Low Birth Weight and Prematurity in Teenage Mothers in Rural Areas of Burkina Faso

Background: Adolescence is associated with adverse fetal outcome, particularly in resources limited settings. We assessed the association between mother’s age and low birth weight or prematurity in Nanoro, a rural health district of Burkina Faso. Methods: We collected data on mothers and their newborns in the framework of the “Safe and Efficacious Artemisinin-based Combination Treatments for African Pregnant Women with Malaria” clinical trial. Low birth weight or prematurity was defined as adverse fetal outcome. Logistic regression was used to compare its occurrence in teenagers and in women aged ≥ 20 years. Results: From June 2010 to November 2013, 870 pregnant women enrolled in the PREGACT study were treated for a Plasmodium falciparum infection and followed up until delivery. Of the 823 women with singleton live-borns, 205 (24.9%) were teenagers of whom 44 (5.3%) were minors (15-17 years). Up to 91.7% of adolescents presented with anemia at entry. The incidence of adverse fetal outcome in teenagers was 39.8%, increasing to 50.0% in minors. Anemic adolescents were significantly at higher risk of delivering low birth weight or preterm babies compared to their older counterparts. In multivariate analysis, teenagers with both anemia and fever presented the highest and significant odds ratios of adverse fetal outcome, whatever was their BMI: Teenagers with anemia, fever and high BMI at entry, AOR=3.46, 95% CI: (1.40, 8.58), teenagers with anemia, fever and low BMI at entry, AOR=2.86, 95% CI: (1.14, 7.13). Conclusion: Teenager’s pregnancy is associated with adverse fetal outcome in the rural health district of Nanoro, mainly when teenagers experiment anemia and fever. In low resources setting, multidisciplinary approach including education and setting up favorable socio-economic environment are needed to prevent early motherhood.