Ngonzi Joseph, Byamukama Onesmus, Birungi Wilson, Kamugisha Arnold, Ntaro Moses, Nambozi Grace, Tibaijuka Leevan, Bebell Lisa, Tushabomwe-Kazooba Charles, Roelens Kristien
Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA.
Community Health, Mbarara University of Science and Technology, Mbarara, UGA.
Cureus. 2024 Sep 9;16(9):e69040. doi: 10.7759/cureus.69040. eCollection 2024 Sep.
Each year, millions of teenagers in low-resource areas experience unintended pregnancies, many of which result in childbirth. These pregnancies often carry an increased risk of negative perinatal outcomes.
The study determined the prevalence and factors associated with adverse perinatal outcomes among teenagers delivering at a tertiary referral hospital in southwestern Uganda.
This cross-sectional study was carried out in the Department of Obstetrics and Gynecology. We consecutively included all teenagers (13-19 years) in the postnatal ward who delivered. Descriptive statistics were used to summarize demographic and outcome data, and multivariable logistic regression analysis was used to identify factors associated with adverse perinatal outcomes.
Overall, 327 participants were enrolled. The mean age was 18.4 (SD 1.1) years, while the mean number of antenatal care (ANC) visits attended was 4.6 (SD 1.9). Less than half delivered by cesarean 136 (41.6%) and 16 (4.9%) were HIV seropositive. Approximately 140 (42.8%) participants had adverse perinatal outcomes, including neonatal death (7, 2.1%), APGAR score at five minutes <7 (44, 13.5%), or low birth weight <2.5 kg (52, 15.9%). ANC attendance was mildly protective against adverse perinatal outcomes (aOR 0.91 (95% CI 1.14, 3.01), p=0.03). Feeling indifferent toward the pregnancy was associated with increased odds of one or more adverse perinatal outcomes compared to feeling happy about the pregnancy (aOR 3.39 (95% CI 1.11, 10.37), p=0.02). Participants with a history of prior miscarriage had increased odds of adverse perinatal outcomes (aOR 9.03 (95% CI 2.45, 25.53), p=0.04).
Nearly half of teenagers experienced adverse perinatal outcomes, and a history of prior miscarriage was a significant risk factor for adverse perinatal outcomes, while ANC was protective. Prospective cohort studies to explore the newborn and child developmental outcomes among children born to teenage mothers are also recommended.
每年，资源匮乏地区有数百万青少年意外怀孕，其中许多导致分娩。这些怀孕往往会增加围产期不良结局的风险。
本研究确定了乌干达西南部一家三级转诊医院中分娩的青少年围产期不良结局的患病率及相关因素。
这项横断面研究在妇产科进行。我们连续纳入了产后病房中所有分娩的青少年（13 - 19岁）。描述性统计用于总结人口统计学和结局数据，多变量逻辑回归分析用于确定与围产期不良结局相关的因素。
总体而言，共纳入327名参与者。平均年龄为18.4（标准差1.1）岁，产前检查（ANC）的平均就诊次数为4.6（标准差1.9）次。剖宫产分娩的不到一半，有136例（41.6%），16例（4.9%）HIV血清学呈阳性。约140例（42.8%）参与者有围产期不良结局，包括新生儿死亡（7例，2.1%）、5分钟时阿氏评分<7分（44例，13.5%）或低出生体重<2.5千克（52例，15.9%）。产前检查对围产期不良结局有轻度保护作用（调整后比值比0.91（95%置信区间1.14，3.01），p = 0.03）。与对怀孕感到高兴相比，对怀孕无动于衷与一种或多种围产期不良结局的几率增加有关（调整后比值比3.39（95%置信区间1.11，10.37），p = 0.02）。有过流产史的参与者围产期不良结局的几率增加（调整后比值比9.03（95%置信区间2.45，25.53），p = 0.04）。
近一半的青少年经历了围产期不良结局，有过流产史是围产期不良结局的一个重要危险因素，而产前检查具有保护作用。还建议进行前瞻性队列研究，以探讨青少年母亲所生孩子的新生儿和儿童发育结局。
