青少年妊娠在埃塞俄比亚西北部的不良新生儿结局。

Adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia.

机构信息

Pan African University Life and Earth Sciences Institutes, Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria.

College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

PLoS One. 2019 Jun 13;14(6):e0218259. doi: 10.1371/journal.pone.0218259. eCollection 2019.

DOI:10.1371/journal.pone.0218259

PMID:31194833

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6564016/

Abstract

BACKGROUND

Adolescents have physical, social and psychological characteristics that are different from adults. Adolescent pregnancy results in pregnancy and childbirth complications- an area neglected in developing countries like Ethiopia. This study, therefore, was conducted to assess the adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia.

METHODS

Institutional-based study was conducted in East Gojjam zone, Northwest Ethiopia. A total of 374 adolescent (15-19 years) and 760 adult (20-34 years) women were included in this study. Data were collected among women who came to randomly selected health facilities in East Gojjam zone. Data were collected by trained research assistants using a structured data collection questionnaire. Descriptive statistics, chi-square test, and Student's t-tests were utilized. Bivariate and multivariable logistic regression analysis were employed to adjust for confounding factors of adverse neonatal outcomes. Statistical significance was declared when the p-value was less than 0.05.

RESULTS

Higher proportion of adolescent than adult women were from rural area (57.2% vs 44.7%), were not married (5.1% vs 1.7%), were pregnant for the first time (91.7% vs 34.1%), didn't attend antenatal care (ANC) follow-up (12% vs 4.5%), and had late initiation of ANC follow-up. After adjusting for known confounding factors, the odds of low birth weight (LBW) was higher among adolescents than adult women (AOR 2.14; 95% CI, 1.36, 3.36, p-value = 0.001). Similarly, the odds of preterm birth was higher among adolescents than adult women (AOR 1.65; 95% CI, 1.09, 2.49, p-value = 0.017). There was no statistically significant difference in the rate of low Apgar score at first and five minutes after birth and neonatal Intensive Care Unit (ICU) admission between babies born from adolescent and adult women.

CONCLUSIONS

Adolescent women were less likely to receive ANC service. Babies born from adolescent women are at higher odds of adverse neonatal outcomes like LBW and preterm birth than babies born from adult women. Use of community- and health facility-based intervention programs that can prevent adolescent pregnancy and reduce adverse neonatal outcomes among adolescent girls is recommended.

摘要

背景

青少年在生理、社会和心理方面有别于成年人。青少年妊娠会导致妊娠和分娩并发症，而这一问题在埃塞俄比亚等发展中国家被忽视。因此，本研究旨在评估西北埃塞俄比亚青少年妊娠的不良新生儿结局。

方法

本研究为在埃塞俄比亚东北贡德尔地区进行的基于机构的研究。共纳入 374 名青少年（15-19 岁）和 760 名成年（20-34 岁）妇女。数据来自东北贡德尔地区随机选择的卫生机构的妇女。数据由经过培训的研究助理使用结构化数据收集问卷收集。采用描述性统计、卡方检验和学生 t 检验。采用二变量和多变量逻辑回归分析来调整不良新生儿结局的混杂因素。当 p 值小于 0.05 时，认为具有统计学意义。

结果

与成年妇女相比，青少年妇女更多来自农村地区（57.2% 比 44.7%）、未婚（5.1% 比 1.7%）、首次怀孕（91.7% 比 34.1%）、未接受产前保健（ANC）随访（12% 比 4.5%）和 ANC 随访开始较晚。在调整了已知混杂因素后，青少年发生低出生体重（LBW）的几率高于成年妇女（OR 2.14；95%CI，1.36，3.36，p 值=0.001）。同样，青少年发生早产的几率也高于成年妇女（OR 1.65；95%CI，1.09，2.49，p 值=0.017）。在出生后 1 分钟和 5 分钟新生儿 Apgar 评分和新生儿重症监护病房（NICU）入院率方面，青少年和成年妇女所生婴儿之间没有统计学差异。