Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study

Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study

Author Ganchimeg, T. Google Scholar
Mori, R. Google Scholar
Ota, E. Google Scholar
Koyanagi, A. Google Scholar
Gilmour, S. Google Scholar
Shibuya, K. Google Scholar
Torloni, Maria Regina Autor UNIFESP Google Scholar
Betran, A. P. Google Scholar
Seuc, A. Google Scholar
Vogel, J. Google Scholar
Souza, J. P. Google Scholar
Institution Univ Tokyo
Natl Ctr Child Hlth & Dev
Universidade Federal de São Paulo (UNIFESP)
Univ Western Australia
Abstract ObjectiveTo investigate the risk of adverse pregnancy outcomes and caesarean section among adolescents in low- and middle-income countries.DesignSecondary analysis using facility-based cross-sectional data from the World Health Organization (WHO) Global Survey on Maternal and Perinatal Health.SettingTwenty-three countries in Africa, Latin America, and Asia.PopulationWomen admitted for delivery in 363 health facilities during 2-3months between 2004 and 2008.MethodsWe constructed multilevel logistic regression models to estimate the effect of young maternal age on risks of adverse pregnancy outcomes.Main outcome measuresRisk of adverse pregnancy outcomes among young mothers.ResultsA total of 78646 nulliparous mothers aged 24years and their singleton infants were included in the analysis. Compared with mothers aged 20-24years, adolescents aged 16-19years had a significantly lower risk of caesarean section (adjusted OR 0.75, 95% CI 0.71-0.79). When the analysis was restricted to caesarean section indicated for presumed cephalopelvic disproportion, the risk of caesarean section was significantly higher among mothers aged 15years (aOR 1.27, 95% CI 1.07-1.49) than among those aged 20-24years. Higher risks of low birthweight and preterm birth were found among adolescents aged 16-19years (aOR 1.10, 95% CI 1.03-1.17; aOR 1.16, 95% CI 1.09-1.23, respectively) and 15years (aOR 1.33, 95% CI 1.14-1.54; aOR 1.56, 95% CI 1.35-1.80, respectively).ConclusionsAdolescent girls experiencing pregnancy at a very young age (i.e. <16years) have an increased risk of adverse pregnancy outcomes.
Keywords Adolescent pregnancy
caesarean section
low- and middle-income countries
low birthweight
perinatal mortality
preterm birth
Language English
Sponsor UNDP/UNFPA/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP)
Department of Reproductive Health and Research (RHR)
Ministry of Health, Labour and Welfare of Japan
United States Agency for International Development (USAID)
Ministry of Public Health, Beijing, China
Indian Council of Medical Research, Delhi, India
Grant number Ministry of Health, Labour and Welfare of Japan: 09151353
Date 2013-12-01
Published in Bjog-an International Journal of Obstetrics and Gynaecology. Hoboken: Wiley-Blackwell, v. 120, n. 13, p. 1622-1630, 2013.
ISSN 1470-0328 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 1622-1630
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000326712000006

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