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Obstetric outcome of teenage pregnancies at a tertiary hospital in Enugu, Nigeria
HU Ezegwui, LC Ikeako, F Ogbuefi
Nigerian Journal of Clinical Practice , 2012,
Abstract: Context: Maternal age, parity, and socioeconomic class are important determinants of obstetric outcome of pregnancy. Teenage pregnancy constitutes a high risk pregnancy with complications arising from a combination of physiological, anatomical, and socioeconomic factors. Objective: The objective was to determine the current incidence of all teenage pregnancies and their obstetric outcomes at UNTH, Enugu. Materials and Methods: This was a retrospective review of all teenage pregnancies at University of Nigeria Teaching Hospital, Enugu over a 6-year period (2000--2005). A total of 74 teenage pregnancies were analyzed and compared with 105 controls (adult mothers). Results: Records of 74 teenage pregnancies were identified within the study period which constitutes 1.67% of 4422 deliveries within the period. Majority of the teenagers (78.3%) were nulliparous. There was statistically significant differences between the teenage mothers and older mothers in the rate of unemployment (75.7% vs. 24.8%, P = 0.000), booking status (41.9% vs. 100%, P = 0.000) anemia (32.4% vs. 24.8%, P = 0.001), unsure of last menstrual period (32.4% vs. 15.2%, P = 0.007), caesarean section (18.9% vs. 10.5%, P = 0.000), cephalopelvic disproportion as an indication for caesarean section (9.4% vs. 3.8%, P = 0.001), preterm delivery (18.9% vs. 11.4%, P = 0.001), low birth weight (23.0% vs. 10.5%, P = 0.005), episiotomy (61.7% vs. 28.7%, P = 0.001), instrumental delivery (6.8% vs. 2.9% P = 0.001), Apgar score at 1 minute (35.1% vs. 19.1% P = 0.005), and perinatal mortality (16.2% vs. 12.4%). There were no maternal deaths. Conclusion: Pregnant teenagers are at higher risk than their older counterparts. Female socioeducational development and proper use of contraceptive services will help reduce teenage pregnancy rate, while perinatal care will help to minimize it associated hazards.
Outcome of Teenage Pregnancy  [PDF]
M Tripathi,A Sherchand
Journal of Universal College of Medical Sciences , 2014, DOI: 10.3126/jucms.v2i2.11168
Abstract: INTRODUCTION: Teenage pregnancy is coming up as one of the most important social and public health problem all over the world. Teenage pregnancy is a common social phenomenon with public health and medical consequences worldwide. The study was done to compare obstetric and perinatal outcome in teenage and non-teenage pregnancies.
Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria
Ago BU,Abeshi S,Njoku C,Agan TU
Adolescent Health, Medicine and Therapeutics , 2012,
Abstract: Boniface Uji Ago, Sylvester Abeshi, Charles Njoku, Thomas Udagbor Agan, John EkabuaDepartment of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaBackground: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH) in Nigeria.Methods: A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared.Results: There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery) between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02) and more preterm labor (P = 0.05), and delivered more low-birth-weight babies (P = 0.02).Conclusion: Supervised teenage pregnancy may not be as hazardous as previously thought.Keywords: teenage pregnancy, booked pregnancy, obstetric outcome
Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria
Ago BU, Abeshi S, Njoku C, Agan TU, Ekabua J
Adolescent Health, Medicine and Therapeutics , 2012, DOI: http://dx.doi.org/10.2147/AHMT.S35234
Abstract: stetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria Original Research (1697) Total Article Views Authors: Ago BU, Abeshi S, Njoku C, Agan TU, Ekabua J Published Date October 2012 Volume 2012:3 Pages 105 - 109 DOI: http://dx.doi.org/10.2147/AHMT.S35234 Received: 19 July 2012 Accepted: 14 August 2012 Published: 25 October 2012 Boniface Uji Ago, Sylvester Abeshi, Charles Njoku, Thomas Udagbor Agan, John Ekabua Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria Background: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH) in Nigeria. Methods: A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared. Results: There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery) between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02) and more preterm labor (P = 0.05), and delivered more low-birth-weight babies (P = 0.02). Conclusion: Supervised teenage pregnancy may not be as hazardous as previously thought.
Obstetric Outcome of Teenage Pregnancy in Kano, North-Western Nigeria
A Omole-Ohonsi, RA Attah
West African Journal of Medicine , 2010,
Abstract: BACKGROUND: Teenage pregnancies are regarded as high risk, because they often occur outside marriage. There is the need to evaluate the outcome of teenage pregnancies in a predominantly Islamic society like Kano where most occur within marriage, and timely prenatal care is usually available to most of them. OBJECTIVE: To review the obstetric outcome of teenage primigravida in Aminu Kano Teaching Hospital, Kano, Nigeria. METHODS: A retrospective case-control study of 500 booked teenage primigravidae, who delivered in our labour ward from January 2002 to December 2005 (study group) was performed. Their obstetric outcome was compared with that of an equal number of booked primigravidae aged 20–34 years, who met the recruitment criteria and delivered immediately after a selected teenage mother (control group). The study variables of interest were the demographic characteristics of the women in the two groups, antenatal/intrapartum complications and neonatal outcome. RESULTS: There were no significant differences in the mean birth weight, mean gestational age at delivery, mean height and perinatal mortality between the two groups, but mean maternal weight and body mass index (BMI) were higher among the older women. The teenage mothers had increased incidence of preterm labour and low birth weight infants (P < 0.05). The incidence of caesarean section and instrumental deliveries were lower among the teenage mothers. CONCLUSION: The results of this study show that teenage mothers who receive good family and community support, timely quality antenatal care and deliver in the hospital, should expect similar obstetric outcome to that of their older peers.
Obstetric Outcome of Teenage Pregnancy  [PDF]
S Kayastha,A Pradhan
Nepal Journal of Obstetrics and Gynaecology , 2012, DOI: 10.3126/njog.v7i2.11139
Abstract: Aims: To assess the prevalence of teenage pregnancies and to compare the obstetric performance of teenage pregnant woman with that of adult pregnant woman. Methods: A prospective study was conducted in Nepal Medical College Teaching Hospital from August, 2010 to February, 2012 (one and half year duration). All the teenage pregnancies were included and outcomes were compared with adult (20-24 years) pregnancies, selected randomly who had delivered during the same period of time. The patient characteristics (age, gravidity, parity, gestation age) and obstetric outcome (medical and obstetrical complications, mode of delivery, complications during delivery, fetal outcome, birth weight) were compared between the two groups. Statistical analysis was preformed using PHSTATZ and Z test for proportion. Results: There were total 2708 deliveries during the study period, out of which teenage pregnancy was 264 (9.7%). There were 69(26.1%0) teenage mothers of age 16 to 17 years and 195(73.9%) of age group 18 to 19 years. As expected, maximum patients in the test group i.e. teenagers were primigravida as compared to control group. (90.1% vs. 68.5%). As for mode of delivery, normal delivery in test and control was 82.9% vs 81.1% (p=0.56) and rate of cesarean delivery was similar 10.2% and 10.7%, (p=0.84) in both the groups. The incidence of instrumental delivery was more in control group although it was not statistically significant( 0.7% vs 2.2%, p=0.16). Preterm delivery was 3.0% in teenage as compared to control which is 2.2%. The percentage of intrauterine fetal death was 0.7% vs 0% in test and control group (p=0.15). Proportion of low birth weight babies in test and control group was 7.2% vs 5.9% (p=0.55). Similarly pregnancy related complications were also compared in teenage and control groups. It was found that postpartum hemorrhage occurred more in teenage pregnancy 1.8% vs 0.7% (p=0.84) but statistically not significant. Incidence of hypertensive disorders was 6.4% and 5.6% (p=0.66) in test and control group. Proportion of babies with intrauterine growth restriction was 3.0% in test and 1.1% (p=0.009) in control, the only parameter that is statistically significant. Fetal congenital anomaly was 0.7% vs 0.4% (p=0.54) Conclusions: Teenage pregnancy can have an equally good outcome if we give good obstetric care and encourage institutional delivery. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11139 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 29-32
A comparison of obstetrics and perinatal outcomes of teenagers and older women: Experiences from rural South Africa
Monjurul Hoque,Shahnaz Hoque
African Journal of Primary Health Care & Family Medicine , 2010, DOI: 10.4102/phcfm.v2i1.171
Abstract: Background: Teenage pregnancy is a known risk factor for a negative pregnancy outcome and poses a health risk to teenagers; it is thus considered a public health problem. It is also an indicator of problems with the sexual and reproductive health of a country’s young population. In South Africa, most of the adolescent pregnancies are to be found within the context of unstable relationships with the father of the baby and are unplanned or unwanted. Objectives: This study estimates and compares the incidence of adverse obstetric and perinatal outcomes of teenage women with older women, to identify specific health needs of teenage mothers during pregnancy and delivery. Methods:A retrospective cohort study targeted pregnant women who delivered at Empangeni Hospital from April to December 2005, whilst comparing the obstetric and perinatal outcomes of all teenage (ages < 19 years) pregnant women with those of older pregnant women (ages ≥ 19 years) for this study period. Data were collected from the labour ward delivery registry. Pearson’s chi-square test was performed to measure the level of significance (alpha = 0.05) for association amongst variables. The student t-test was used to find the significance difference between two proportions and the binary logistic regression method was employed to find the significant predictor for outcome variables. Results:There were 7836 deliveries over the study period, of which 1236 (16%) were teenage mothers.The rate of gestational age at delivery (e.g. pre-term delivery of 12%), vaginal and forceps deliveries,foetal presentation at birth, multiple pregnancies, low birth-weight and live births deliveries and mean Apgar scores were similar for both groups. The caesarean delivery rate (20%) and macerated stillbirth rate (1.1%) were significantly lower (p < 0.05) for teenagers than for older women. Conclusion: Although there was a higher rate of teenage pregnancy, it did not appear that it was associated with extra perinatal negative outcome such as preterm delivery, low birth-weight delivery and stillbirth. However, strategies are urgently needed to delay conception and improve the socio-economic development of teenage girls. How to cite this article:Hoque M, Hoque S. A comparison of obstetrics and perinatal outcomes of teenagers and older women: Experiences from rural South Africa. Afr J Prm Health Care Fam Med.2010; 2(1), Art. #171, 5 pages.DOI: 10.4102/phcfm.v2i1.171
Obstetrical and Perinatal Outcomes of Teenage Pregnant Women Attending a Secondary Hospital in Hyderabad  [PDF]
Sana Zahiruddin, Pushpa Chetandas, Sheikh Irfan Ahmed, Raheela Baloch
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.75052
Abstract: Objective: To evaluate the frequency of adverse maternal and perinatal outcomes in teenage pregnancies at secondary hospital Hyderabad. Methods: Retrospective record review was conducted between January 2012 to January 2016. Total No. of deliveries was 15,395 out of which No. of teenage was 452. Results: Rate of teenage pregnancy in our hospital during study period was 2.93%. Majority of women were uneducated. Teenage mother more likely to develop pregnancy induced hypertension 19.5%, frequency of mild, moderate, and severe anemia were reported to be 69.9%, 28.8% and 1.3% respectively. Conclusion: Fetal and neonatal outcome was not adversely affected. Teenage pregnancy outcome can be achieved favorable with good antenatal care.
Perinatal morbidity and early neonatal mortality in twin pregnancies  [PDF]
Corinna Peter, Paul Wenzlaff, Jan Kruempelmann, Gerhard Alzen, Eva Bueltmann, Susanne E. Gruessner
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.31017
Abstract:

Purpose: The purpose of this study was to investigate the impact of maternal, fetal and obstetric parameters in twin pregnancies due to chorionicity, perinatal morbidity and early neonatal mortality. Methods: Early neonatal outcome parameters were retrospectively analysed in 240 twin pregnancies (51 monochorionic [MC], 189 dichorionic [DC] twins) over a 7.5 years period. Beside chorionicity, we focused on risk factors affecting perinatal morbidity and early neonatal outcome in the overall study cohort and subgroups 1) late preterm and 2) pregnancies conceived by artificial fertilization (IVF/ICSI). Mixed effects logistic regression models were used for multivariate risk analyses. Results: MC vs DC pregnancies showed significantly lower birth weights (p < 0.01), decreased gestational ages (p < 0.01), increased rates of mechanical ventilation (p < 0.05) and higher early neonatal mortality rates (p < 0.05). Additional risk factors for perinatal morbidity and adverse early neonatal outcome were prematurity (<36 completed weeks of gestation), severe intertwin birth weight discordance >25% and amniotic inflammation (amniotic infection syndrome [AIS]). A gestational age >36 completed weeks was accompanied by a decrease of early neonatal complications (p < 0.05). Pregnancies conceived by IVF/ ICSI didn’t differ from the overall study cohort regarding the investigated risk factors. Conclusions: Twin pregnancies complicated by prematurity, AIS and severe intertwin birth weight discordance are associated with higher perinatal morbidity and adverse early neonatal outcome. In addition, MC twins are jeopardized by an increased early neonatal mortality and therefore represent considerable challenges to both obstetricians and neonatologists. Based on our results, we recommend such twin pregnancies to be monitored and delivered at tertiary perinatal care centres to minimize perinatal morbidity and adverse early neonatal outcomes.

Diabetes and Perinatal Mortality in Twin Pregnancies  [PDF]
Zhong-Cheng Luo, Yan-Jun Zhao, Fengxiu Ouyang, Zu-Jing Yang, Yu-Na Guo, Jun Zhang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0075354
Abstract: Background Diabetes in pregnancy has been associated with a paradoxically reduced risk of neonatal death in twin pregnancies. Risk “shift” may be a concern in that the reduction in neonatal deaths may be due to an increase in fetal deaths (stillbirths). This study aimed to clarify the impact of diabetes on the risk of perinatal death (neonatal death plus stillbirth) in twin pregnancies. Methods This was a retrospective cohort study of twin births using the largest available dataset on twin births (the U.S. matched multiple birth data 1995-2000; 19,676 neonates from diabetic pregnancies, 541,481 from non-diabetic pregnancies). Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR) of perinatal death accounting for twin cluster-level dependence. Results Comparing diabetic versus non-diabetic twin pregnancies, overall perinatal mortality rate was counterintuitively lower [2.1% versus 3.3%, aHR 0.70 (95% confidence intervals 0.63-0.78)]. Individually, both stillbirth and neonatal mortality rates were lower in diabetic pregnancies, but we identified significant differences by gestational age and birth weight. Diabetes was associated with a survival benefit in pregnancies completed before 32 weeks [aHR 0.55 (0.48-0.63)] or with birth weight <1500 g [aHR 0.61 (0.53-0.69)]. In contrast, diabetes was associated with an elevated risk of perinatal death in pregnancies delivered between 32 and 36 weeks [aHR 1.38 (1.10-1.72)] or with birth weight >=2500 g [aHR 2.20 (1.55-3.13)]. Conclusions Diabetes in pregnancy appears to be “protective” against perinatal death in twin pregnancies ending in very preterm or very low birth weight births. Prospective studies are required to clarify whether these patterns of risk are real, or they are artifacts of unmeasured confounders. Additional data correlating these outcomes with the types of diabetes in pregnancy are also needed to distinguish the effects of pre-gestational vs. gestational diabetes.
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