Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study
Article first published online: 7 AUG 2013
© 2013 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 13, pages 1622–1630, December 2013
How to Cite
Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study. BJOG 2013 ; DOI: 10.1111/1471-0528.12391., , , , , , , , , , .
- Issue published online: 11 NOV 2013
- Article first published online: 7 AUG 2013
- Manuscript Accepted: 21 APR 2013
- UNDP/UNFPA/WHO/World Bank Special Program of Research
- Development and Research Training in Human Reproduction (HRP)
- Department of Reproductive Health and Research (RHR)
- Ministry of Health, Labour and Welfare of Japan
- United States Agency for International Development (USAID)
- Ministry of Public Health, Beijing, China
- Indian Council of Medical Research, Delhi, India. Grant Number: 09151353
- Adolescent pregnancy;
- caesarean section;
- low- and middle-income countries;
- low birthweight;
- perinatal mortality;
- preterm birth
To investigate the risk of adverse pregnancy outcomes and caesarean section among adolescents in low- and middle-income countries.
Secondary analysis using facility-based cross-sectional data from the World Health Organization (WHO) Global Survey on Maternal and Perinatal Health.
Twenty-three countries in Africa, Latin America, and Asia.
Women admitted for delivery in 363 health facilities during 2–3 months between 2004 and 2008.
We constructed multilevel logistic regression models to estimate the effect of young maternal age on risks of adverse pregnancy outcomes.
Main outcome measures
Risk of adverse pregnancy outcomes among young mothers.
A total of 78 646 nulliparous mothers aged ≤24 years and their singleton infants were included in the analysis. Compared with mothers aged 20–24 years, adolescents aged 16–19 years had a significantly lower risk of caesarean section (adjusted OR 0.75, 95% CI 0.71–0.79). When the analysis was restricted to caesarean section indicated for presumed cephalopelvic disproportion, the risk of caesarean section was significantly higher among mothers aged ≤15 years (aOR 1.27, 95% CI 1.07–1.49) than among those aged 20–24 years. Higher risks of low birthweight and preterm birth were found among adolescents aged 16–19 years (aOR 1.10, 95% CI 1.03–1.17; aOR 1.16, 95% CI 1.09–1.23, respectively) and ≤15 years (aOR 1.33, 95% CI 1.14–1.54; aOR 1.56, 95% CI 1.35–1.80, respectively).
Adolescent girls experiencing pregnancy at a very young age (i.e. <16 years) have an increased risk of adverse pregnancy outcomes.