Complications associated with adolescent childbearing in Sub-Saharan Africa: A systematic literature review and meta-analysis

Abstract

ObjectiveTo examine whether childbearing before age 18 in Sub-Saharan Africa is associated with increased risk of maternal and child complications through a systematic literature review and meta-analysis.MethodsThe literature on adolescent pregnancy and associated complications in Sub-Saharan Africa was reviewed. A systematic electronic database search in Medline and Embase identified relevant papers. Studies were eligible for inclusion if they had numeric data on maternal mortality, pre-eclampsia, eclampsia, preterm birth, low birth weight, small for gestational age, stillbirth, neonatal death or perinatal death. We included studies on adolescents aged 17 years or younger, and with a comparison group of adult women aged between 20 and 35 years. The quality of the articles was assessed. Meta-analyses were conducted when there were at least three included studies with minor clinical heterogeneity in population and outcome measures.ResultsEighteen studies met our inclusion criteria. There were many studies from Sub-Saharan Africa with data on the age group 15–19 years old, but few studies had separate data on adolescents <18 years old. All included studies were of either moderate or low quality. Adolescents had an increased risk of low birth weight, pre-eclampsia/eclampsia, preterm birth and maternal and perinatal mortality. We found a lower, nonsignificant risk of stillbirth and for small for gestational age babies among the young mothers.ConclusionIn this systematic review, the findings indicate that young maternal age is associated with some unfavorable outcomes in Sub-Saharan Africa. High quality observational studies that adjust for sociodemographic factors are lacking.

Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

“…Globally, pregnancy and childbirth complications are one of the leading causes of death among adolescent girls. Adolescent mothers face an increased risk of perinatal morbidities such as eclampsia, puerperal endometritis, systemic infections, low birth weight, preterm delivery, and severe neonatal conditions [10][11][12]. Indeed, early adolescent pregnancy has been linked with an increased risk of HIV infection [13].…”

Adverse Neonatal Birth Outcomes Among Adolescent Pregnancies in Kampala, Uganda Between 2015 –2018

“…In this study, we observed that adolescent mothers were more likely to have an infant with the adverse birth outcome of preterm delivery, LBW, for preterm delivery in adolescent pregnancies, [6,13,15] which could be attributable to the maternal-fetal competition for nutrients that arises when pregnancy coincides with continuing or incomplete growth in adolescents. [20] Our study nds that adolescent mothers were more likely to deliver LBW babies is consistent with results from the Uganda Demographic Health Survey 2011.…”

“…[1, [6][7][8][9][10][11][12] However, few studies on birth outcomes among adolescents have been conducted in developing countries of sub-Saharan Africa, and available data is based on studies with small sample sizes. [13] We aimed to compare the occurrence of adverse birth outcomes (preterm birth, LBW, and ENND) and major external birth defects among adolescent mothers (12-19 years) to older mothers (20-34 years).…”

Adolescence and Preeclampsia

“…Several studies and meta-analysis [22] detect a significant difference between pregnant adolescents and adult women, with up to 20% more preeclampsia events in pregnant adolescents than in adult women [23]; they actually report a greater risk of preeclampsia-eclapmsia in the group of adolescents between the ages of 13 and 16 when compared with women between the ages of 20 and 34, OR 2.97 (95%CI 1.62-5.42) [24], as well as lower frequencies of preeclampsia in adolescents (5%) vs. 1.5% in the adult group, and the difference was statistically significant, OR 3.66 (95%CI 1.67-7.72) [25].…”