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Adolescent pregnancies in Addis Ababa
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Addis Ababa University, Addis Ababa, P.O. Box 7076, Ethiopia.
Objective:
To determine the pattern, obstetric outcome, knowledge and practice of modern family planning methods and factors that predispose to pregnancy among adolescent mothers.
Design:
A descriptive study comparing findings in adolescent and mature mothers.
Setting:
Two teaching Hospitals in Addis Ababa.
Subjects:
Adolescent mothers under 20 years of age and mature mothers aged between 20 and 34 years.
Main Outcome Measures:
Age at pregnancy, demographic variables, gestational age, parity, antenatal care attendance, modes of deliveries, birthweight, Apgar scores, condition of babies at birth and knowledge and utilisation of modern contraceptive methods.
Results:
Five hundred and sixty nine (74%) of the adolescents were single compared with 226 (29%) of mature mothers (p<0.001, OR 6.83, 95%; CI=5.47-8.45). There were 391 (51%) unemployed adolescents compared with 99 (13%) of mature mothers (p<0.001, OR 7.0, 95% CI 3.06-5.05). Five hundred and twelve (67%) of the adolescent pregnant mothers failed to attend antenatal clinic compared with 344 (45%) of the mature mothers (p<0.001, OR 0.41, 95% CI=0.33, 0.5). Two hundred (26%) of adolescent mothers underwent Caesarean section compared with 82 (11%) of mature mothers (p<0.001, OR 2.44, 95% CI=1.90, 4.56). Two hundred and fifty six (33%) of the adolescent mothers delivered low birthweight babies compared with 106 (14%) of mature mothers (p<0.001, OR 3.12, 95% CI=2.4, 3.99). The one and five minute Apgar scores were less than seven in 301 (39%) babies born to adolescent mothers compared with 20 (27%) babies born to mature mothers (p<0.001, OR 1.73, 95% CI=1.39, 2.14. Five hundred and twelve (67%) of adolescent mothers had no knowledge about modern contraceptive methods compared with 147 (19%) mature mothers (p<0.001, OR 0.12, 95% CI=0.45-0.49).
Conclusion:
Adolescent pregnancy is common in the city of Addis Ababa. Adolescent pregnancy study revealed low birthweight, high Caesarean section rate and foeto-pelvic disproportion as a consequence of incomplete development of the bony pelvis. Improved education and contraceptive services are needed to reduce the incidence of adolescent pregnancy.