Format

Send to

Choose Destination
BMJ Open. 2016 Jun 29;6(6):e011783. doi: 10.1136/bmjopen-2016-011783.

Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study.

Author information

1
Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany German Centre for Infection Research (DZIF), Tübingen, Germany Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
2
Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany German Centre for Infection Research (DZIF), Tübingen, Germany.
3
ManhiçaHealthResearch Center (CISM), Manhiça, Mozambique ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
4
Faculté de Sciences de la Santé, Université Abomey Calavi, Cotonou, Benin Institut pour la Recherche et le Développement (IRD), Paris, France.
5
Ifakara Health Institute, Dodoma, Tanzania.
6
Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany Ngounie Medical Research Centre, Fougamou, Gabon.
7
Institut pour la Recherche et le Développement (IRD), Paris, France.
8
Ngounie Medical Research Centre, Fougamou, Gabon.
9
ManhiçaHealthResearch Center (CISM), Manhiça, Mozambique.
10
Faculté de Sciences de la Santé, Université Abomey Calavi, Cotonou, Benin.
11
Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany German Centre for Infection Research (DZIF), Tübingen, Germany Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
12
Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
13
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
14
Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany German Centre for Infection Research (DZIF), Tübingen, Germany Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.

Abstract

OBJECTIVES:

One of Africa's most important challenges is to improve maternal and neonatal health. The identification of groups at highest risk for adverse pregnancy outcomes is important for developing and implementing targeted prevention programmes. This study assessed whether young adolescent girls constitute a group at increased risk for adverse birth outcomes among pregnant women in sub-Saharan Africa.

SETTING:

Data were collected prospectively as part of a large randomised controlled clinical trial evaluating intermittent preventive treatment of malaria in pregnancy (NCT00811421-Clinical Trials.gov), conducted between September 2009 and December 2013 in Benin, Gabon, Mozambique and Tanzania.

PARTICIPANTS:

Of 4749 participants, pregnancy outcomes were collected for 4388 deliveries with 4183 live births including 83 multiple gestations. Of 4100 mothers with a singleton live birth delivery, 24% (975/4100) were adolescents (≤19 years of age) and 6% (248/4100) were aged ≤16 years.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Primary outcomes of this predefined analysis were preterm delivery and low birth weight.

RESULTS:

The overall prevalence of low birthweight infants and preterm delivery was 10% (371/3851) and 4% (159/3862), respectively. Mothers aged ≤16 years showed higher risk for the delivery of a low birthweight infant (OR: 1.96; 95% CI 1.35 to 2.83). Similarly, preterm delivery was associated with young maternal age (≤16 years; OR: 2.62; 95% CI 1.59 to 4.30). In a subanalysis restricted to primiparous women: preterm delivery, OR 4.28; 95% CI 2.05 to 8.93; low birth weight, OR: 1.29; 95% CI 0.82 to 2.01.

CONCLUSIONS:

Young maternal age increases the risk for adverse pregnancy outcomes and it is a stronger predictor for low birth weight and preterm delivery than other established risk factors in sub-Saharan Africa. This finding highlights the need to improve adolescent reproductive health in sub-Saharan Africa.

TRIAL REGISTRATION NUMBER:

NCT00811421; Post-results.

KEYWORDS:

adolescent pregnancy; low birth weight; preterm birth; sub-Saharan Africa

PMID:
27357200
PMCID:
PMC4932321
DOI:
10.1136/bmjopen-2016-011783
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center