Open Journal of Obstetrics and Gynecology, 2012, 2, 239-243 OJOG
http://dx.doi.org/10.4236/ojog.2012.23049 Published Online September 2012 (http://www.SciRP.org/journal/ojog/)
Socio-demographic determinants of teenage pregnancy
in the Niger Delta of Nigeria
Ayuba Ibrahim Isa1*, Ibukun Olugbenga Owoeye Gani2
1Department of Ob s tetrics and Gynaec ology, College of Health Sciences, Niger Delta University, Amassoma, Nigeria
2Department of Community Medicine, College of Health Sciences, Niger Delta Unversity, Amassoma, Nigeria
Received 27 April 2012; revised 30 May 2012; accepted 13 June 2012
ABSTRACT
Sub-Saharan Africa has the highest rates of maternal
and neonatal mortality worldwide. Young maternal
age at delivery has been proposed as risk factor for
adverse pregnancy outcome, it occurs in all races,
faiths, socioeconomic statuses, and regions. Teenage
mothers are likely to be unmarried, poor and to sac-
rifice education. Isolation, unstable marriages, stress,
and guilt are among many social and psychological
problems. The aim of this study is to determine the
socio-demographic factors associated with teenage
pregnancy in our environment, in order to proffer
measures that can help curtail this continuing socio-
medical problem. The records of all teenage mothers
(aged 13 - 19) who had delivery at the Niger Delta
University Teaching Hospital, Bayelsa State, Nigeria,
over a period of 4 years (January 1 2007 to December
31 2010) were retrospectively reviewed. There were a
total of 1341 deliveries during the study period, out
which 83 were teenagers giving an incidence of 6.2%.
The age of the patients ranged from 14 to 19 years
with a mean age of (28.1 ± 5.7) years. Their parity
ranged from zero to three, with a mean of 2.4 ± 1.9.
About a third (20%/24.1%) were primigr avid ae, 3 3%/
39.9% had at least secondary education and majority
(48%/57.8%) were unbooked, unmarried (60%/72.3%),
unemployed (62%/74.7%) and of low social class.
Majority 71 (85.5%) of the teenage mothers had never
used any form of modern contraceptive method and
45 (54.2%) of them had terminated at least one preg-
nancy in the past. 26 (31.3%) had Caesarean sections,
majority of which were emergencies 22 (84.6%). It
was concluded that teenage mothers in the Niger
Delta tend to have unfavorable socio-demographic
and obstetric factors. Concrete measures must be put
in place to address these.
Keywords: Teenage Pregnancy; Socio-Demographic
Factors; Niger Delta
1. INTRODUCTION
Adolescence, according to WHO refers to the period
between the ages of 10 and 19 years in which the indi-
vidual progresses from the initial appearances of secon-
dary sexual characteristics to full sexual maturity and
during which psychological and emotional processes
develop from those of a child to those of an adult. It also
represents a transition from the state of socio-economic
dependence to one of rela t i ve independence [1,2] .
Adolescent pregnancy is defined as gestation in women
before having reached the full somatic development. The
percentage of childbearing adolescent women is region-
ally highly variable depending on cultural, religious, po-
litical, economic and other factors. Pregnancy in the very
young is generally considered to be a high risk event
because of the additional burden imposed by reproduc-
tion on a still growing body [3-5].
Large epidemiologic studies on this topic were how-
ever largely reported from high or medium income coun-
tries showing conflicting results. Most importantly to
date there is a lack of epidemiologic evidence from Sub-
Saharan Africa [6-10].
Most of the pregnancies result from coitus with their
first only partner, who often times is of similar age and
no more advantaged socially. Adolescent pregnancies
constitute major socio-medical and socio-econ omic prob-
lems in both developed and developing countries and are
becoming more prevalent in recent times [11].
The emergence of this adolescent problem has been
attributed to various factors including early marriage,
social permissiveness favouring early exposure to casual
sexual activity, poor knowledge, availability and use of
contraceptives, maternal deprivation, pre-existing psy-
chosocial problems in the family and general non-func-
tioning family unit among others [12-14].
In many developing countries, lack of resources makes
contraception and reproductive advice inaccessible. This
*Corresponding a uthor.

A. Ibrahim Isa, I. O. Owoeye Gani / Open Journal of Obstetrics and Gynecology 2 (2012) 239-243 240
situation may be exacerbated by religious beliefs that
disapprove of artificial birth control methods. The result
is that many adolescents, both married and unmarried
find it difficult to locate, or even seek help about sexual
matters. There may be few facilities offering such sup-
port, particularly in remote rural areas. The poorest often
lack the resources to travel to these facilities and any fees
charged for the services on offer would push them even
further out of reach. In some cases, the ante-natal clinic
is the only place where a young woman can obtain re-
productive advice, but pregnancy is a pre-condition.
Contraception may not be offered to married women
until they have born e a child. There is an urgent need for
“youth friendly” health services, as adolescents are
unlikely to seek help about sexual matters from a service
that is unsympathetic to their needs and anxieties. Girls
aged 15 to 19 give birth to 15 million baby a year. Many
of these girls give birth without attending an antenatal
clinic or receiving the help of a professional midwife. It
is essential to devise programs to reach girls in and out of
marriage with reproductive advice and services [15].
Complications seen in adolescents during pregnancy
include anaemia from malaria, infection and inadequate
nutrition, spontaneous abortions, preterm labour and de-
livery, pre-eclampsia and eclampsia, antepartium haem-
orrhage and feto pelvic disproportion with its attendant
risks of high operative intervention rates, obstructed la-
bour and its sequalae notably genital fistulae. In the pu-
erperium, puerperal sepsis, anaemia and other complica-
tions resulting from obstructed labour are common [16,
17]. Evidence shows that infant mortality among the
children is someti mes two times high er than among tho se
of old peers. A stronger likelihood of low birth-weight in
the infant has been recorded among adolescent mothers
than among older peers. This is mainly associated with
poor maternal nutrition. Low birth-weight babies are 5 -
30 times more likely to die than babies of normal weight
[18,19]. If a mother is under 18, her baby’s chance of
dying in the first year of life is 60 per cent higher than
that of a baby born to a mother older than 19. Part of this
heavy toll has more to do with poor socio-economic
status and lack of ante-natal and obstetric care than
physical maturity alone [20].
Cervical carcinoma, which is increasing in incidence
and presenting at a younger age, is directly linked to the
age of first intercourse and to the number of partners, and
the spread of infection by human immunodeficiency vi-
rus (HIV) is also linked to the number of sexual partners.
These medical problems emphasize the risks associated
with teenage intercourse, partic ularly if with a number of
partners, in addition to the risks of the pregnancy itself.
Pregnancy-related deaths are the leading cause of mor-
tality for 15 - 19 year-old girls (married and unmarried)
worldwide. Mothers in this age group face a 20 to 200
per cent greater chance of dying in pregnancy than
women aged 20 to 24 [21]. The socio-economic conse-
quences of adolescen t pregnancy include mor e unwanted
pregnancies and out-of-wedlock children, greater marital
instability, poor education, fewer assets and lower in-
come later in life. The problems associated with adoles-
cent pregnancy can be significantly reduced through sex
education, provision of contraceptive counseling and
services, education of women up to the University level
and medical, social and psychological support for af-
fected adolescents. Provision of good antenatal, intrana-
tal and postnatal care for these adolescents is also em-
phasized [22, 2 3] .
2. MATERIALS AND METHODS
The study is a four year retrospective study of Teenage
pregnancies managed at Niger Delta University Teaching
Hospital (NDUTH) Okolobiri, a tertiary hospital in
Bayelsa State, from January 1, 2007 to December 31,
2010. The sources of information were Antenatal, labour,
and neonatal ward records, theater records, patient’s re-
cords and case notes. The information obtained were
coded and transferred onto a profoma already design for
the study.
Variables relating to the socio demographic character-
istics of the women, antenatal an d intrapartum complica-
tions and neonatal outcome were obtained. Statistical
Analysis: Statistical analysis was performed with Statis-
tical Package for Social Sciences (SPSS version 10).
Ethical Consideration: Approval for this work was
given by the Ethical Committee of the NDUTH.
3. RESULTS
There were a total of 1341 deliveries, during the study
period, out whi c h 83 were te enagers (6.2%) .
The age of the patients ranged from 14 to 19 years
with a mean age of (28.1 ± 5.7) years. Their parity
ranged from zero to three, with a mean of 2.4 ± 1.9.
About a third 20 (24.1%) w ere primigravidae, 33 (39.9%)
had at least secondary education and majority 48 (57.8%)
were unbooked and unmarried 60 (72.3%) (Table 1).
Majority of the patients were of low social class, only
1 (4.3%) patient is of social class one (Table 2).
The three commonest complications are preterm la-
bour (51.8%), postpartum haemmorrhage (34.9%) and
anaemia in pregnancy (22.9%) (Table 3).
26 (31.3%) of the teenage mothers delivered by cae-
sarean section, (p = 0.014) maj ority of which were emer-
gencies 22 (84.6%), 55 (66.2%) had spontaneous vaginal
delivery, while 2 (2.5%) had instrumental vaginal de-
livery (Table 4).
There were 11 perinatal deaths with a perinatal mor-
tality rate of 133/1000. There was no maternal mortality.

A. Ibrahim Isa, I. O. Owoeye Gani / Open Journal of Obstetrics and Gynecology 2 (2012) 239-243 241
Table 1. Soc io-demographic characteristics of the patients.
Characteristics Teenage Mothers Freq (%)
Age (years)
14 - 16 20 (24.1)
17 - 19 63 (75.9)
Total 83 (100)
X + SD 17.8 + 1.3
95% CI 17.5 - 18.1
t = 24.25
Parity
0 20 (24.1)
1 - 3 63 (75.9)
4 - 7 0 (0)
>7 0 (0)
Total 83 (100)
x2= 55.37
Educational Status
Nil 19 (22.9)
Primary 26 (31.1)
Secondary 33 (39.9)
Tertiary 5 (6.1)
Total 83 (100)
x2= 16.29
Booking Status
Booked 35 (42.2)
Unbooked 48 (57.8)
Total 83 (100)
x2= 17.74
Marital Status
Married 23 (27.7)
Not Married 60 (72.3)
Total 83 (100)
x2= 27.2
4. DISCUSSION
The frequency of pregnancy during adolescence is highly
variable in Africa [8-10]. Cultural and religious norms
may be one of the reasons for these demographic differ-
ences. In addition, these cultural factors may modify
Table 2. Social class of patients with teenage pregnancy at
niger delta university teaching hospital (nduth) okolobiri (2007-
2010).
Social Class Frequency
I 1 (4.3)
II 3 (13.1)
III 4 (17.4)
IV 7 (30.4)
V 8 (34.8)
Total 23 (100)
Table 3. Pregnancy complications in teenage mothers.
Complication Teenage Mothers n = 83 Freq (%)
Iron Deficiency Anaemia19 (22.9%)
Preeclampsia 12 (14 .5%)
Aproptio Placenta 5 (6.0%)
Placenta Praevia 0 ( 0%)
Preterm Labour 43 ( 51.8%)
Postpartum Haemorrhage29 (34.9%)
Table 4. Route of delivery.
Teenage Mothers n = 83 Freq (%)
Spontaneous Vaginal Delivery55 (66.2)
Instrumental Delivery 2 (2.4)
Caesarean Section 26 (31.3)
Emergency 22 (84.6)
Elective 4 (15.4)
health care seeking behavior of young pregnant women
and may therefore constitute by themselves confounding
factors for pregnancy outcome as on ly 6.2% of the partu-
rient are teenagers in this study, which is lower than 9%
from Thailand, but higher than 1.7%, and 2.2% from
Benin and Ibadan in Nigeria respectively [22,23].
The review also revealed that, marital status, educa-
tional qualification and unemployment are important
socio-demographic factors contributing to teenage preg-
nancy, furthermore, majority of the patients were of low
social class. The social class of the patients were deter-
mine using the su mmation of the score obtained from the
educational status of the women and the occupation of
their hus bands [24].
Majority of them were single, unemployed, unbooked
with less formal education. This is similar to the finding

A. Ibrahim Isa, I. O. Owoeye Gani / Open Journal of Obstetrics and Gynecology 2 (2012) 239-243 242
from the same region [23]. In a study from Zimbabwe,
transport costs and costs for prenatal services have been
characterized as major factors influencing adolescents
late or non-utilization of prenatal services. In the same
study the limited knowledge of young women about an-
tenatal care programs and the fear of HIV testing have
been further obstacles to efficient antenatal care [25].
Contraceptive utilization among the patients showed
that 85.5% had never used any form of contraceptive.
Other studies had shown that only 3% - 5% of married
couples use a modern contraceptive method and 2% to
6% of the sexually active adolescents practice any form
of contraception [26].
In Nigeria, family planning services are few and pro-
viders tend to ignore or discriminate against single ado-
lescents. 54.2% had the history of at least one previous
termination of pregnancy. This finding is not surprising
because of the significantly low prevalence of contracep-
tive usage in our communities [26].
Anaemia in pregnancy, preeclampsia, preterm labour,
and postpartum haemmoraghe, were some of the obstet-
rics Complications documented among the teenagers
seen in this review. This is similar to findings from pre-
vious studies [5,23] most of these patients were referred
from private and public primary and secondary health
facilities both within and sometimes outside Bayelsa
state.
Several reasons for the high risk of delivering a low
birth weight infant by adolescent mothers have been
discussed in scientific literature. Anatomic immaturity
and continued maternal growth may represent biologic
growth barriers for the fetus. Moreover, adolescent moth-
ers may represent a particularly d isadvantaged risk group
characterized by low socioeconomic status, financial
income and level of education as was found from this
study [3,11, 2 0] .
Vaginal delivery was the major route of delivery in the
study group (66.2%), however, 31.3% had Caesarean
section, of which 84.6% were emergencies, often times,
and they had been in labour for more than 24 hours at
other centres and often referred late in the night with
varied reasons. This is the main reason why emergency
procedures accounted for a larger proportion of the cases.
This is similar to findings from previous studies [5,23].
In conclusion the socio-demographic factors and the
medical problems associated with teenage pregnancy
have been amply documented in this country and also by
this study. Amidst the poor er social segments parenthood
is seen as a sign of social status; however it is associated
with adverse fetal and maternal outcomes. The adverse
outcomes can be ameliorated by free and compulsory
education for the girl child, education of the populace
about the social and medical consequences of teenage
pregnancy, making contraceptives available to teens,
especially emergency contraceptives, quality antenatal
care, and provision of essential obstetric care.
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