Adverse pregnancy outcomes and associated factors among teenage mothers delivering at Kawempe National Referral Hospital – A comparative study

Abstract

Introduction: Complications related to pregnancy and childbirth are considered the leading cause of death among teenage mothers in developing countries like Uganda. However, the extent to which the observed associations are caused by the biological immaturity of the teenage mothers or are confounded by their frequently poor socioeconomic conditions and lack of health care is still a matter of debate. This study aimed to determine the adverse pregnancy outcomes and associated factors among teenage mothers. Methods: A comparative cross-sectional study was conducted among teenage and adult mothers in Kawempe National Referral Hospital following delivery. Participants were recruited by systematic sampling method. Pregnancy outcomes were recorded using a pre-tested interviewer administered questionnaire. Chi-square analysis was used to compare the occurrence of adverse pregnancy events among pregnant and adult mothers. The factors associated with adverse pregnancy outcomes were assessed using logistic regression. A p value < 0.05 was considered statistically significant. Results: A total of 364 teenage mothers and 364 adult mothers were enrolled in the study, with average ages of 18.85 (±1.007) and 26.09 (±1.007) years respectively. The prevalence of adverse maternal outcomes was higher among teenage mothers compared to adult mothers (64.4% vs. 48.8%), as was the prevalence of adverse neonatal outcomes (52.5% vs. 44.2%). Among teenage mothers, adverse maternal outcomes were associated with tobacco smoking (aOR=2.916 [95% CI 1.031-3.763], p=0.004), shisha smoking (aOR=1.901 [95% CI 0.784-2.912], p=0.004), contraceptive use (aOR=2.781 [95% CI 1.618-3.424], p=0.001), history of hypertension (aOR=1.786 [95% CI 1.231-3.636] , p=0.003), malaria history (aOR=3.971 [95% CI 2.133 -4.915], p=0.003), and previous hospital admissions (aOR=1.987 [95% CI 0.948-3.419], p=0.001). Similarly, adverse neonatal outcomes were significantly associated with hashish/Shisha use (aOR=5.256 [95% CI 3.952 - 7.284], p=0.071), history of stillbirths (aOR=3.047 [95% CI 2.032 - 4.414], p=0.001), history of hypertension (aOR=4.481 [95% CI 2.726 - 7.005], p=0.001), and physical assault (aOR=1.416 [95% CI 1.365 - 3.254], p=0.009). Conclusion: This study notes that teenage mothers have an increased risk of both adverse maternal and neonatal outcomes as compared to adult mothers. This calls for deliberate interventions aimed at reducing the rate of teenage pregnancy and provision of specialized antenatal care services tailored to the needs of teenage mothers.