Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Abstract

BackgroundAdolescent pregnancies are a growing public health problem in Cameroon. We sought to study the outcome of such pregnancies, in order to inform public health action.MethodsA cross-sectional analysis of 5997 deliveries which compared the outcome of deliveries in adolescent (10–19 years old) pregnant women registered at the Yaoundé Central Hospital between 2008 and 2010 to that of their non-adolescent adult (≥ 20 years old) counterparts. Variables used for comparison included socio-demographic and obstetric characteristics of parturients, referral status, and maternal and fetal outcomes. Predictors of maternal and of perinatal mortality were determined through binomial logistic modeling.ResultsAdolescent deliveries represented 9.3% (560) of all pregnancies registered. Adolescent pregnancies had significantly higher rates of both gestational duration extremes: preterm as well as post-term deliveries (29.3% versus 24.5%, p = 0.041 OR 1.28 95% CI 1.01-1.62 and 4.9 versus 2.4%, p = 0.014 OR 2.11 95% CI 1.46-3.87 respectively). Both groups did not differ significantly with respect to mean blood loss, rates of cesarean or instrumental deliveries. Adolescent deliveries however required significantly twice as many episiotomies (OR 2.15 95% CI 1.59-2.90). The likelihood of perineal tears in the adolescent group was significantly higher than that in the adult group on assuming episiotomies done would have been tears if they had not been carried out (OR 1.45 95% CI 1.16-1.82). Adolescent parturients had a higher likelihood of apparent fetal death at birth as well as perinatal fetal death after resuscitation efforts (AOR 1.75 95% CI 1.25-2.47 and AOR 1.69 95% CI 1.17-2.45 respectively).Comparisons of pregnancy outcomes between early (10–14 years), middle (15–17 years) and late adolescence (18–19 years) found no significant differences. Predictors of maternal death included having been referred, having had ≥5 deliveries and preterm deliveries. These were also predictors of perinatal death, as well as being a single mother, primiparous, and multiple gestations.ConclusionsAdolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality.

Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

“…The disappearance of the higher risk of LBW among infants of adolescent mothers could be associated with lower rates of IUGR in the adolescent group compared with the adult group. Although it may be due to the small sample numbers, the present study showed an increased risk of intrauterine fetal deaths in pregnant young adolescents, consistent with other studies (2,3,8,11,14) (adjusted OR: 4.94). On the contrary, some large population studies reported that fetal death was usually either unaffected or decreased in cases with younger maternal age (3,4,13,15).…”

“…On the contrary, some large population studies reported that fetal death was usually either unaffected or decreased in cases with younger maternal age (3,4,13,15). Also, conflicting results were reported in previous investigations about neonatal mortality in adolescent pregnancy (4,6,(8)(9)(10)(11)13,14). In our study, infants from younger adolescent mothers showed a higher risk of early neonatal death related to preterm delivery and LBW (adjusted OR: 21.09), although this may be due to the small sample numbers.…”

“…In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17)(18)(19)(20)(21)(22).…”

Profile of delivering mothers in Lubumbashi, Democratic Republic of Congo

“…This rate is lower than that recorded by Tambwe et al [8] at the University Clinics of Lubumbashi (DRC) in 1999, which was 13.9%. In African urban areas, the frequency of childbirth varies between 7% and 13% [9][10][11], while in rural areas it is more than 25% [12]. Poverty, illiteracy, and early marriages linked to cultural, ethnic and religious factors may explain this difference between the different environments.…”

Teenage pregnancy outcomes in teaching hospitals in yaoundé

“…Similar results were reported (Iloki LH, 2004). Other studies, (Kemfang Ngowa JD K. J., 2015), (Fouelifack FY, 2014) and (Kumbi S1, 1999)did not find a significant difference in Apgar score as well in the first minute as in the fifth minute. An association exists between poor quality of antenatal care, fever during labor and abnormal Apgar score at birth (Fouelifack FY, 2014) 16 .…”