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喀麦隆青少年怀孕的不良围产期结局

Adverse perinatal outcomes of adolescent pregnancies in Cameroon.

作者信息

Kongnyuy Eugene Justine, Nana Philip N, Fomulu Nelson, Wiysonge Shey Charles, Kouam Luc, Doh Anderson S

机构信息

Child and Reproductive Health Group, Liverpool School of Tropical Medicine, RCOG International Office, Pembroke Place, Liverpool, L3 5QA, UK.

出版信息

Matern Child Health J. 2008 Mar;12(2):149-54. doi: 10.1007/s10995-007-0235-y. Epub 2007 Jun 12.

Abstract

BACKGROUND

There are geographic variations in fetal outcomes of adolescent pregnancies because of socio-economic differences between regions and countries. The aim of our study was to determine adverse fetal outcomes associated with adolescent pregnancies in Cameroon.

METHODS

A cross-sectional study to compare the outcomes of 268 singleton, adolescent pregnancies with 832 controls, delivered in four referral hospitals in Yaounde (Cameroon), between November 2004 and April 2005.

RESULTS

The adverse fetal outcomes related to adolescent pregnancies were low birth weight (<2,500 g) (odds ratios [OR], 1.71; confidence interval [CI], 1.15-2.50), premature babies (<37 weeks) (OR, 1.77; CI, 1.24-2.52) and early neonatal death (OR, 2.18; CI, 1.04-4.48). The rates of stillbirth and intrauterine growth retardation were not significantly higher among adolescents. Adverse maternal outcome associated with adolescent pregnancies were eclampsia (OR, 3.18; CI, 1.21-8.32), preeclampsia (OR, 1.99; CI, 1.24-3.15), perineal tear (OR, 1.45; CI, 1.06-1.99) and episiotomy (OR, 1.82; CI, 1.20-2.73). Caesarean delivery, instrumental delivery and premature rupture of membranes were not significantly associated with adolescent pregnancy. Maternal factors associated with adverse fetal outcome in adolescents were maternal age, number of prenatal visits <4, and the state of being unemployed.

CONCLUSION

Adolescent pregnancies are associated with both adverse fetal and maternal outcomes in Cameroon. Improving compliance with prenatal care could significantly reduce the frequency of adverse fetal outcomes in adolescent populations in Cameroon.

摘要

背景

由于不同地区和国家之间的社会经济差异,青少年怀孕的胎儿结局存在地域差异。我们研究的目的是确定喀麦隆青少年怀孕相关的不良胎儿结局。

方法

一项横断面研究,比较了2004年11月至2005年4月期间在雅温得(喀麦隆)的四家转诊医院分娩的268例青少年单胎妊娠与832例对照的结局。

结果

与青少年怀孕相关的不良胎儿结局为低出生体重(<2500克)(比值比[OR],1.71;可信区间[CI],1.15 - 2.50)、早产(<37周)(OR,1.77;CI,1.24 - 2.52)和早期新生儿死亡(OR,2.18;CI,1.04 - 4.48)。青少年中死产和宫内生长受限的发生率没有显著更高。与青少年怀孕相关的不良母亲结局为子痫(OR,3.18;CI,1.21 - 8.32)、先兆子痫(OR,1.99;CI,1.24 - 3.15)、会阴撕裂(OR,1.45;CI,1.06 - 1.99)和会阴切开术(OR,1.82;CI,1.20 - 2.73)。剖宫产、器械助产和胎膜早破与青少年怀孕没有显著关联。与青少年不良胎儿结局相关的母亲因素为母亲年龄、产前检查次数<4次以及失业状态。

结论

在喀麦隆,青少年怀孕与不良胎儿和母亲结局均相关。提高产前保健的依从性可显著降低喀麦隆青少年人群中不良胎儿结局的发生率。

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