A descriptive study of the obstetric and neonatal outcomes of adolescent pregnancies at a tertiary academic hospital

Abstract

Introduction: Adolescent mothers are at high risk of maternal morbidity and mortality and have poorer perinatal outcomes. Low and middle-income countries and especially Sub-Saharan Africa have a higher adolescent birth rate. Adolescent pregnancy and childbearing have significant health, social and economic consequences. Objectives: To describe the demographics and obstetric outcomes of adolescent females as well as the demographics and neonatal outcomes of their neonates. Methods: This was a retrospective record review of the obstetric, perinatal and neonatal demographics and outcomes of pregnant adolescents who delivered at, or who were referred to a tertiary academic hospital or in the perinatal period between January to December 2015. The group was divided into early (10– 14 years), middle (15– 17 years) and late adolescent (18– 19 years) mothers. Comparison of study variables between age groups was conducted using the chi-squared test for categorical variables, and one-way ANOVA. Results: Two thousand and twenty-two adolescent mothers and 2039 babies’ records were reviewed. Mean maternal age was 17.5 (12 -19) years. 11.3% had previous pregnancies. Of the 94.4% who accessed antenatal care, 52.9% did so after 20 week’s gestation. Two thirds of the 8.6% Human Immunodeficiency Virus (HIV) infections were diagnosed during pregnancy. Hypertensive disorders occurred in 249 mothers (12.3%) with 142 (57.0%) having hypertensive complications. A third of deliveries were by cesarean section, with fetal distress (60.2%) and cephalopelvic disproportion (9.6%), as the most common indications. Complications of normal vaginal deliveries (NVD) include third- and fourth degree tears or cervical injury (2.9%); 94 (4.7%) mothers required postpartum surgical intervention. There were no differences in pregnancy outcomes between the adolescent groups. There was one maternal death (49 per 100 000 live births). 54 were stillbirths and a quarter (26.4%) of the neonates were born premature. 17.0% of the babies required admission for respiratory complaints (8.1%). There were 23 (6.8%) neonatal deaths. Conclusion: Adolescent mothers had complications including premature births, high cesarean section rate and perineal injuries. Numerous school-going pregnancies and adolescents in their second or third pregnancy suggest the need for public health and social interventions addressing reproductive education and family planning.