Comparative analysis of pregnancy outcomes between teenage and adult women at Anaka General Hospital, Northern Uganda

Abstract

BACKGROUND: Teenage pregnancy is a global health concern associated with adverse maternal and neonatal outcomes. In Uganda, while teenage pregnancy rates are high, knowledge about their specific risks compared to those of adult pregnancy remains limited. OBJECTIVE: We determined the proportion of pregnant teenagers and compared the maternal and neonatal outcomes between pregnant teenagers and pregnant adults at a general hospital in northern Uganda. METHODS: We conducted a comparative, retrospective cohort study involving chart reviews of deliveries at the maternity ward of Anaka General Hospital, Nwoya, Uganda between July 2020 and June 2023. We performed systematic random sampling to include patient charts. All the data were analyzed using STATA software 17 SE. Binary logistic regression was performed to compare adverse pregnancy outcomes between teenage mothers and adult mothers. RESULTS: Over the 3-year period, 27.6% (n = 1,842) of the 6,662 deliveries were by teenage mothers. The outcomes of 457 teenage and 457 adult mothers were compared. Compared to adult mothers, teenage mothers had a significantly lower prevalence of HIV (2.2% versus 6.1%, p = 0.003). Teenage mothers had higher odds of having an episiotomy performed (adjusted odds ratio [aOR] = 5.66, 95% confidence interval [CI]: 2.48-12.90, p < 0.001), low birth weight (aOR = 4.66, 95% CI: 2.66-6.37, p < 0.001) or perineal tear (aOR = 2.61, 95% CI: 1.69-4.02, p < 0.001). However, adult mothers had greater odds of developing pre-eclampsia (aOR = 4.0, 95% CI: 1.59-11.1, p = 0.004). CONCLUSIONS: In this study, approximately 1 in every 4 deliveries were by teenage mothers, with increased risks of maternal and neonatal complications, except for pre-eclampsia which was more common among adult mothers. Therefore, it is crucial to implement targeted interventions and comprehensive education programs aimed at reducing teenage pregnancies and providing adequate antenatal care and support for teenage mothers.