Abstract
ABSTRACTBackgroundTeenage pregnancy is a known risk factor for a negative pregnancy outcome and poses a health risk to teenagers; it is thus considered a public health problem. It is also an indicator of problems with the sexual and reproductive health of a country's young population. In South Africa, most of the adolescent pregnancies are to be found within the context of unstable relationships with the father of the baby and are unplanned or unwanted.ObjectivesThis study estimates and compares the incidence of adverse obstetric and perinatal outcomes of teenage women with older women, to identify specific health needs of teenage mothers during pregnancy and delivery.MethodsA retrospective cohort study targeted pregnant women who delivered at Empangeni Hospital from April to December 2005, whilst comparing the obstetric and perinatal outcomes of all teenage (ages < 19 years) pregnant women with those of older pregnant women (ages ≥ 19 years) for this study period. Data were collected from the labour ward delivery registry. Pearson's chi-square test was performed to measure the level of significance (alpha = 0.05) for association amongst variables. The student t-test was used to find the significance difference between two proportions and the binary logistic regression method was employed to find the significant predictor for outcome variables.ResultsThere were 7836 deliveries over the study period, of which 1236 (16%) were teenage mothers. The rate of gestational age at delivery (e.g. pre-term delivery of 12%), vaginal and forceps deliveries, foetal presentation at birth, multiple pregnancies, low birth-weight and live births deliveries and mean Apgar scores were similar for both groups. The caesarean delivery rate (20%) and macerated stillbirth rate (1.1%) were significantly lower (p < 0.05) for teenagers than for older women.ConclusionAlthough there was a higher rate of teenage pregnancy, it did not appear that it was associated with extra perinatal negative outcome such as preterm delivery, low birth-weight delivery and stillbirth. However, strategies are urgently needed to delay conception and improve the socio-economic development of teenage girls.
Highlights
Teenage pregnancy is regarded as a serious public health problem and often occurs in the context of poor social support and maternal well-being.[1]
The rate of gestational age at delivery, vaginal and forceps deliveries, foetal presentation at birth, multiple pregnancies, low birth-weight and live births deliveries and mean Apgar scores were similar for both groups
Conclusion: there was a higher rate of teenage pregnancy, it did not appear that it was associated with extra perinatal negative outcome such as preterm delivery, low birth-weight delivery and stillbirth
Summary
Teenage pregnancy is regarded as a serious public health problem and often occurs in the context of poor social support and maternal well-being.[1] Maternal and child health programmes in South Africa are located within the framework of general development policies,[2,3] which focus on meeting the basic needs of rural and urban communities, maximising human resources potential, enlarging the economy and spreading its benefits, as well as democratising society and its institutions To comply with these policies, free health care services for pregnant mothers and children under the age of 6 years in public health facilities were introduced in 1998.2 Teenage mothers enjoy a similar degree of care to their older peers in public health facilities and, recently, a child support grant was introduced for mothers.[3] Teenage pregnancy is known to be associated with adverse pregnancy outcomes, such as preterm births, low birthweight deliveries, foetal growth retardation and perinatal mortality.[4,5] Teenage pregnancy is linked with the increased risk of assisted delivery and caesarean section,[6] a study has suggested that these effects are related with some other confounders.[7] A high rate of teenage pregnancy indicates problems with the sexual and reproductive health of a country’s young population, which, again, poses serious implications for other health issues such as the spread of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). In South Africa, most of the adolescent pregnancies are to be found within the context of unstable relationships with the father of the baby and are unplanned or unwanted
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