Outcome of delivery in nulliparous teenagers aged less than 17 years: the cameroon university centre hospital experience

Pierre Marie Tebeu, Inoussa Nsangou, Philippe Nana Njotang, Paul Théodore Tjek Biyaga, Anderson Sama Doh, Joseph Nelson Fomulu
DOI: 10.4236/ojog.2011.12010                

Abstract

In a previous study at the Yaoundé-Cameroon University Centre Hospital, we found that delivery at extreme ages of reproductive health was associated with several fetal and maternal risks. We conducted this study aimed at testing the hypothesis that deliveries by teenagers were associated with increased risk. Data collection was retrospective from delivery room registers at between 01/01/1996 and 31/12/2000. Data were collected in singleton pregnancies. The identification of each nulliparous woman aged less than 17 years was followed by that of 4 nulliparous women aged 20 - 29 years following her in the order of delivery. Since it was possible to have consecutive nulliparous teenage pregnancies before four deliveries in women in their twenties, we finally compared 65 cases of teenagers delivery with 218 cases of delivery in women aged 20 - 29 years. The difference was considered significant if p value was less than 0.05. Odd ratio with 95% confidence interval was used to measure the effect of age on the major outcomes. At univariate analysis, the risk of delivery by caesarean section for teenagers (21.5%) was significantly high compared to women in their twenties (11.5%), (OR: 2.1; 95%CI: 1.0 - 4.1; p = 0.041). Similar observation was found for stillbirth delivery with 12.3% by teenagers compared to 5.0% by women in their twenties (OR: 2.7; 95%CI: 1.0 - 7.1; p = 0.044). The risk of premature delivery by teenagers (30.8%) was also significantly increased compared to women in their twenties (12.4%) (OR: 3.6; 95%CI: 1.8 - 7.1; p = 0.0002). After adjustment for different factors associated with the occurrence of several risks, only pre term delivery remained significantly increased at teenage (OR: 3.7; 95%CI: 1.8 - 7.6; p = 0.003). These findings underscore the importance of public health programs in preventing the pregnancy in teenagers, and in developing age-appropriate intervention.

Keywords

Adolescent; Delivery; Risk

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Mahavarkar, S.H., Madhu, C.K. and Mule, V.D. (2008) A comparative study of teenage pregnancy. American Journal of Obstetrics & Gynecology, 28, 604-607. doi:10.1080/01443610802281831
[2]	Maryam, K. and Ali, S. (2008) Pregnancy outcome in teenagers in East Sauterne of Iran. Journal of Pakistan Medical Association, 58, 541-544.
[3]	Chang, S.C., O′Brien, K.O., Nathanson, J. and Witter, F.R. (2003) Characteristics and risk factors for adverse birth outcome in pregnant black adolescents. Journal of Pediatrics, 143, 250-257. doi:10.1067/S0022-3476(03)00363-9
[4]	Dos Santos, G.H., Martins, M.G. and Sousa, M.S. (2008) Teenage pregnancy and factors associated with low birth weight. Revista Brasileira de Ginecologia e Obstetrícia, 30, 224-231.
[5]	Trivedi, S.S. and Pasrija, S. (2007) Teenage pregnancies and their obstetric outcomes. Tropical Doctor, 37, 85-88. doi:10.1258/004947507780609437
[6]	Lewis, L.N., Hickey, M., Doherty, D.A. and Skinner, S.R. (2009) How do pregnancy outcomes differ in teenage mothers? A Western Australian study. The Medical Journal of Australia, 190, 537-541.
[7]	Mahavarkar, S.H., Madhu, C.K. and Mule, V.D. (2008) A comparative study of teenage pregnancy. American Journal of Obstetrics & Gynecology, 28, 604-607. doi:10.1080/01443610802281831
[8]	Tebeu, P.M., Tantchou, J., Obama Abena, M.T., Mevoula, O.D. and Leke, R.J. (2006) Delivery outcome of adolescents in Far North Cameroon. Revue Medicale de Liege, 61, 124-127.
[9]	Tebeu, P.M., Kemfang, J.D., Sandjong, D.I., Kongnyuy, E., Halle, G. and Doh, A.S. (2010) Geographic Distri- bution of Childbirth among Adolescents in Cameroon from 2003 to 2005. Obstetrics and Gynecology International.
[10]	Maryam, K. and Ali, S. (2008) Pregnancy outcome in teenagers in East Sauterne of Iran. Journal of Pakistan Medical Association, 58, 541-544.
[11]	Quinlivan, J.A. and Evans, S.F. (2002) The impact of continuing illegal drug use on teenage pregnancy outcomes: A prospective cohort study. British Journal of Obstetrics and Gynaecology, 109, 1148-1153. doi:10.1111/j.1471-0528.2002.01536.x
[12]	Tebeu, P.M., Major, A.L., Ludicke, F., Obama, M.T., Kouam, L. and Doh, A.S. (2004) Devenir de l’accouchement aux ages extrêmes de la vie reproductive. Revue Medicale de Liege, 59, 455-459.
[13]	Ebeigbe, P.N. and Gharoro, E.P. (2007) Obstetric complications, intervention rates and maternofetal outcome in teenage nullipara in Benin City, Nigeria. Tropical Doctor, 37, 79-83. doi:10.1258/004947507780609356
[14]	Trivedi, S.S. and Pasrija, S. (2007) Teenage pregnancies and their obstetric outcomes. Tropical Doctor, 37, 85-88. doi:10.1258/004947507780609437
[15]	Unfer, V., Piazze Garnica, J., Benedetto, M.R., Castabile, L., Gallo, G. and Anceschi, M.M. (1995) Pregnancy in adolescents. A case control study. Clinical & Experimental Obstetrics & Gynecology, 22, 161-164.
[16]	MacKenzie, I.Z., Cooke, I. and Annan, B. (2003) Indications for caesarean section in a consultant obstetric unit over three decades. American Journal of Obstetrics & Gynecology, 23, 233-238. doi:10.1080/0144361031000098316
[17]	Metello, J., Torgal, M., Viana, R., Martins, L., Maia, M. and Casal, E., et al. (2008) Teenage pregnancy outcome. Revista Brasileira de Ginecologia e Obstetrícia, 30, 620-625. doi:10.1590/S0100-72032008001200006
[18]	Bujold, E., Mehta, S.H., Bujold, C. and Gauthier, R.J. (2002) Interdelivery interval and uterine rupture. American Journal of Obstetrics & Gynecology, 187, 1199-1202. doi:10.1067/mob.[phone]
[19]	Huang, W.H., Nakashima, D.K., Rumney, P.J., Keegan, K.A. and Chan, K. (2002) Interdelivery interval and the success of vaginal birth after cesarean delivery. American Journal of Obstetrics & Gynecology, 99, 41-44. doi:10.1016/S0029-7844(01)01652-0
[20]	Yetman, T.J. and Nolan, T.E. (1989) Vaginal birth after cesarean section: A reappraisal of risk. American Journal of Obstetrics & Gynecology, 161, 1119-1123.
[21]	Olausson, P.O., Cnattingius, S. and Haglund, B. (2001) Does the increased risk of preterm delivery in teenagers persist in pregnancies after the teenage period? British Journal Obstetrics Gynecology, 108, 721-725.
[22]	Anate, M. and Akeredolu, O. (1996) Pregnancy outcome in elderly primigravidae at University of Ilorin Teaching Hospital, Nigeria. East Africa Medical Journal, 73, 548-551.
[23]	Quinlivan, J.A. and Evans, S.F. (2004) Teenage antenatal clinics may reduce the rate of preterm birth: A prospective study. British Journal of Obstetrics and Gynecology, 111, 571-578. doi:10.1111/j.1471-0528.2004.00146.x
[24]	Phipp,s M.G. and Sowers, M. (2002) Defining early adolescent childbearing. American Journal of Public Health, 92, 125-128. doi:10.2105/AJPH.92.1.125
[25]	Ndyomugyenyi, R. and Magnussen, P. (1999) Anaemia in pregnancy: Plasmodium falciparum infection is an important cause in primigravidae in Hoima district, western Uganda. Annals of Tropical Medicine and Parasitology, 93, 457-465. doi:10.1080/00034989958195
[26]	Ebeigbe, P.N. and Gharoro, E.P. (2007) Obstetric com- plications, intervention rates and maternofetal outcome in teenage nullipara in Benin City, Nigeria. Tropical Doctor, 37, 79-83. doi:10.1258/004947507780609356
[27]	Barnet, B., Duggan, A.K. and Devoe, M. (2003) Reduced low birth weight for teenagers receiving prenatal care at a school-based health center: Effect of access and comprehensive care. Journal of Adolescent Health, 33, 349-358. doi:10.1016/S1054-139X(03)00211-8
[28]	Malviya, M.K., Bhardwaj, V.K., Chansoria, M. and Khare, S. (2003) Anthropometric profile and perinatal outcome of babies born to young women (<18 years). Indian Pediatrics, 40, 971-976.