] [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: 10/19/2022]
Abstract
The provision of antenatal care in adolescents in refugee populations presents particular difficulties because of conflict, nutritional deficiencies, language barriers and lack of access to health care facilities. Due to the absence of prenatal care, associated medical complications can occur. A total of 525 adolescent women who gave birth to singletons agreed to participate in this study. Data about maternal demographic and obstetric characteristics, as well as neonatal outcomes were analysed. In conclusion, adolescent pregnancy continues to be an important social problem due to health support needs. However, the results of our present study are important in terms of showing that perinatal care is quietly improving in Turkey.Impact StatementWhat is already known on this subject? Adolescent pregnancies are at much higher risk than adult pregnancies in terms of complications. These complications include preterm delivery, intrauterine growth retardation, maternal morbidity and mortality, neonatal morbidity and mortality. According to various beliefs and traditions, marriages in early ages are observed in some societies and as a result, adolescents become pregnant. Additionally, the present study includes early adolescent aged pregnancies as 14,15 and 16. As far as we search in the literature, there is no reported about early adolescent pregnancies.What do the results of this study add? Often, such pregnancies occur more frequently in societies with low socioeconomic levels. For this reason routine pregnancy screening, support during pregnancy, prenatal care is not adequately provided. Some of the complications develop on them. Primarily, the adolescent pregnancies should be gotten under control, if not, some complications can be prevented by routine pregnancy follow-up and adequate provision of prenatal care and support.What are the implications of these findings for clinical practice and/or further research? As a guide on clinical practices and further studies; an effective method of contraception should be applied to sexually active women at early maternal age. If not, pregnancies should be kept under close follow-up and with adequate support to avoid complications.
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Affiliation(s)
- Muhammet Serhat Yildiz
- Faculty of Medicine, Department of Obstetrics and Gynecology, Alanya Education and Research Hospital, Alaaddin Keykubat University, Alanya, Turkey
| | - Meral Tugba Cimsir
- Faculty of Medicine, Department of Obstetrics and Gynecology, Alaaddin Keykubat University, Alanya, Turkey
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25
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Kadhim Jasim S, Al-Momen H, Abdul Razzak Obaid A. Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study. Int J Reprod Biomed 2022; 19:1005-1014. [PMID: 34977458 PMCID: PMC8717083 DOI: 10.18502/ijrm.v19i11.9916] [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: 06/10/2020] [Revised: 12/22/2020] [Accepted: 02/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and third pregnancy groups was 96 and 47, respectively. Results There was a significant risk of preeclampsia in the first pregnancy group (p = 0.01). Low birth weight, five-min Apgar score < 7, and neonatal intensive care unit admission were the most significant neonatal outcomes in the first pregnancy group. In the third pregnancy group, significant predictors of neonatal complications included very young age in the first pregnancy ( ≤ 15 yr), an inter-pregnancy interval < 2 yr, current anemia, and history of obstetric and/or neonatal complications in previous pregnancies. Conclusion Based on the results, teenagers with their first pregnancy had comparable obstetric outcomes (except for preeclampsia) as teenagers with their third pregnancy, whereas neonatal complications occurred more frequently in the first pregnancy group. Overall, we can predict high-risk neonates in the third pregnancy, based on the abovementioned parameters.
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Affiliation(s)
- Shaymaa Kadhim Jasim
- Department of Obstetrics and Gynecology, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Hayder Al-Momen
- Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Ali Abdul Razzak Obaid
- Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
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26
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Tiruye G, Shiferaw K, Tura AK, Debella A, Musa A. Prevalence of premature rupture of membrane and its associated factors among pregnant women in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2021; 9:20503121211053912. [PMID: 34733510 PMCID: PMC8558797 DOI: 10.1177/20503121211053912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Premature rupture of the membrane is a serious public health problem, especially in low- and middle-income countries with significant maternal and perinatal morbidity and mortality. Despite its substantial contributions to feto-maternal complications, the burden of premature rupture of the membrane was not systematically analyzed in Ethiopia. Hence, this review aimed to identify the burden of premature rupture of the membrane and associated factors among pregnant women in Ethiopia. Methods PubMed/Medline, Scopus, and African journal online databases and Google Scholar were searched for articles published in the English language. Independent review authors selected and screened studies. Appraisal for methodological quality of studies was conducted using the Joanna Briggs Institute assessment checklist. RevMan 5.3 software was used for meta-analysis. The I 2 statistical significance and Egger's test were used to assess heterogeneity and publication bias, respectively. Results The pooled prevalence of premature rupture of the membrane among pregnant women in Ethiopia was 9.2% (95% confidence interval = 5.0, 16.4). Factors significantly associated with premature rupture of the membrane were no antenatal care visit (odds ratio = 2.87, confidence interval = 1.34, 6.14), history of premature rupture of the membrane (odds ratio = 4.09, 95% confidence interval = 2.82, 5.91), history of abortion (odds ratio = 3.13, confidence interval = 1.63, 6.01), abnormal vaginal discharge (odds ratio = 6.78, confidence interval = 4.11, 11.16), and urinary tract infection (odds ratio = 3.04, confidence interval = 1.21, 7.63). Conclusion Nearly one in ten pregnancies in Ethiopia encounters premature rupture of the membrane complications. The finding highlights improving antenatal care utilization, thus preventing or treating urinary and reproductive tract infections, and tailored interventions for pregnant women with a history of premature rupture of the membrane or abortion contribute to reduced premature rupture of the membrane.
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Affiliation(s)
- Getahun Tiruye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kassiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulbasit Musa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Bain LE, Ahinkorah BO, Seidu AA, Budu E, Okyere J, Kongnyuy E. Beyond counting intended pregnancies among young women to understanding their associated factors in sub-Saharan Africa. Int Health 2021; 14:501-509. [PMID: 34520526 PMCID: PMC9450639 DOI: 10.1093/inthealth/ihab056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/01/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background In this article we report the prevalence and determinants of intended or wanted pregnancies among young women 15–24 y of age in selected sub-Saharan African countries. Methods This cross-sectional study used pooled data from current Demographic and Health Surveys conducted between 1 January 2010 and 31 December 2019 in 29 countries in sub-Saharan Africa (SSA). The sample size comprised 14 257 young women (15–24 y of age). Multivariable binary logistic regression models were used to present the results as adjusted odds ratios. Results The prevalence of intended pregnancies was 67.7%, with the highest and lowest prevalence in Gambia (89.9%) and Namibia (37.7%), respectively. Intended pregnancy was lower among young women who had knowledge of modern contraceptives, those with a secondary/higher education and those with four or more births. Lower odds of intended pregnancy were observed among young women in the richer wealth quintile and those who lived in southern Africa. Conclusions To reduce intended pregnancies in sub-Saharan African countries such as Gambia, Burkina Faso and Nigeria, there is a need for government and non-governmental organisations to recalibrate current and past interventions such as investment in increasing formal education for women and poverty alleviation programmes, as well as augmenting job creation, including skill-building. These interventions have to be sensitive to the cultural realities of each setting, especially with regards to early marriages and womanhood.
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Affiliation(s)
- Luchuo Engelbert Bain
- Lincoln International Institute for Rural Health, College of Social Science, University of Lincoln. Brayford Pool, Lincoln, Lincolnshire. LN6 7TS, UK.,Global South Health Research and Services, GSHS, Amsterdam, The Netherlands
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia.,Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Eugene Budu
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial. PLoS One 2021; 16:e0256479. [PMID: 34473750 PMCID: PMC8412258 DOI: 10.1371/journal.pone.0256479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch. Objective To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda. Methods A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care. Results Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition. Conclusion Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents’ fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.
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Olapeju B, Hong X, Wang G, Summers A, Burd I, Cheng TL, Wang X. Birth outcomes across the spectrum of maternal age: dissecting aging effect versus confounding by social and medical determinants. BMC Pregnancy Childbirth 2021; 21:594. [PMID: 34470614 PMCID: PMC8411515 DOI: 10.1186/s12884-021-04077-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the trend of increasing maternal age and associated adverse reproductive outcomes in the US, this study aimed to assess whether this association is due to an independent aging or confounded by sociodemographic, biomedical, or behavioral determinants in a predominantly Black US population. METHODS Data was from 8509 women enrolled in the Boston Birth Cohort. Adverse reproductive outcomes included spontaneous preterm delivery, cesarean delivery, and low birth weight. Covariates included sociodemographic (parity, race/ethnicity, education, marital status, income, receipt of public assistance, nativity); biomedical (obesity, hypertensive disorders, diabetes mellitus); and behavioral (consistent intake of multivitamin supplements, support from father of baby, support from family, major stress in pregnancy, cigarette smoking, alcohol intake). Analysis included Lowess and marginal probability plots, crude and adjusted sequential logistic regression models to examine age-outcome associations and to what degree the association can be explained by the above covariables. RESULT Overall, the study sample had high levels of spontaneous preterm birth (18%), cesarean delivery (33%) and low birth weight (26%). Unadjusted models showed no significant difference odds of spontaneous preterm birth by maternal age but higher odds of cesarean section (aOR: 1.77, 95% CI: 1.60, 1.95) and low birth weight (aOR: 1.15, 95% CI: 1.04, 1.28) among women 30 years or older. Adjustment for sociodemographic factors, biomedical conditions and behavioral factors revealed higher odds of spontaneous preterm birth: (aOR: 1.30, 95% CI: 1.14, 1.49), cesarean section deliveries (aOR: 1.68, 95% CI: 1.51, 1.87) and low birth weight (aOR: 1.36, 95% CI: 1.21, 1.53). Across all ages, optimal BMI status and consistent multivitamin supplement intake were protective of spontaneous preterm birth and low birth weight. CONCLUSION In this high-risk minority population, we demonstrated that the association between increasing maternal age and adverse pregnancy outcomes was due to an independent aging effect and the presence of confounding by sociodemographic, biomedical, and behavioral factors. Some modifiable risk factors to counteract aging effect, include optimizing BMI and consistent intake of multivitamin supplement. A fundamental change in how care is provided to women, particularly low income Black women, is needed with emphasis on the protective role of optimal nutritional status. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03228875.
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Affiliation(s)
- Bolanle Olapeju
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
- Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Amber Summers
- Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Irina Burd
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tina L Cheng
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA.
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Sendeku FW, Beyene FY, Tesfu AA, Bante SA, Azeze GG. Preterm birth and its associated factors in Ethiopia: a systematic review and meta-analysis. Afr Health Sci 2021; 21:1321-1333. [PMID: 35222597 PMCID: PMC8843273 DOI: 10.4314/ahs.v21i3.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background Preterm birth is a public health concern globally. In low- and middle-income countries, like Ethiopia, preterm birth is under reported and underestimated. Therefore, this systematic review and meta-analysis assessed the pooled prevalence and associated risk factors for preterm birth in Ethiopia. Methods In this review the databases used were PubMed, Google scholar, EMBASE, HINARI and African journal online. Publication bias was checked using a funnel plot and Eggers test. Results A total of 30 studies were included in this systematic review and meta-analysis. The overall pooled prevalence of preterm birth in Ethiopia was 11.4% (95% CI; 9.04, 13.76). On pooled analysis, preterm birth was associated with pregnancy-induced hypertension being HIV-positive, premature rupture of membrane, rural residence, the mother having a history of abortion, multiple pregnancies, and anemia during pregnancy. Conclusion The national prevalence of preterm birth in Ethiopia was low. Early identifying those pregnant women who are at risk of the above determinants and proving quality healthcare and counsel them how to prevent preterm births, which decrease the rate of preterm birth and its consequences. So, both governmental and non-governmental health sectors work on the minimization of these risk factors.
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Affiliation(s)
- Fikadu Waltengus Sendeku
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fentahun Yenealem Beyene
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Azimeraw Arega Tesfu
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Simachew Animen Bante
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getnet Gedefaw Azeze
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Getaneh T, Asres A, Hiyaru T, Lake S. Adverse perinatal outcomes and its associated factors among adult and advanced maternal age pregnancy in Northwest Ethiopia. Sci Rep 2021; 11:14072. [PMID: 34234283 PMCID: PMC8263553 DOI: 10.1038/s41598-021-93613-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 06/25/2021] [Indexed: 02/06/2023] Open
Abstract
Even though reduction of neonatal mortality is needed to achieve Sustainable Development Goals 2030, advanced maternal age is still an independent and a substantial risk factor for different adverse perinatal outcomes, in turn causes neonatal morbidity and mortality. In Ethiopia, research has validated that advanced maternal age is a significant factor in adverse perinatal outcomes, but researches which addressed or estimated its adverse perinatal outcomes are limited, reported inconsistent result and specifically no study was done in the study area. Therefore, this study was aimed to compare adverse perinatal outcomes and its associated factors among women with adult and advanced maternal age pregnancy in Northwest Ethiopia. Comparative cross-sectional study was conducted in Awi Zone, public hospitals, Northwest Ethiopia. Systematic random sampling was employed to select 348 adult and 176 advanced aged pregnant women. Structured questionnaire were used to collect the data. The collected data were analyzed using Statistical Package for the Social Sciences version 25. Binary and multivariate logistic regressions were fitted to assess the association between adverse perinatal outcomes and explanatory variables. P-value less than 0.05 was used to declare statistical significance. Significant percentage of advanced aged women (29.1%) had adverse perinatal outcomes compared to (14.5%) adult aged women. Similarly, proportion low birth weight, preterm birth and low Apgar score were significantly higher among advanced maternal age. The odds of composite adverse perinatal outcomes were higher among advanced maternal age women when compared to adult aged women (AOR 2.01, 95% CI 1.06, 3.79). No formal education (AOR 2.75, 95% CI 1.27, 5.95), short birth interval (AOR 2.25, 95% CI 1.07, 4.73) and complications during pregnancy (AOR 2.12, 95% CI 1.10, 4.10) were also factors significantly associated with adverse perinatal outcomes. Being advanced maternal age is at higher risk for adverse perinatal outcomes compared to adult aged women. Maternal illiteracy, short birth interval and complications during pregnancy were also significantly associated with adverse perinatal outcomes. Access of equal education, provision of family planning and perinatal care (including early detection and management of complication) is recommended.
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Affiliation(s)
- Temesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Azezu Asres
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Toyiba Hiyaru
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamawit Lake
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Honorato DJP, Fulone I, Silva MT, Lopes LC. Risks of Adverse Neonatal Outcomes in Early Adolescent Pregnancy Using Group Prenatal Care as a Strategy for Public Health Policies: A Retrospective Cohort Study in Brazil. Front Public Health 2021; 9:536342. [PMID: 33898367 PMCID: PMC8062755 DOI: 10.3389/fpubh.2021.536342] [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: 04/17/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care. Objective: To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services. Methods: This retrospective cohort study followed pregnant adolescents (aged 10-17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10-13 years were compared to those of adolescents aged 14-15 years and 16-17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences. Results: Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7-11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10-13 age group, 8.7% for the 14-15 age group and 12.1% for the 16-17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10-13, 14-15, and 16-17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups (p > 0.05). The infants born to mothers aged 10-13 years presented significantly (p < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range. Conclusions: Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.
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Affiliation(s)
| | - Izabela Fulone
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
| | - Marcus Tolentino Silva
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
| | - Luciane Cruz Lopes
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
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Mezmur H, Assefa N, Alemayehu T. An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study. Glob Pediatr Health 2021; 8:2333794X21999154. [PMID: 33748345 PMCID: PMC7940719 DOI: 10.1177/2333794x21999154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference (P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.
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Serunjogi R, Barlow-Mosha L, Mumpe-Mwanja D, Williamson D, Valencia D, Tinker SC, Adler MR, Namale-Matovu J, Kalibbala D, Nankunda J, Nabunya E, Birabwa-Male D, Byamugisha J, Musoke P. Comparative analysis of perinatal outcomes and birth defects amongst adolescent and older Ugandan mothers: evidence from a hospital-based surveillance database. Reprod Health 2021; 18:56. [PMID: 33663555 PMCID: PMC7934544 DOI: 10.1186/s12978-021-01115-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background Uganda has one of the highest adolescent pregnancy rates in sub-Saharan Africa. We compared the risk of adverse birth outcomes between adolescents (age 12–19 years) and mothers (age 20–34 years) in four urban hospitals. Methods Maternal demographics, HIV status, and birth outcomes of all live births, stillbirths, and spontaneous abortions delivered from August 2015 to December 2018 were extracted from a hospital-based birth defects surveillance database. Differences in the distributions of maternal and infant characteristics by maternal age groups were tested with Pearson’s chi-square. Adjusted odds ratios (aORs) and 95% confidence intervals (CI) were calculated using logistic regression to compare the prevalence of adverse birth outcomes among adolescents to mothers 20–34 years. Results A total of 100,189 births were analyzed, with 11.1% among adolescent mothers and 89.0% among older mothers. Adolescent mothers had an increased risk of preterm delivery (aOR: 1.14; CI 1.06–1.23), low birth weight (aOR: 1.46; CI 1.34–1.59), and early neonatal deaths (aOR: 1.58; CI 1.23–2.02). Newborns of adolescent mothers had an increased risk of major external birth defects (aOR: 1.33; CI 1.02–1.76), specifically, gastroschisis (aOR: 3.20; CI 1.12–9.13) compared to mothers 20–34 years. The difference between the prevalence of gastroschisis among adolescent mothers (7.3 per 10,000 births; 95% CI 3.7–14.3) was statistically significant when compared to mothers 20–34 years (1.6 per 10,000 births; 95% CI 0.9–2.6). Conclusions This study found that adolescent mothers had an increased risk for several adverse birth outcomes compared to mothers 20–34 years, similar to findings in the region and globally. Interventions are needed to improve birth outcomes in this vulnerable population. Adolescent pregnancies are a global problem occurring in high-, middle-, and low-income countries with Uganda having one of the highest adolescent pregnancy rates in sub-Saharan Africa. We compared the risk of adverse birth outcomes, including major external birth defects, between adolescents, (age 12–19 years) and mothers (age 20–34 years) in four urban hospitals. All informative births, including live births, stillbirths, and spontaneous abortions; regardless of gestational age, delivered at four selected hospitals in Kampala from August 2015 to December 2018 were examined. Demographic data were obtained by midwives through maternal interviews and review of hospital patient notes. Of the 100,189 births, 11.0% were among adolescent mothers and 89.0% among mothers (20–34 years). Adolescent mothers were more likely than mothers (20–34 years) to have an infant with preterm delivery, low birth weight, early neonatal death, and major external birth defects. Adolescent pregnancies were also associated with an increased risk of gastroschisis when compared to mothers (20–34 years). In conclusion, this study found that adolescent mothers had an increased risk for several adverse birth outcomes compared to mothers 20–34 years. Research on the potential underlying causes or mechanisms for these adverse outcomes among adolescent births is necessary to identify possible interventions.
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Affiliation(s)
- Robert Serunjogi
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda.
| | - Linda Barlow-Mosha
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda
| | - Daniel Mumpe-Mwanja
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda
| | - Dhelia Williamson
- US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Diana Valencia
- US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sarah C Tinker
- US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Michelle R Adler
- US Centers for Disease Control and Prevention (CDC), Kampala, Uganda
| | - Joyce Namale-Matovu
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda
| | - Dennis Kalibbala
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda
| | - Jolly Nankunda
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Evelyn Nabunya
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Doreen Birabwa-Male
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Josaphat Byamugisha
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Philippa Musoke
- Makerere University-Johns Hopkins University Research Collaboration, P. O. Box 23491, Kampala, Uganda.,Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Sámano R, Chico-Barba G, Martínez-Rojano H, Hernández-Trejo M, Birch M, López-Vázquez M, García-López GE, Díaz de León J, Mendoza-González CV. Factors Associated With Weight, Length, and BMI Change in Adolescents' Offspring in Their First Year of Life. Front Pediatr 2021; 9:709933. [PMID: 34532303 PMCID: PMC8438192 DOI: 10.3389/fped.2021.709933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Young maternal age is associated with negative outcomes at birth and with offspring's growth. In low- and middle-income countries, adolescents' offspring growth little has been studied. Objective: To determine the association of maternal sociodemographic characteristics with weight, length, and BMI change in adolescents' offspring in their first year of life. Methods: This is a one-year follow-up study that included adolescent mothers and their offspring from 2010 to 2017. The infant anthropometric variables were performed at birth, 3, 6, and 12 months. Maternal health, pregnancy, and social variables were evaluated as well as birth outcomes. Crude, percentage, Z score, and percentile changes of weight, length, and BMI were evaluated from birth to 1-year-old. Statistical analyses were adjusted by maternal chronological age, socioeconomic status, breastfeeding duration, the timing of introduction of complementary feeding, among other variables. Results: We examined 186 dyads (mother-infant). The median maternal age was 15.5 years, and the mean pre-pregnancy BMI was 20. The mean gestational age was 39.1 weeks for infants, birth weight was 3,039 g, and length at birth was 49.5-cm. Maternal chronological age, the timing of introduction of complementary feeding, socioeconomic status, and maternal occupation were associated with offspring's weight gain at 12 months. Length gain was associated with exclusive breastfeeding. Socioeconomic status and occupation were associated with offspring's BMI change. When performing adjusted multivariable analyses, weight and length at birth were associated weight and BMI at 12 months. Conclusions: Weight at birth may negatively predict infant's weight and BMI changes at 12 months, while length at birth may positively predict the changes. Maternal chronological age, socioeconomic level, occupation, and the timing of the introduction of complementary feeding were associated with the weight change. Only exclusive breastfeeding was associated with length Z-score change in adolescents' offspring in their first 12-months of life.
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Affiliation(s)
- Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Programa de Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Gabriela Chico-Barba
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad Panamericana, Mexico City, Mexico
| | - Hugo Martínez-Rojano
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City, Mexico.,Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos, Mexico City, Mexico
| | - María Hernández-Trejo
- Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Mery Birch
- Licenciatura en Nutrición, Universidad del Valle de México, Mexico City, Mexico
| | | | | | - Jesús Díaz de León
- Licenciatura en Nutrición, Universidad del Valle de México, Mexico City, Mexico
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Birhanie MW, Adekunle AO, Arowojolu AO, Dugul TT, Mebiratie AL. Micronutrients Deficiency and Their Associations with Pregnancy Outcomes: A Review . NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s274646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Tetteh J, Nuertey BD, Dwomoh D, Udofia EA, Mohammed S, Adjei-Mensah E, Yawson AE. Teenage pregnancy and experience of physical violence among women aged 15-19 years in five African countries: Analysis of complex survey data. PLoS One 2020; 15:e0241348. [PMID: 33108400 PMCID: PMC7591093 DOI: 10.1371/journal.pone.0241348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/13/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pregnant teenage women are prime targets of violence against women perpetrated by intimate partners, family members, and miscreants in their neighborhoods. This study estimated the prevalence of Teenage pregnancy (TP) and Physical Violence (PV) and further assessed the relationship between TP and PV in five Low-and-Middle-Income Countries (LMICs). METHODS The study was conducted among five LIMCs (Burkina Faso, Kenya, Malawi, Nigeria, and Tanzania) using data from the most recent Demographic and Health Surveys conducted in these countries. Modified Poisson with the robust standard error was used to quantify the association between TP and PV. All analyses adjusted for the complex survey design structure (clustering, weighting, and stratification). RESULTS The analysis involved a total of 26055 adolescent women aged 15-19 years across the five countries. The overall prevalence of TP was 25.4% (95%CI = 24.4-26.4) with the highest prevalence occurring among Malawians [29.0% (95%CI = 27.4-30.7)]. Meanwhile, the prevalence of TP among older adolescents (18-19 years) was approximately two-thirds significantly higher compared with young adolescents [aPR(95%CI) = 1.60[1.49-1.71)]. The prevalence of PV among teenagers across the five countries was 24.2% (95%CI = 22.3-26.2). The highest prevalence of PV was recorded among Nigerian adolescent women [31.8% (95%CI = 28.5-35.3)]. The prevalence of PV among adolescent women who were pregnant was approximately 5-folds significant compared to those who were not pregnant (adjusted prevalence ratio; aPR = 4.70; 95% CI: 3.86-5.73; p<0.0001). CONCLUSION There was a high prevalence of pregnancy among older teenagers aged 18-19 years. Close to a quarter of teenage women ever experienced physical violence. Pregnant teenage women ever experience of physical violence was very high compared to non-pregnant peers. Intervention should target PV and TP by adopting a gender-sensitive approach to eliminate physical violence, particularly among teenagers to prevent TP.
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Affiliation(s)
- John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Benjamin D. Nuertey
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sheriff Mohammed
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Evelyn Adjei-Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Gedefaw G, Alemnew B, Demis A. Adverse fetal outcomes and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Pediatr 2020; 20:269. [PMID: 32493464 PMCID: PMC7268488 DOI: 10.1186/s12887-020-02176-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite the reduction of neonatal morbidity and mortality, is one of the third Sustainable Development Goal to end the death of children, the burden of the problem still the major challenge in Ethiopia. Globally, the most common causes of neonatal morbidity and mortality are adverse fetal outcomes (low birth weight, stillbirth, prematurity, congenital defect). Therefore this systematic review and meta-analysis aimed to estimate the pooled prevalence of adverse fetal outcomes and its associated factors in Ethiopia. METHOD International databases (PubMed, Google scholar, web of science and science direct) were searched. Seventeen articles were included, among these, fourteen were cross-sectional and three of them were case-control studies. Publication bias was employed using a funnel plot and eggers test. The I2 statistic was computed to check the heterogeneity of studies. Subgroup analysis was performed for the evidence of heterogeneity. RESULT A total of 11,280 study participants were used to estimate the pooled prevalence of adverse fetal outcomes. The overall pooled prevalence of adverse fetal outcomes in Ethiopia was 26.88% (95% CI; 20.73-33.04). Low birth weight 10.06% (95% CI; 7.21-12.91) and prematurity 8.76% (95% CI; 5.4-12.11) were the most common adverse birth outcome at the national level. Rural in residency (AOR = 2.31; 95% CI: 1.64-3.24), lack of antenatal care follow up (AOR = 3.84; 95% CI: 2.76-5.35), pregnancy-induced hypertension (AOR = 7.27; 95% CI: 3.95-13.39), advanced maternal age ≥ 35(AOR = 2.72; 95% CI: 1.62-4.58, and having current complication of pregnancy (AOR = 4.98; 95% CI: 2.24-11.07) were the factors associated with adverse birth outcome. CONCLUSION The pooled prevalence of adverse fetal outcomes in Ethiopia was high. Rural in residency, lack of antenatal care follow up, pregnancy-induced hypertension, advanced maternal age ≥ 35, and having current complications of pregnancy were the factors associated with adverse fetal outcomes. PROSPERO PROTOCOL REGISTRATION CRD42020149163.
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Affiliation(s)
- Getnet Gedefaw
- Department of Midwifery, College of health sciences, Woldia University, Woldia, Ethiopia.
| | - Birhan Alemnew
- Department of Medical laboratory science, College of health sciences, Woldia University, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of Nursing, College of health sciences, Woldia University, Woldia, Ethiopia
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Zhang T, Wang H, Wang X, Yang Y, Zhang Y, Tang Z, Wang L. The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China. BMC Pregnancy Childbirth 2020; 20:339. [PMID: 32487101 PMCID: PMC7268722 DOI: 10.1186/s12884-020-03022-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10–50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China. Methods There were 238,598 singleton pregnant women aged 10–34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10–19 years) and adult group (aged 20–34 years). The adolescent group was divided into two subgroups (aged 10–17 years, aged 18–19 years), the adult group was divided into two subgroups (aged 20–24 years, aged 25–34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy. Results Compared with women aged 20–34 years, women aged 10–19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70–0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41–0.73). Women aged 10–19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54–2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08–1.30), stillbirth (aRR: 2.58, 95%CI: 1.83–3.62), neonatal death (aRR: 2.63, 95%CI: 1.60–4.32). The adolescent women aged 10–17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36–9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74–15.33) compared with the women aged 25–34 years. Younger adults (20–24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20–1.32), stillbirth (aRR: 1.45, 95%CI: 1.23–1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21–1.90) compared with women aged 25–34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy. Conclusions The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.
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Affiliation(s)
- Ting Zhang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.,Graduate School, Hebei North University, Zhangjiakou, Hebei, China
| | - Huien Wang
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xinling Wang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yue Yang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.,Graduate School, Hebei North University, Zhangjiakou, Hebei, China
| | - Yingkui Zhang
- Hebei Women and Children's Health Center, Shijiazhuang, China
| | - Zengjun Tang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.
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Baş EK, Bülbül A, Uslu S, Baş V, Elitok GK, Zubarioğlu U. Maternal Characteristics and Obstetric and Neonatal Outcomes of Singleton Pregnancies Among Adolescents. Med Sci Monit 2020; 26:e919922. [PMID: 32087083 PMCID: PMC7055197 DOI: 10.12659/msm.919922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Adolescent pregnancy remains a global public health issue with serious implications on maternal and child health, particularly in developing countries The aim of this study was to investigate maternal characteristics and obstetric and neonatal outcomes of singleton pregnancies among adolescents. Material/Methods A total of 241 adolescent women who gave birth to singletons between January 2015 and December 2015 at our hospital were included in this descriptive cross-sectional study. Data on maternal sociodemographic and obstetric characteristics as well as neonatal outcome were recorded. Results Primary school education (66.0%), lack of regular antenatal care (69.7%), religious (36.7%) and consanguineous (37.0) marriage, Southeastern Anatolia hometown (34.9%) and Eastern Anatolia hometown (21.2%) were noted in most of the adolescent pregnancies, while 95% were desired pregnancies within marriage. Pregnancy complications were noted in 19.5% (preeclampsia in 5.8%) and cesarean delivery was performed in 44.8% of adolescent pregnancies. Preterm delivery rate was 27.0% (20.3% were in >34 weeks). Overall, 13.3% of neonates were admitted to neonatal intensive care unit (NICU) in the postpartum period (prematurity in 28.1%), while 25.3% were re-admitted to NICU admission in the post-discharge 1-month (hyperbilirubinemia in 55.7%). Adolescent pregnancies were associated considerably high rates of fetal distress at birth (28.7%), preterm delivery (26.9%), and re-admission to NICU after hospital discharge (25.3%). Conclusions In conclusion, our findings indicate that along with considerably high rates of poor antenatal care, maternal anemia and cesarean delivery, adolescent pregnancies were also associated with high rates for fetal distress at birth, preterm delivery, and NICU re-admission within post-discharge 1-month.
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Affiliation(s)
- Evrim Kiray Baş
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Vedat Baş
- Department of Pediatrics, Istanbul Arel University, Istanbul, Turkey
| | - Gizem Kara Elitok
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Umut Zubarioğlu
- Department of Neonatology, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
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What Are the Maternal and Neonatal Outcomes of Adolescent Pregnancy in Women Referring to Ayatollah Mousavi Hospital in Zanjan? A Comparative Cross-sectional Study. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2019. [DOI: 10.52547/pcnm.9.3.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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