Factors influencing the perinatal outcomes of teenage deliveries in a regional hospital in KwaZulu‐Natal Province, South Africa
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Abstract
Background. Teenage pregnancy is a global problem and is associated with maternal and neonatal complications. Developing countries show a rising prevalence in teenage pregnancies. A limited number of studies have investigated perinatal outcomes within the pregnant teenage population.
Objectives. To describe and analyse the effect of maternal factors on perinatal outcomes of teenage pregnancies.
Methods. Data were collected retrospectively from the labour ward and neonatal admission registers of a regional hospital in South Africa over a 6-month period in 2018. Teenagers between 10 and 19 years of age, who delivered at the institution, were included in the study. Maternal factors were analysed for the risk of a complicated perinatal outcome, which was defined as either stillbirth or live neonate requiring admission to the neonatal nursery. A secondary analysis was conducted on the risk of stillbirth, prematurity and low birthweight (LBW).
Results. The prevalence of teenage deliveries was 15.6% (n=707/4 519). One-fifth (20%) of teenagers were ≤16 years old. Complicated perinatal outcomes were present in 19.5% of deliveries and were associated with a lack of antenatal care (ANC) and emergency caesarean section (CS). Unbooked teenagers had a ten-fold higher chance of delivering a stillbirth and were three times more likely to deliver an LBW baby. Maternal complications were also associated with LBW. Age, parity and HIV status did not show any statistically significant difference in perinatal outcomes.
Conclusion. The prevalence of teenage pregnancy was high in our cohort. Lack of ANC, maternal complications and emergency CS in teenagers were associated with adverse perinatal outcomes.
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References
Dos Reis LV, Júnior EA, Guazzelli CAF, Cernach MCSP, Torloni MR, Moron AF. [Congenital anomalies detected at birth in newborns of adolescent women.] Acta Med Port 2015;28(6):708-714.
Abebe AM, Fitie GW, Jember DA, Reda MM, Wake GE. Teenage pregnancy and its adverse obstetric and perinatal outcomes at Lemlem Karl Hospital, Tigray, Ethiopia, 2018. Biomed Res Int 2020;2020:3124847. https://doi. org/10.1155%2F2020%2F3124847
UNICEF data. Early childbearing and teenage pregnancy rates by country. https:// data.unicef.org/topic/child-health/adolescent-health/ (accessed 13 July 2022).
Department of Home Affairs. South African Home Affairs Annual report 2012/2013. Pretoria: DHA, 2013. http://www.dha.gov.za/files/Annual%20 Reports/Annual_Report_2012-2013.pdf (accessed 13 July 2022).
Massyn N, Pillay Y, Padarath A. District Health Barometer 2017/2018. Durban: Health Systems Trust, 2018. https://www.hst.org.za/publications/Pages/ DHB20172018.aspx (accessed 13 July 2022).
Subedi R, Jahan I, Baatsen P. Factors influencing modern contraceptive use among adolescents in Nepal. J Nepal Health Res Counc 2018;16(3):251-256.
Kabagenyi A, Reid A, Ntozi J, Atuyambe L. Socio-cultural inhibitors to use of
modern contraceptive techniques in rural Uganda: A qualitative study. Pan Afr
Med J 2016;25:78. https://doi.org/10.11604%2Fpamj.2016.25.78.6613
SeamarkC.DesignorAccident?TheNaturalHistoryofTeenagePregnancy.JRoyal
Soc Med 2001;94(6):282-285. https://doi.org/10.1177%2F014107680109400607 9. Toska E, Cluver LD, Boyes M, Pantelic M, Kuo C. From ‘sugar daddies’ to ‘sugar babies’: Exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa. Sex Health 2015;12(1):59-66.
https://doi.org/10.1071/SH14089
Strode A, Slack C, Essack Z. Child consent in South African law: Implications for researchers, service providers and policy-makers. S Afr Med J 2011;101(9):604- 606. 100(4):247-249. https://doi.org/10.7196/SAMJ.3609
Statistics South Africa. Profiling Health Challenges Faced by Adolescents (10 - 19 years) in South Africa. Pretoria: StatsSA, 2022. https://openafrica.net/ de/dataset/profiling-health-challenges-faced-by-adolescents-10-19-years-in- south-africa (accessed 13 July 2022).
Department of Justice and Constitutional Development, South Africa. Criminal Law (Sexual Offences and Related Matters) Amendment (Act No. 5 of 2015). Government Gazzette No. 593:38977. 2015. https://www.gov.za/ documents/criminal-law-sexual-offences-and-related-matters-amendment- act-8-jul-2015-1357 (accessed 8 November 2022).
Statistics South Africa. The Young and the Restless – Adolescent Health in SA. Pretoria: StatsSA, 2020. https://www.statssa.gov.za/?p=15261 (accessed 20 July 2022). 14. Brosens I, Muter J, Gargett CE, Puttemans P, Benagiano G, Brosens JJ. The impact of uterine immaturity on obstetrical syndromes during adolescence. Am J Obstet Gynecol 2017;217(5):546-555. https://doi.org/10.1016/j.
ajog.2017.05.059
Gortzak-Uzan L, Hallak M, Press F, Katz M, Shoham-Vardi I. Teenage pregnancy: Risk factors for adverse perinatal outcome. J Matern Fetal Med 2001;10(6):393- 397. https://doi.org/10.1080/jmf.10.6.393.397
Khashan AS, Baker PN, Kenny LC. Preterm birth and reduced birthweight in first and second teenage pregnancies: A register-based cohort study. BMC Preg Childbirth 2010;10:36. https://doi.org/10.1186/1471-2393-10-36
Papamicheal E, Pillai R, Yoong W. Children having children: Outcome of extreme teenage pregnancies (13 - 15 years). Acta Obstetricia Gynecologica Scand 2009;88(11):1284-1287. https://doi.org/10.3109/00016340903229427
Aminu M, Unkels R, Mdegela M, Utz B, Adaji S, van den Broek N. Causes of and factors associated with stillbirth in low- and middle-income countries: A systematic literature review. BJOG 2014;121(Suppl 4):141-153. https://doi. org/10.1111/1471-0528.12995
Smith GC, Pell JP. Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: Population-based retrospective cohort study. BMJ 2001;323(7311):476. https://doi.org/10.1136/bmj.323.7311.476
Christofides NJ, Jewkes RK, Dunkle KL, Nduna M, Shai NJ, Sterk C. Early adolescent pregnancy increases risk of incident HIV infection in the Eastern Cape, South Africa: A longitudinal study. J Int AIDS Soc 2014;17(1):18585. https://doi.org/10.7448/IAS.17.1.18585
Jackson-Gibson M, Zash R, Mussa A, et al. High risk of adverse birth outcomes among adolescents living with HIV in Botswana compared to adult women living with HIV and adolescents without HIV. BMC Preg Childbirth 2022;22:372. https://doi.org/10.1186/s12884-022-04687-y
Pons-Duran C, Casellas A, Bardají A, et al. Adolescent, pregnant, and HIV- infected: Risk of adverse pregnancy and perinatal outcomes in young women from southern Mozambique. J Clin Med 2021;10(8):1564. https://doi. org/10.3390/jcm10081564.
United Nations Children’s Fund. Adolescent girls’ health and well-being in West and Central Africa. New York: UNICEF, 2019:1-11. https://data.unicef. org/resources/adolescent-girls-health-and-well-being-in-west-and-central- africa/ (accessed 13 July 2022).
MassynN,DayC,NdlovuN,PadayacheeT.DistrictHealthBarometer2019/2020. Durban: Health Systems Trust, 2020. https://www.hst.org.za/publications/Pages/ DHB2019-20.aspx (accessed 27 July 2022).
Govender T, Reddy P, Ghuman S. Obstetric outcomes and antenatal access among adolescent pregnancies in KwaZulu-Natal, South Africa. South African Fam Pract 2018;60(1):1-7. https://doi.org/10.1080/20786190.2017.1333783
Iklaki CU, Inaku JU, Ekabua JE, Ekanem EI, Udo AE. Perinatal outcome in unbooked teenage pregnancies in the University of Calabar Teaching Hospital, Calabar, Nigeria. ISRN Obstet Gynecol 2012;2012:1-5. https://doi. org/10.5402/2012/246983