A longitudinal cohort study of\xa0rural adolescent vs adult South African mothers and their children from birth to 24\u2009months

Karl Le Roux,Elaine Dippenaar,Ingrid M Le Roux,Christina Laurenzi,Linnea Stansert-Katzen,Joan Christodoulou,Mark Tomlinson,Mary Jane Rotheram-Borus

doi:10.1186/s12884-018-2164-8

Abstract

BackgroundAdolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries. We examine the structural, personal, and caretaking challenges of adolescent mothers and their children in rural South Africa compared to adult mothers over the first 24 months post-birth.MethodsA cohort of sequential births (n = 470/493) in the rural OR Tambo District was recruited and reassessed at 3, 6, 9, 12, and at 24 months post-birth, with a retention rate above 84% at all timepoints. Maternal and child outcomes were examined over time using multiple linear and logistic regressions.ResultsAdolescent mothers reflect 17% of births (n = 76/458). Adolescent mothers were more likely to have water in their households, but less likely to live with a partner and to be seropositive for HIV than adult mothers. Risks posed by mental health symptoms, alcohol, and partner violence were similar. Adolescents exclusively breastfed for shorter time and it took longer for them to secure a child grant compared to adult mothers. Although obtaining immunizations was similar, growth was significantly slower for infants of adolescent mothers compared to adult mothers over time.ConclusionsIn rural South Africa, almost one in five pregnant women is an adolescent. Caretaking tasks influencing child growth, especially breastfeeding and securing the child grant appear as the greatest problems for adolescent compared to adult mothers.

Highlights

Adolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries
The current study aims to examine the rate of adolescent pregnancies in a deeply rural area of South Africa (SA), as well as to document the structural, personal risk histories, and caretaking of adolescent compared to adult mothers and compare their children’s development over the first 24 months post-birth
Over 24 months post-birth, 22 of the children whose mothers were recruited to the study died; five of these had adolescent mothers

Summary

Introduction

Adolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries. Personal, and caretaking challenges of adolescent mothers and their children in rural South Africa compared to adult mothers over the first 24 months post-birth. Childbirth is the leading cause of death among young adolescent women aged 15–19 years old globally [1]. Newborns of adolescent mothers are twice as likely to suffer stillbirth and neonatal death and are more likely to be born with low birth weight, when compared to the babies of mothers who are 20–29 years old [2]. Adolescent mothers often have less structural resources: they are often less educated and lack financial independence than adult mothers in both high (HIC). It may be that adolescents are more dependent on their families than young women may be in urban settings with greater resources [4]

Objectives

Methods

Results

Discussion

Conclusion