Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 18  |  Issue : 1  |  Page : 43-46

Obstetric outcome of teenage pregnancy at Aminu Kano Teaching Hospital: A 3-year review


1 Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria

Date of Web Publication1-Mar-2016

Correspondence Address:
Rabiu Ayyuba
Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, P.M.B. 3011, Kano, Nigeria
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2276-7096.177830

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  Abstract 

Background: Teenage pregnancy is generally considered to be a high-risk event. Teenage mothers are physically and psychologically ill-prepared for reproduction. Low socioeconomic status and lack of prenatal care are among the factors influencing pregnancy outcome in these patients.
Objective: To assess the obstetric outcome of teenage pregnancy, its current trends, sociodemographic determinants, and incidence in Aminu Kano Teaching Hospital.
Materials and Methods: A retrospective study of 540 teenage primigravidae who delivered in Aminu Kano Teaching Hospital between 1st of January 2009 and 31st of December 2011.
Results: The incidence of teenage pregnancy over the study period was 5.8% (58/1000 deliveries). Majority of the patients (78.9%) belonged to low socioeconomic class. Pregnancy complications prevalent in these patients included anemia (33.5%), low birth weight (17.8%), preeclampsia/eclampsia (12.4%), preterm labor (11.5%), and stillbirth (2.5%). Cesarean section rate among them was 18.9%.
Conclusion: Teenage pregnancy is a high-risk pregnancy because of the associated pregnancy complications which are more prevalent in the unbooked patients. Access to health care services, girl-child education, and improvement of the socioeconomic status of the patients will reduce its incidence.

Keywords: Kano, obstetric outcome, sociodemographic determinants, teenage pregnancyfrom


How to cite this article:
Garba I, Adewale TM, Ayyuba R, Abubakar IS. Obstetric outcome of teenage pregnancy at Aminu Kano Teaching Hospital: A 3-year review. J Med Trop 2016;18:43-6

How to cite this URL:
Garba I, Adewale TM, Ayyuba R, Abubakar IS. Obstetric outcome of teenage pregnancy at Aminu Kano Teaching Hospital: A 3-year review. J Med Trop [serial online] 2016 [cited 2019 Aug 20];18:43-6. Available from: http://www.jmedtropics.org/text.asp?2016/18/1/43/177830


  Introduction Top


Teenage pregnancy is defined as “pregnancy in human females under the age of twenty at the time that the pregnancy ends.”[1]

Teenage pregnancy represents one of the most important social and public health problems of the 21st century. Adolescence or teenage refers to the transition from childhood to adulthood and has been defined by the world health organization as the period between 10 and 19 years.[2] This is the period when structural, functional, and psychosocial developments occur in a child to prepare her for assuming the responsibility of motherhood.

The incidence of teenage pregnancy varies dramatically between different countries. Approximately, 90% of teenage birth occurs in developing countries, and more than a third of women from these countries give birth before the age of twenty.[3] The teenage birth rates range from 8% in East Asia to 55% in sub-Saharan Africa depending on cultural factors such as religion, female education, and access to contraceptives.[4]

In Nigeria, the incidence of teenage pregnancy was 2.18% in Nnewi,[5] 9.8% in Uyo,[6] 2.4% in Ibadan,[7] 1.93% in Ilorin,[8] and 1.6% in Jos.[9]

Contributing factors to the rising incidence of teenage pregnancy include broken homes, stressed families, early marriage, risky sexual behavior, lack of knowledge about sex and how to use contraceptives; barriers to access contraceptives including negative attitudes of health staff; peer pressure; sexual coercion and rape, low self-esteem; low educational expectations and heightened sex-based messages in the media.[10]

Pregnancy in very young women is generally considered to be a very high-risk event because teenage girls are physically and psychologically immature for reproduction.[11] In addition, there are some extrinsic factors such as inadequate prenatal care, illiteracy, and poor socioeconomic conditions that affect the outcome of pregnancy in teenage girls.[12] Medical conditions such as preterm birth, poor maternal weight gain, pregnancy-induced hypertension, anemia, and sexually transmitted diseases are strongly associated with teenage pregnancy.[6],[8],[13]

Early marriage soon after menarche is a long established custom in Northern Nigeria.[14] Although teenage pregnancy after the marriage has social approval in our society, it has an adverse impact on maternal mortality and perinatal morbidity. With <37% institutional delivery,[15] high illiteracy level and poor socioeconomic factors,[16] teenage pregnancy contributes to the high maternal mortality ratio in this part of the country as well as the higher prevalence rate of eclampsia.[17]

The previous study has shown that teenage mothers who received good family and community support, timely quality antenatal care, and deliver in the hospital have similar obstetric outcome when compared with their older peers.[18] Therefore, the obstetric risks of teenage pregnancy are predominantly due to social and economic factors rather than chronological age.

The objective of this study was to assess the obstetric outcome of teenage pregnancy, know its current trends and sociodemographic determinants, as well as determine the incidence of teenage deliveries in Aminu Kano Teaching Hospital over the study period.


  Materials and Methods Top


This was a retrospective study of 540 teenage primigravidae who delivered at Aminu Kano Teaching Hospital between 1st of January 2009 and 31st of December 2011. The case notes of the patients were retrieved and analyzed with respect to the sociodemographic characteristics, booking status, pregnancy complications, labor, delivery, and fetal outcome.

The social class was determined using a combination of patients' educational status and husbands' occupation.

The data were analyzed using Epi Info software Version 3.5.4 (Centers for Disease Control and Prevention, 1600 Clifton Road Atlanta, GA, USA), 2012, and presented in the form of tables and charts.


  Results Top


A total of 9312 deliveries were conducted during the study period, 540 of which were teenage deliveries. This gives an incidence of 5.8% (58/1000 deliveries). The annual teenage deliveries over the 3-year period were 58.2%, 54.7%, and 61.1% per 1000 deliveries in 2009, 2010, and 2011, respectively [Figure 1].
Figure 1: Annual distribution of teenage deliveries

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The ages of the teenage mothers ranged between 15 and 19 years with mean age ± standard deviation of 18.3 ± 0.85. There were 528 (97.8%) married teenage mothers, and 192 (36%) of the teenage mothers were unbooked [Table 1].
Table 1: Sociodemographic characteristics

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Teenage mothers aged 19 years accounted for 240 (44.4%) and those aged 15 years represented 12 (2.2%).

Four hundred and twenty-eight (79.2%) of the subjects had no formal education while 424 (78.5%) of their husbands were unskilled. One hundred and sixteen (21.5%) of the husbands were middle-level, and none of them was a professional. The socioeconomic status was determined using a combination of the women's educational status and their husbands' occupation. Majority of them belonged to social Class 4 and 5, and none of them was in social Class 1 and 2 [Table 1].

The pregnancy complications among teenage mothers were depicted in [Table 2]. Anemia accounted for 186 (33.5%), preeclampsia/eclampsia 67 (12.4%), preterm labor 62 (11.5%), low birth weight 96 (17.8%), and stillbirth 14 (2.5%). One hundred and twenty (22.2%) did not have any complication.
Table 2: Mode of delivery and pregnancy complications among teenage mothers

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Four hundred and twenty-six (78.9%) had spontaneous vaginal deliveries, 102 (18.9%) had cesarean section whereas 12 (2.2%) had vacuum delivery [Table 2].

The indication for cesarean section was eclampsia in 78 (76.5%), cephalo-pelvic disproportion in 15 (14.7%), and fetal distress in 9 (8.8%) [Table 3].
Table 3: Indications for caesarean section

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  Discussion Top


The incidence of teenage pregnancy in this study was 5.8% (58/1000 deliveries). This is higher than the reported incidence of 2.25% in Abakaliki [19] and 2.4% in Ibadan.[7] The high incidence in this study might be because most of them are married. Cultural permissiveness of early marriage and poor girl-child education may also be responsible.[20]

This study also shows that majority of the patients were of low socioeconomic status as most of them had no formal education. This agrees with the work done in previous studies.[7],[8] Low socioeconomic status is a risk factor for teenage pregnancy with associated increased maternal and perinatal morbidity and mortality.[21]

The teenage mothers in this study were aged 15–19 years and were mostly married (97.8%). This is similar to the finding by Omole-Ohonsi and Attah [18] and also agrees with the finding of Treffers.[22] This clearly shows that early marriage is still a problem in this part of the world, and the resultant early pregnancy and childbirth lead to complications which are the major causes of death in women of this age group in developing countries.[4] The average age of marriage for women in Nigeria is <19 years.[23]

This study shows that 36% of the teenage mothers were unbooked. This implies that lack of antenatal care is common among teenage mothers. This has also been reported by other researchers.[7],[13] This might be due to ignorance, poverty, inadequate health care facility, and lack of family and social support.

Anemia was the most common pregnancy complication among the teenage mothers in this study accounting for 33.5%. Similar findings have been reported in other studies.[6],[8] This is probably due to poor nutrition and lack of antenatal clinic attendance.

The cesarean section rate among the teenage mothers was 18.9%. This is higher than 7.8% reported by Aboyeji in Ilorin [24] but agrees with the finding of Ezegwui et al.[20] in Enugu (18.9%). The high incidence is probably because of the large number of unbooked patients who had complications necessitating emergency cesarean section. Other workers have reported similar findings.[5],[8],[9] This is, however, in contrast to the finding of 9.8% by Emem et al.[6] in Uyo. Preeclampsia/eclampsia was the most common indication for caesarean section accounting for 76.8%.

The incidence of preterm delivery among the teenagers in this study was 11.5%. This is lower than 18.9% observed in Enugu.[20] This may be due to a higher percentage of unbooked patients in that study. It is, however, higher than that in the general obstetric population (9.6%)[25] but agrees with findings by previous authors.[26],[27] Preterm delivery was more prevalent among the unbooked patients and was probably due to anemia malnutrition and lack of antenatal care.

In this study, the incidence of low birth weight among the teenage mothers was 22.9% while that of stillbirth was 4.4%. This is comparable to the findings by other authors.[5],[6],[8],[28]


  Conclusion Top


This study has shown that low socioeconomic status and early marriage are some of the factors responsible for the high incidence of teenage pregnancy.

It also reveals that obstetric complications in the teenage mothers are related to their unbooked status rather than the chronological age. Hence, access to health care services especially at the primary and secondary levels, provision of emergency obstetric care, improvement of the socioeconomic status of the people, and girl-child education will reduce teenage birth rate and its associated health hazards.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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