BMC pregnancy and childbirth · 2020
The burden of adolescent motherhood and health consequences in Nepal.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Gurung Rejina, Målqvist Mats, Hong Zhou, Poudel Pragya Gautam, Sunny Avinash K, Sharma Srijana, Mishra Sangeeta, Nurova Nisso, Kc Ashish
Аннотация
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 two-fold 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.
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 two-fold 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.