The burden of adolescent motherhood and health consequences in Nepal

Abstract

Background: Annually, 18 million babies are born to mothers 18 years or less. Two thirds of these births take place in South Asia and Sub-Saharan Africa. Due to social and biological factors, adolescent mothers have a higher risk of adverse birth outcomes. We conducted this study to assess the incidence, risk factors, maternal and neonatal health consequences among adolescent mothers. Methods: We conducted an observational study in 12 hospitals of Nepal for a period of 12 months. Patient medical record and semi-structured interviews were used to collect demographic information of mothers, intrapartum care and outcomes. The risks of adverse birth outcomes among adolescent compared to adult mothers were assessed using multivariate logistic regression. Results: During the study period, among the total 60,742 deliveries, 7.8% were adolescent mothers. Two third of the adolescent mothers were from disadvantaged ethnic groups, compared to half of adult mothers (66.1% vs 47.8%, p-value< 0.001). One third of the adolescent mothers did not have formal education, while one in nine adult mothers did not have formal education (32.6% vs 14.2%, p-value< 0.001). Compared to adult mothers, adolescent mothers had higher odds of experiencing prolonged labour (aOR-1.56, 95% CI, 1.17-2.10, p-0.003), preterm birth (aOR-1.40, 95% CI, 1.26-1.55, p < 0.001) and of having a baby being small for gestational age (aOR-1.38, 95% CI 1.25-1.52, p < 0.001). The odds of major malformation increased by more than twofold in adolescent mothers compared to adult mothers (aOR-2.66, 95% CI 1.12-6.33, p-0.027). Conclusion: Women from disadvantaged ethnic group have higher risk of being pregnant during adolescent age. Adolescent mothers were more likely to have prolonged labour, a preterm birth, small for gestational age baby and major congenital malformation. Special attention to this high-risk group during pregnancy, labour and delivery is critical.

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“…13,14 In the study conducted in Nepal, finding has shown that nearly 2/3 rd of females were married before the age of 19 years in the year 2017/18. 15,16 Furthermore, this trend was mostly prevalent in families from lower economical groups. On the other hand, it has also been found that women having higher level of educational status have higher preference for CS.…”

Cesarean Section and Its Correlates Among Early Child Bearing Women in Nepal

“…Similarly, early pregnancies are also considered as a universal burden covering all countries irrespective of their economic status (4). It has been estimated that around sixteen million girls between the age of [15][16][17][18][19] years give birth each year globally and babies delivered from theses teen-age mothers occupies 11% of total birth worldwide. It is staggering to note that highest numbers (around 95,153) of such early pregnancies occurs in Eastern-Asia (5).…”

“…Multi-parity, teen-age pregnancy, less or no antenatal visits being some of the basic key indicators of the vaginal delivery at home (13,14). In the study conducted in Nepal, nding has shown that nearly 2/3rd of females were married before the age of 19 years in the year 2017/18 (15,16). Furthermore, this trend was mostly prevalent in families from lower economical groups.…”

Trend in the utilization of antenatal care during pregnancy among the adolescents in Bangladesh: Evidence from national survey data 2012/2013 and 2019

“…Adolescents are vulnerable to pregnancy and childbirth due to several adverse health and socioeconomic consequences both for mother and child 1,2 . Adolescent mothers had the risk of prolonged labor pain, preterm birth, and malnourished babies 3 . Pregnancy during adolescence is considered a sexual and reproductive health problem and a leading cause of maternal death especially for low‐ and middle‐income countries (LMICs) 4,5 .…”