BackgroundTeenage pregnancy is a high-risk condition that requires skilled antenatal care for good outcome. World estimates in 2008 report about 16 million births to adolescent mothers, most of them occurring in low and middle-income countries. In Cameroon, about 12 % of all births are to adolescent mothers. This study determines the prevalence of hospital teenage deliveries in the Buea Health District and compares the delivery outcomes and demographic characteristics between pregnant teenage mothers (14–19) and adult mothers (20–29 years). We also identify factors associated with adverse pregnancy outcomes.MethodsWe undertook a retrospective study of case files of patients who gave birth in the Buea Regional Hospital during the period 2009–2012, to determine the prevalence of hospital-delivered teenage pregnancies in the BHR. We also undertook a, cross-sectional study to compare the outcomes of 148 singleton adolescent births with 360 adult births in three health facilities in the Buea Health District during the period March 1 to August 31, 2013.ResultsThe prevalence of teenage births was 13.3 %. The adverse fetal outcomes imputable to adolescent births were low birth weight (<2,500 g) (OR, 2.79; 95 % CI, 1.28-6.09), preterm babies (<37 weeks) (OR: 1.85; 95 % CI, 1.01-3.41), low 5 min Apgar score < 7 (OR: 1.66; 95 % CI, 0.91-3.0). Adverse maternal outcomes associated with teenage pregnancies were mainly perineal tear (OR, 1.6; 95 % CI, 0.95-2.7). Teenage births were not discovered in any significant way to cause preeclampsia/eclampsia, episiotomy, premature rupture of membranes and caesarean section. Maternal factors like age and gravidity were discovered to lead to adverse fetal outcomes in adolescents, while maternal factors like age, unemployment, marital status and gravidity were, for their part, directly responsible for adverse maternal outcomes in adolescents.ConclusionTeenage pregnancies are quite prevalent in the Buea Health District, and hospital delivery common. Adolescent pregnancies are more likely to lead to adverse fetal and maternal outcomes than adult pregnancies.