Adolescent pregnancy in Sao Tome and Principe: a cross-sectional hospital-based study

Abstract

Background Pregnancy starts early in Sao Tome and Principe (STP) and rates of adolescent pregnancy increased 16% in recent years reaching a 27.3% prevalence. This study aimed to understand the pregnant adolescents’ characteristics and factors associated to early childbearing in STP. Methods A cross-sectional hospital-based study was undertaken in Hospital Dr. Ayres de Menezes between 2016 and 2018 with a randomly selected total sample size of 518 mothers. Mothers’ clinical records and interviews were used to collect relevant data. The results among adolescent girls 19 years of age and younger (n=104) were compared to adult mothers (n=414). A subgroup analysis of adolescent pregnant girls was also conducted. Statistically significance was considered at a p-value ≤0.05. Data were analysed using SPSS software. Results The study revealed that 20.1% were adolescent mothers. Pregnancy at a very early age (≤15) was experienced by 7.7%. The characteristics founded to be positively associated with adolescent pregnancy were: 1) being single (OR 0.39, 95% CI=0.2–0.6, p≤0.001); 2) having a relationship with the baby´s father for a period of less than one year (OR 0.16, 95% CI=0.09-0.3, p≤0.001); 3) lack of the baby´s father support (OR 0.41, 95% CI=0.2–0.7, p=0.002); 4) not using a contraceptive method (OR 0.33, 95% CI=0.2–0.5, p≤0.001), and 5) inappropriate knowledge concerning the identification of the newborn’s danger signs (OR 15.7, 95% CI= 9–26, p≤0.001). Comparing pregnancy at very early age (≤15) to late (>18 and ≤19) adolescents, main differences were that previous contraceptives were not used at all in girls ≤15 years compared to 9.8% of late childbearing subgroup. Conclusions Unfavourable factors linked to adolescent pregnancies were absence of a contraceptive method, getting pregnant in the early first months of one relationship and to be single. Gap age difference between adolescents’ partners, polygamous sexual relationships, previous abortion and having already other living children were also identified. Adolescents also had inappropriate knowledge of the identification of the newborns’ danger signs. Before being sexually active, adolescents critically need sexual and reproductive health information provided by a healthy community and through school programmes on sexual education. Schools should promote girl’s empowerment and awareness and, at the same time, reinforce boy’s role in fatherhood and shared responsibilities. The government should work on the prevention of early sexual initiation, as well as on improving family planning programmes to protect them from pregnancy with special focus for the very early adolescent girls. None of these goals can be achieved if the government doesn’t, simultaneously, improve educational and economic opportunities for girls.

Factors associated with peri-neonatal mortality in Sao Tome & Principe: a prospective cohort study

“…These results are in line with studies conducted in Cameroon [69] and Ethiopia [36] as well as published literature that suggests that lower APGAR scores are associated with severe multiorgan damage resulting in brain damage, lung dysfunction, cardiomyopathy, renal failure, hepatic failure, necrotizing enterocolitis and consequently death [70]. Previous studies [23,24] that compared outcomes between adolescent pregnant girls and older counterparts identified that adverse outcomes imputable to adolescent births were fetal distress (OR 1.94, 95% CI 1.18-3.18) and performance of neonatal resuscitation maneuvers (OR 2.4, 95% CI1.07-5.38), highlighting the risks surrounding this period among deliveries at HAM maternity unit.…”

“…To the best of our knowledge, this is the first study to assess peri-neonatal mortality in STP, and it was undertaken within the context of a broader project on neonatal adverse birth outcomes (ABOs) in this LMIC [23][24][25].…”

Intestinal Parasitic Infections, Treatment and Associated Factors among Pregnant Women in Sao Tome and Principe: A Cross-Sectional Study

“…To our knowledge, intestinal parasitic infections among pregnant women in Sao Tome and Principe have never been studied. Tis study was undertaken within the context of a broader project on the causes and risk factors contributing to neonatal mortality and adverse birth outcomes in STP [30,31].…”

Adolescent pregnancy in Sao Tome and Principe: are there different obstetric and perinatal outcomes?

“…There is, however, a knowledge gap concerning the obstetric and perinatal characteristics of this major public health problem in this country. The authors have also studied these pregnant adolescents´ characteristics and factors associated with early childbearing in STP, whose results were published in another article [ 40 ].…”