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Title: Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study
Authors: Mombo-Ngoma, Ghyslain
Mackanga, Jean-Rodolphe
González, Raquel
Ouédraogo, Smaı̈la
Kakolwa, Mwaka A.
Manego, Rella Zoleko
Basra, Arti
Rupérez, María
Cot, Michel
Kabanywanyi, Abdunoor M.
Matsiegui, Pierre-Blaise
Agnandji, Seldiji T.
Valá, Anifa
Massougbodji, Achille
Abdulla, Salim
Adegnika, Ayôla A.
Sevene, Esperança
Macete, Eusébio
Yazdanbakhsh, Maria
Kremsner, Peter G.
Aponte, John J.
Menéndez, Clara
Ramharter, Michael
Keywords: Pregnancy
Alolescent pregnancy
Maternal health
Neonatal health
Issue Date: 14-Apr-2016
Publisher: BMJ
Citation: Mombo-Ngoma G, Mackanga JR, González R, et al Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study.BMJ Open 2016;6:e011783. doi: 10.1136/bmjopen-2016-011783
Abstract: Objectives One of Africa's most important challenges is to improve maternal and neonatal health. The identification of groups at highest risk for adverse pregnancy outcomes is important for developing and implementing targeted prevention programmes. This study assessed whether young adolescent girls constitute a group at increased risk for adverse birth outcomes among pregnant women in sub-Saharan Africa. Setting Data were collected prospectively as part of a large randomised controlled clinical trial evaluating intermittent preventive treatment of malaria in pregnancy (NCT00811421—Clinical, conducted between September 2009 and December 2013 in Benin, Gabon, Mozambique and Tanzania. Participants Of 4749 participants, pregnancy outcomes were collected for 4388 deliveries with 4183 live births including 83 multiple gestations. Of 4100 mothers with a singleton live birth delivery, 24% (975/4100) were adolescents (≤19 years of age) and 6% (248/4100) were aged ≤16 years. Primary and secondary outcome measures Primary outcomes of this predefined analysis were preterm delivery and low birth weight. Results The overall prevalence of low birthweight infants and preterm delivery was 10% (371/3851) and 4% (159/3862), respectively. Mothers aged ≤16 years showed higher risk for the delivery of a low birthweight infant (OR: 1.96; 95% CI 1.35 to 2.83). Similarly, preterm delivery was associated with young maternal age (≤16 years; OR: 2.62; 95% CI 1.59 to 4.30). In a subanalysis restricted to primiparous women: preterm delivery, OR 4.28; 95% CI 2.05 to 8.93; low birth weight, OR: 1.29; 95% CI 0.82 to 2.01. Conclusions Young maternal age increases the risk for adverse pregnancy outcomes and it is a stronger predictor for low birth weight and preterm delivery than other established risk factors in sub-Saharan Africa. This finding highlights the need to improve adolescent reproductive health in sub-Saharan Africa
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