A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: the case of Luapula Province, Zambia.

Background: About three in ten young women aged 15-19 have begun childbearing among the Zambian population, with adolescent pregnancy levels as high as 35% in rural areas. In 2009, Luapula reported 32.1% adolescent pregnancies. The study sought to investigate obstetric and perinatal outcomes among adolescents compared to mothers aged 20-24 years delivering at selected health facilities in Kawambwa and Mansa districts of Luapula.

Methods: A retrospective analysis was carried out of all deliveries to mothers aged between 10 and 24 years for the period January 2012 to January 2013. A total of 2795 antenatal and delivery records were reviewed; 1291 adolescent mothers and 1504 mothers aged 20-24 years. Crude and adjusted odds ratios for the association between maternal age and adverse obstetric and perinatal outcomes were obtained using logistic regression models.

Results: The mean age of the adolescent mothers was 17.5 years. Mothers younger than 20 years faced a higher risk for eclampsia, anaemia, haemorrhage, Cephalopelvic disproportion, prolonged labour and caesarean section. After adjustment for potential confounders, the association between maternal age and adverse obstetric and perinatal outcome diminished. Children born to mothers younger than 20 were at increased risk for low birth weight, pre-term delivery, low Apgar score and neonatal death; the risk for asphyxia, however, tended to increase with age.

Conclusion: The findings demonstrate that adolescent pregnancy increases the risk of adverse obstetric and perinatal outcomes. High rates of adolescent pregnancies in Luapula province are likely as a result of the predominantly rural and poor population. Understanding the factors that contribute to the high levels of adolescent pregnancy in the region will be vital in addressing the situation and subsequently reducing the high obstetric and perinatal morbidity and mortality.