Adolescence as a Predictor of Adverse Pregnancy Outcomes: A comparative longitudinal study conducted in a national referral hospital in Western Kenya.

Abstract

Adolescents present with unusual reproductive health, anatomical, psychological, and social characteristics, a situation that predisposes them high-risk pregnancies, necessitating prioritized obstetric services. Therefore, this study compared maternal and fetal outcome between adolescent (15–19 years) and adult (20-30years) pregnant mothers who delivered at Moi Teaching and Referral Hospital (MTRH) in Western Kenya. It adopted a six-month (1st July to 31st December 2021) prospective case-control study (ratio 1:3) among 836 (209 adolescents and 627 adult mothers) expectant mothers admitted at MTRH labour ward for delivery services. Maternal sociodemographic and reproductive characteristics data were collected using an interviewer administered questionnaire. Additionally, pregnancy outcomes data were collected after delivery and documented in the same questionnaire. Statistically, mean and frequencies, tests of association (Fisher’s exact tests), risk ratios and multivariate logistic regression were conducted. Out of 836 participants, 547 (65.4%) were married (54 adolescents and 493 adults) and 289 (34.6%) were single. Level of education was distributed as primary (17.9%; n = 150), secondary (42.5%; n = 355) and Tertiary (39.5%; n = 330) with majority (56.3%: n = 112) of the adolescents being students. The mean antenatal visits were 3.960 ± 1.721 with more than two-thirds (68.1%) attending at least 4 visits. Adolescent mothers were significantly (p < 0.001) more likely (OR = 4.952; 95% CI: 3.313, 7.402) not to have used contraception prior to the current pregnancy, at risk of anaemia at labour (p = 0.008), hypertension in pregnancy (p = 0.011), preterm labour (p = 0.011), perineal trauma (p = 0.004) and having newborns with a low 5-minute Apgar score (RR = 1.601; 95% CI: 1.179, 2.174). In conclusion, expectant adolescent mothers have a significantly increased risk of adverse maternal and fetal outcomes compared to adults, warranting targeted obstetric care