Ngonzi Joseph, Birungi Wilson, Byamukama Onesmus, Kamugisha Arnold, Asiimwe Josephine, Ntaro Moses, Nambozi Grace, Tibaijuka Leevan, Tushabomwe-Kazooba Charles
Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA.
Business Administration, Mbarara University of Science and Technology, Mbarara, UGA.
Cureus. 2024 Aug 5;16(8):e66168. doi: 10.7759/cureus.66168. eCollection 2024 Aug.
Many female teenagers in low-resource settings conceive, of which half are unplanned and end in many deaths in sub-Saharan Africa, accounting for the majority of the cases. Teenage pregnancy is associated sometimes with poor maternal, newborn, and child deaths.
The aim of the study was to determine the prevalence, maternal obstetric outcomes, and factors associated with poor maternal obstetric outcomes among teenage mothers delivering at Mbarara Regional Referral Hospital.
This was a cross-sectional study carried out in a maternity ward at Mbarara Regional Referral Hospital, where 9,200 mothers deliver annually. All the women coming in for the delivery of their babies were consecutively approached for inclusion in the study. The women were enrolled in the post-delivery ward after delivery and interviewed with pretested questionnaires to capture the sociodemographic, obstetric, and medical profiles of the mothers. Factors were significant if the pvalue was <0.05. Results: Out of the 327 participants, the majority were rural dwellers (68.5%), married (75.8%), attained primary education (69.4%), had not used contraception (89%), and had had a planned pregnancy (63.3%). The prevalence of adverse maternal obstetrical events was 59.9%. The HIV-positive rate was 4.9%, and about half of the participants had delivered by cesarean section (41.6%). The participants' mean age was 18.4 years and SD 1.1. The mean number of antenatal care contacts attended was 4.59 and SD 1.9. The adverse maternal outcomes included episiotomy (30.9%), perineal tear (18.7%), premature rupture of membranes (10.1%), placenta abruption (5.2%), and pre-eclampsia/eclampsia (4%). Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants by 97% (adjusted odds ratio (aOR) (95% CI) of 0.03 (0.02-0.06), p-value<0.001). Having a prior history of a miscarriage was significantly associated with the occurrence of adverse maternal obstetrical events among the participants (aOR (95% CI) of 6.55 (1.46-29.42), p-value0.014).
Slightly more than half of the teenage mothers had adverse maternal obstetrical outcomes, and a history of a miscarriage in previous pregnancies was significantly associated with adverse maternal obstetrical outcomes. Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants. Teenage mothers are at a high risk of adverse maternal obstetrical outcomes, and close antepartum and intrapartum surveillance is recommended.
在资源匮乏地区，许多少女怀孕，其中一半是意外怀孕，在撒哈拉以南非洲导致许多死亡，占大多数此类案例。青少年怀孕有时与孕产妇、新生儿和儿童死亡风险高有关。
本研究的目的是确定在姆巴拉拉地区转诊医院分娩的青少年母亲中不良孕产妇产科结局的患病率、孕产妇产科结局以及与之相关的因素。
这是一项在姆巴拉拉地区转诊医院产科病房进行的横断面研究，该病房每年有9200名母亲分娩。所有前来分娩的妇女均被连续纳入研究。妇女在分娩后进入产后病房，并接受经过预测试的问卷访谈，以获取母亲的社会人口统计学、产科和医学资料。如果p值<0.05，则因素具有统计学意义。结果：在327名参与者中，大多数是农村居民（68.5%），已婚（75.8%），接受过小学教育（69.4%），未使用过避孕措施（89%），且为计划内怀孕（63.3%）。不良孕产妇产科事件的患病率为59.9%。艾滋病毒阳性率为4.9%，约一半的参与者通过剖宫产分娩（41.6%）。参与者的平均年龄为18.4岁，标准差为1.1。产前检查的平均次数为4.59次，标准差为1.9。不良孕产妇结局包括会阴切开术（30.9%）、会阴撕裂（18.7%）、胎膜早破（10.1%）、胎盘早剥（5.2%）和子痫前期/子痫（4%）。发现剖宫产可使参与者中不良孕产妇产科事件的发生率显著降低97%（调整后的优势比（aOR）（95%置信区间）为0.03（0.02 - 0.06），p值<0.001）。既往有流产史与参与者中不良孕产妇产科事件的发生显著相关（aOR（95%置信区间）为6.55（1.46 - 29.42），p值0.014）。
略多于一半的青少年母亲有不良孕产妇产科结局，既往怀孕流产史与不良孕产妇产科结局显著相关。发现剖宫产可显著降低参与者中不良孕产妇产科事件的发生率。青少年母亲发生不良孕产妇产科结局的风险很高，建议加强产前和产时密切监测。
