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

Abstract

Objective To investigate the risk of adverse pregnancy outcomes and caesarean section among adolescents in low-and middle-income countries.Design Secondary analysis using facility-based cross-sectional data from the World Health Organization (WHO) Global Survey on Maternal and Perinatal Health.Setting Twenty-three countries in Africa, Latin America, and Asia.Population Women admitted for delivery in 363 health facilities during 2-3 months between 2004 and 2008.Methods We constructed multilevel logistic regression models to estimate the effect of young maternal age on risks of adverse pregnancy outcomes.Main outcome measures Risk of adverse pregnancy outcomes among young mothers.Results A total of 78 646 nulliparous mothers aged ≤24 years and their singleton infants were included in the analysis. Compared with mothers aged 20-24 years, adolescents aged 16-19 years 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 ≤15 years (aOR 1.27, 95% CI 1.07-1.49) than among those aged 20-24 years. Higher risks of low birthweight and preterm birth were found among adolescents aged 16-19 years (aOR 1.10, 95% CI 1.03-1.17; aOR 1.16, 95% CI 1.09-1.23, respectively) and ≤15 years (aOR 1.33, 95% CI 1.14-1.54; aOR 1.56, 95% CI 1.35-1.80, respectively).Conclusions Adolescent girls experiencing pregnancy at a very young age (i.e. <16 years) have an increased risk of adverse pregnancy outcomes.

Low Birth Weight and Prematurity in Teenage Mothers in Rural Areas of Burkina Faso

“…In our univariate analysis adolescence was associated with LBW or PTB, as already demonstrated elsewhere [3,4,18,19,21,30,31]. Conversely studies from Nigeria and Brazil showed no association between maternal age and LBW or preterm birth [32,33].…”

“…Although low BMI was frequent in teenagers and could indicate biological immaturity, this did not lead to a significant increased risk of adverse fetal outcome in our study as hypothesized elsewhere [2,31,38].…”

“…Higher proportions (LBW 38.9%, PTB 27.7%) were found in India [29]. We link this to the greater proportion (11%) of young teenagers (15-17 years) in this study, given that inverse relationship between maternal age and adverse fetal outcome [4,30,31].…”

Extraordinary intelligence and the care of infants

“…Second, we assume that a characteristic size V constrains neonates' head size at birth. Children who are born with a head size larger than V will be assumed to be relatively unlikely to survive birth, matching the observation that our brains come with the cost of complex and dangerous childbirth (29)(30)(31), as well as the commonality of deaths due to cephalopelvic disproportion in humans and other primates (32)(33)(34)(35). The shift to large infants has been argued to have occurred early in human evolution, with Australopithecus carrying neonates with nearly the same proportion of their body mass as modern humans, potentially an important driver of the development of alloparenting (36).…”

Reducing health inequalities among girls and adolescent women living in poverty: the success of Bangladesh

“…A global study across 23 low and J U S T A C C E P T E D middle income countries found higher risks of low birthweight and preterm birth among adolescents aged 16-19 years (adjusted OR 1.10, 95% CI 1.03-1.17; adjusted OR 1.16, 95% CI 1.09-1.23, respectively) and ≤15 years (adjusted OR 1.33, 95% CI 1.14-1.54; adjusted OR 1.56, 95% CI 1.35-1.80, respectively) compared to women aged 20-24 years (Ganchimeg et al, 2013). Furthermore, female educational attainment has been associated with gender disparities in child mortality (Monden and Smits, 2013).…”