A comparison of obstetrics and perinatal outcomes of teenagers and older women: Experiences from rural South Africa

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.