马拉维伊丽莎白女王中央医院的青少年妊娠结局：一项横断面研究。
Adolescent pregnancy outcomes at Queen Elizabeth Central Hospital, Malawi: a cross-sectional study.
机构信息
Kamuzu University of Health Sciences, Malawi.
Malawi-Liverpool Wellcome Trust, Kamuzu University of Health Sciences, Malawi.
出版信息
Malawi Med J. 2021 Dec;33(4):261-268. doi: 10.4314/mmj.v33i4.6.
UNLABELLED
Malawi has a growing population with a high Maternal Mortality Ratio (MMR) of 439 per 100,000 live births to which adolescents contribute 25%. Current data suggests adolescent pregnancies in low resource settings are at an increased risk of both maternal and neonatal morbidity.
OBJECTIVES
This study assessed the pregnancy outcomes amongst adolescents while using women from the early adulthood (20 - 24-year-old) and advanced maternal age (35 years old and above) groups as reference.
METHODS
This was a cross-sectional study, carried out at the Chatinkha maternity (labour) and post-natal wards at QECH, and included all adolescents (10 - 19 years old) and women between 20 - 24 years old (early adulthood) and 35 years old or older (advanced maternal age), presenting in labor, at any gestational age ≥ 28 weeks or with a birth weight of 1000 grams or above.
RESULTS
The study found the prevalence of adolescent pregnancy to be 20.4% (N=5035) out of all the deliveries during the recruitment period. Sexually transmitted infections were proportionally higher in the adolescent group, with 12% testing HIV seroreactive and 10% syphilis seroreactive. Neonatal outcomes of birth asphyxia (3.5%), low birth weight (5%), prematurity (4.3%) and early neonatal death (4.3%) were not statistically different from the outcomes of the older age groups. The major causes of maternal morbidity were determined to be a high caesarean section rate of 31.9% and intrapartum diagnosis of urinary tract infection (7.4%), malaria (7.4%) and hypertensive disorders (14.5%).
CONCLUSIONS
Adolescents are a significant proportion of the pregnant population in Malawi. These adolescents are at increased risk of some pregnancy and peripartum complications when compared to women of older age groups. However, our study determined that these outcomes appear to be more likely related to the peripartum care received and not solely specific to maternal age.
未加标签
马拉维人口不断增长，孕产妇死亡率（MMR）高达每 10 万活产儿 439 例，其中青少年的比例占 25%。目前的数据表明，在资源匮乏的环境中，青少年怀孕的母婴发病率都有所上升。
目的
本研究评估了青少年妊娠的结局，并将年轻成年组（20-24 岁）和高龄产妇组（35 岁及以上）的女性作为参考。
方法
这是一项横断面研究，在 QECH 的 Chatinkha 产科（分娩）和产后病房进行，纳入了所有 10-19 岁的青少年以及 20-24 岁（年轻成年）和 35 岁及以上（高龄产妇）的孕妇，其分娩时的孕周≥28 周或出生体重≥1000 克。
结果
在招募期间，研究发现青少年妊娠的患病率为 20.4%（N=5035），占所有分娩人数的比例。性传播感染在青少年组中的比例较高，12%的人 HIV 血清反应阳性，10%的人梅毒血清反应阳性。新生儿结局中，窒息（3.5%）、低出生体重（5%）、早产（4.3%）和新生儿早期死亡（4.3%）与年龄较大组的结局无统计学差异。产妇发病率高的主要原因是剖宫产率为 31.9%，以及分娩时诊断出尿路感染（7.4%）、疟疾（7.4%）和高血压疾病（14.5%）。
结论
青少年是马拉维孕妇人群中的一个重要组成部分。与年龄较大的妇女相比，这些青少年在妊娠和围产期并发症方面的风险更高。然而，我们的研究表明，这些结果更可能与围产期护理有关，而不仅仅是与产妇年龄有关。
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