Outcomes and factors associated with adolescent pregnancies at the University Teaching Hospital, Lusaka, Zambia

Abstract

Objectives: These were to determine obstetric outcomes associated with adolescent pregnancies and those of older women at the UTH, identify factors associated with and compare the obstetric outcomes between the two age groups with determining the scale of adolescent pregnancy.

Materials and methods: This was a comparative prospective cross sectional study with a purposeful sample of 200 pregnant adolescents and women aged between 20 and 30 years in a ratio of 1:1.

Results: 3,456 women delivered between September and October, 2015 out of which 480 (13.9%) were adolescents. Of the 100 adolescents studied, 62(62%) had dropped out of school due to pregnancy and 81(81%) of the pregnancies were unplanned. Factors associated with adolescent pregnancies noted included mean age at coitarche (p<0.001), early marriages (p<0.001; AOR 14.6, 95% CI: 4.642 - 45.99), primary education (p 0.002; AOR 4.522, 95% CI: 1.758 – 11.634), having a boyfriend (p<0.001; AOR 12.70, 95% CI: 4.04 – 39.91) and contraceptive use. There were 95(95%) adolescents who had never used a contraceptive before compared to 40(40%) older women (p<0.001). Adolescents were also significantly associated with first degree perineal tears (p<0.001; AOR 3.46, 95% CI: 1.83 - 6.56) and preterm deliveries (p 0.026, AOR 2.60, 95% CI: 1.16 - 5.78). Furthermore, although not statistically significant, more adolescents 22(22%) had low birth weight babies compared to 14(14% older women and 11(11%) had pregnancy induced hypertension versus 7(7%) older mothers. In addition, out of the 10 documented caesarean sections among the study participants, 8(80%) were done among adolescents (p 0.052).

Conclusion: Several factors and adverse obstetric outcomes are associated with adolescent pregnancies seen at the UTH. Although adolescent pregnancy is reducing, it remains high and contributing significantly to discontinuation of school. Key stakeholders need to continue targeting adolescents with appropriate health messages including an emphasis on increased access to and utilization of effective contraceptives.