Association between quality of antenatal care service utilisation and adverse birth outcomes among adolescent women in 22 Sub-Saharan African countries. A mixed-effects multilevel analysis

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-09 DOI:10.1016/j.srhc.2024.101036

Tadesse Tolossa , Lisa Gold , Eric HY Lau , Merga Dheresa , Julie Abimanyi-Ochom

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Abstract

Objectives

This study aimed to assess the association between the quality of antenatal care (ANC) service utilisation and adverse birth outcomes among adolescent women in Sub-Saharan Africa (SSA).

Methods

A two-level mixed-effects model was employed using the recent Demographic Health Survey (DHS) data from 22 SSA countries. Both bivariable and multivariable multilevel analyses were conducted to assess the association between individual and community level factors with adverse birth outcomes. The results of the fixed effects model were interpreted in the form of adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs).

Results

In SSA, 23.5 % of adolescent mothers experienced adverse birth outcomes. This study found that receiving high quality ANC was associated with a 28 % reduction in the likelihood of adverse birth outcomes (AOR = 0.72, 95 % CI: 0.63, 0.83). Among the individual-level factors, middle-aged adolescence (AOR = 1.23, 95 % CI: 1.11, 1.36), being a female newborn (AOR = 1.15, 95 % CI: 1.05, 1.26), single marital status (AOR = 0.87, 95 % CI: 0.78, 0.96) and higher educational status (AOR = 0.83, 95 % CI: 0.74, 0.93) were significantly associated with adverse birth outcomes. From the community-level variables, women from Eastern Africa had positive significant association with adverse birth outcomes (AOR = 1.30, 95 % CI: 1.15, 1.46).

Conclusions

Nearly one-fourth of adolescent women in SSA experienced at least one type of adverse birth outcome. Low quality of ANC was significantly associated with adverse birth outcomes. Policymakers need to consider a comprehensive, essential, and minimal package of ANC to enhance the quality of ANC, which is crucial for better adolescent birth outcomes.

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22 个撒哈拉以南非洲国家少女产前保健服务利用质量与不良分娩结果之间的关系。混合效应多层次分析

本研究旨在评估产前保健（ANC）服务利用质量与撒哈拉以南非洲地区（SSA）青少年女性不良分娩结局之间的关系。方法利用最近来自 22 个撒哈拉以南非洲地区国家的人口健康调查（DHS）数据，采用两级混合效应模型。采用双变量和多变量多层次分析来评估个人和社区因素与不良生育后果之间的关系。固定效应模型的结果以调整后的几率比（AORs）和 95% 的置信区间（95% CIs）来解释。本研究发现，接受高质量产前护理与不良分娩结局发生率降低 28% 相关（AOR = 0.72，95% CI：0.63, 0.83）。在个人层面的因素中，中年青春期（AOR = 1.23，95 % CI：1.11，1.36）、女性新生儿（AOR = 1.15，95 % CI：1.05，1.26）、单身婚姻状况（AOR = 0.87，95 % CI：0.78，0.96）和较高的教育程度（AOR = 0.83，95 % CI：0.74，0.93）与不良分娩结局显著相关。从社区层面的变量来看，来自东非的妇女与不良分娩结局呈显著正相关（AOR = 1.30，95 % CI：1.15，1.46）。低质量的产前护理与不良分娩结局有很大关系。政策制定者需要考虑全面、基本和最低限度的产前护理一揽子计划，以提高产前护理的质量，这对改善青少年的分娩结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.