Pregnancy and Childbirth in Unmarried Adolescents at the Commune V District Hospital in Bamako, Mali

Introduction: Pregnancy and childbirth are frequent among adolescents and carry a high risk of maternal and foetal morbidity and mortality in unmarried adolescents. We undertook this study with the aim of investigating the factors associated with pregnancy and childbirth in unmarried adolescents at the Hospital of Commune V, District of Bamako, Mali. Materials and Methods: This was a cross-sectional study with retrospective data collection and case-control analysis over 60 months. The variables studied were sociodemographic, in relation to maternal morbidity and mortality, and in relation to perinatal morbidity and mortality. Results: For a minimum sample size of 460 cases and 920 controls, we collected 540 cases and 1080 controls. Births of unmarried adolescents accounted for 1.35% of all births. The most common age group was 16 to 17 years old, i.e. 64.1%, with an average age of 17.5 years old. Pupils/students were in the majority, accounting for 11.66% of cases compared with 3.70% of controls. Almost all the pregnancies were unwanted. We recorded 9.38% caesarean deliveries among the adolescent cases, compared with 12.34% among the controls. Eclampsia was the most common complication at 1.2%, followed by endometritis (0.24%) and breast abscess (0.12%). The APGAR score was morbid in 4.38% of cases versus 2.96% of controls (p = 0.000). There were twelve maternal deaths, five in the cases (infection (2), eclampsia, anemia and HIV) and seven in the controls PPH (3), post caesarean section peritonitis (2), eclampsia and heart disease (p = 0.344). Our study enabled us to identify links between various factors, including: the father’s information and his profession, the parents’ family situation and communication within the family, the mother’s working hours and communication within the family, the parents’ financial situation and the adolescent’s family situation, the reproducer’s level of education and knowledge, the reproducer’s level of education and profession, parity and the occurrence of pre-eclampsia. Conclusion: Childbirth in unmarried adolescents is associated with a poor prognosis. The use of contraceptive methods and high-quality antenatal, peripartum and postnatal care improve indicators of maternal and neonatal morbidity and mortality.