Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011.

Rina Pradhan,Karen Wynter,Jane Fisher

doi:10.3390/ijerph15020229

Abstract

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy.

Highlights

Pregnancy among adolescent women is associated with high risks to both the mother and her child
Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy
For the Nepal Demographic Health Surveys (NDHS) surveys, ethics approval was obtained from the Nepal Health Research Council, Kathmandu, Nepal, and ICF Macro Institutional Review Board, Maryland, USA

Summary

Introduction

Pregnancy among adolescent women is associated with high risks to both the mother and her child. Pregnancy-related deaths are twice as common among women aged 15–19 years, than women aged in their twenties [1,2]. Pregnancies during adolescence are associated with adverse maternal outcomes, including obstructed labour, nutritional anaemia, preterm birth, postpartum infections, unsafe abortion [3], and adverse child outcomes, including infant mortality, foetal growth retardation, and low birth weight [2,3,4,5]. Births to adolescents occur globally, approximately 95% of these births occur in low-income countries. Due to this burden of morbidity and mortality, adolescent pregnancy is recognized as a public health priority.

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