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

Abstract

Background Adolescent childbirth is a major public health problem in Sao Tome and Principe (STP). Adolescent pregnancy and childbirth can carry a risk of morbidity associated with the physiological and sociological characteristics of teenage girls. This study aims to identify the main adverse obstetric and perinatal outcomes for adolescent pregnancies in the Hospital Dr. Ayres de Menezes (HAM), the only hospital in STP. Methods An institution-based cross-sectional study. Pregnant women ≤ 19 years of age (n = 104) were compared to non-adolescent women (n = 414). The obstetric and perinatal outcomes were compared between groups using the t test. Odds ratio (OR) were calculated through Cochran’s and Mantel–Haenszel statistics test for odds ratio equal to 1, 95% confidence intervals (CI) and p values (p < 0.05) were considered significant. Results The adverse perinatal outcomes imputable to adolescent births were foetal distress with low first minute Apgar score < 7 (OR 1.94, 95% CI 1.18–3.18, p = 0.009) and performance of neonatal resuscitation manoeuvres (OR 2.4, 95% CI 1.07–5.38, p = 0.032). Compared to older mothers, teenage girls were likely to have a non-statistically significant threefold higher risk of having an obstructed labour (OR 3.40, 95% CI 0.89–12.94, p = 0.07). Other perinatal outcomes as neonatal asphyxia, risk for cerebral palsy, premature birth, early neonatal infection, and neonatal death were identical between groups as well as maternal anaemia, mode of delivery or other obstetrical outcomes. Conclusion Adolescent pregnancies were associated with worse perinatal outcomes as foetal distress and higher need for neonatal resuscitation manoeuvres. This study may support STP health authorities in their efforts to make Sustainable Development Goals 3 (good health and wellbeing), 4 (quality education) and 5 (gender equality) a reality by 2030, since it identifies specific problems that need to be addressed to improve maternal adolescent health.

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.…”

“…stillbirths excluded *Fetal distress was defined as a low Apgar score <7 at the first minute of life (score from 0 to <7) [24,44].…”

“…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].…”

Adverse birth outcomes and associated factors among newborns delivered in a western African country: a case‒control study

“…Sampling method Sample size followed the WHO-steps approach [32] applying a web-based sample size calculator, Raosoft (http://www.raosoft.com/samplesize.html) which suggested a minimum sample size of The definition of birth asphyxia was only determined using the components of the APGAR score table [30,31] since techniques such as umbilical arterial blood gas samples from a clamped section of the umbilical cord are not available in STP. This was similarly applied to both term and preterm infants [23]. Infection as early-onset neonatal sepsis diagnosed in STP is only possible in a suspicion-based algorithm since there are no microbiologic techniques such as, blood culture, available.…”

“…For this study, ABOs were defined as PTB, LBW, macrosomia, congenital anomaly, birth asphyxia and neonatal sepsis suspicion. This present study is included in a broader project on neonatal health and adverse outcomes [22][23][24], and the authors studied the determinants for perinatal and neonatal mortality (until the 28 th day of life) in STP in another study. This current study aimed to identify the risk factors for adverse birth outcomes among newborns delivered at the only hospital maternity unit in STP.…”