Outcomes of Adolescent Pregnancy -Gaza Governorate
نور اسعد الغريز
Adolescent pregnancy is considered a health risk for mother and her fetus and it is associated with high maternal, fetal and neonatal morbidity and mortality. This study aimed to examine the relationship between adolescent pregnancy and the increased risk for adverse pregnancy outcomes for both mothers and neonates in Gaza in order to shed light on the maternal and neonatal outcomes of adolescence pregnancy and to provide possible recommendations to help in reducing adverse outcomes of this health problem. A hospital based cross-sectional comparative study was carried out in The Obstetrics and Gynecology hospital at El Shifa Complexand included delivered women attended the hospital for delivery during the period of data collection. The study sample consisted of 110 cases (adolescent delivered mothers) and 110 matched controls (adult delivered mothers). Data were collected through a highly valid interviewing questionnaire by the researcher herself. findings showed that the mean age of cases was 18.1 years compared to 23.5 for controls. The researcher found that the adolescent mothers had a significantly higher incidence of preterm delivery, low birth weight babies, admission to neonate intensive care unit and meconium aspiration when compared to the control group (OR, 2.87; CI 95%, 1.15-7.20; OR, 1.86 CI 95%, 1.05 – 3.29; OR, 3.33, CI 95%, 1.83 – 6.06; OR, 4.51, CI 95%, 1.45 – 13.9, respectively). Furthermore, there was no statistically significant difference between the two groups regarding fetal distress, low Apgar score, birth asphyxia, stillbirth and neonatal malformation. Results also revealed that adolescent mothers had a significantly higher incidence of low educational level and access to antenatal care when compared to the control group (OR, 3.5; CI 95%, 1.5 - 8.3; OR, 2.50 CI 95%, 1.40 - 4.46 respectively). Regarding intrapartum outcomes, cesarean section, vacuum instrumental delivery, episiotomy, induction labor, abnormal amniotic fluid color were reported a significantly higher incidence among adolescent mothers (OR, 6.58; CI 95%, 1.8 - 23.3; OR, 5.55 CI 95%, 1.1 - 26.4; OR, 5.02, CI 95%, 2.83 - 8.92; OR, 1.55, CI 95%, 0.80 - 3.00; OR, 3.89, CI 95%, 1.59 – 9.50, respectively). In term of postpartum outcomes, adolescent mothers had a significantly higher incidence of postpartum hemorrhage and blood transfusion (OR, 3.16; CI 95%, 1.1 - 8.3; OR, 2.81 CI 95%, 0.96 - 8.18 respectively). Pregnant adolescent mothers had more maternal ,fetal and neonatal complications than those of pregnant adults. For that the researcher recommends a plan to enhance adolescent women's accessibility to the antenatal care and supplying them with extra nutrients during pregnancy to improve outcome and to decrease complications;increasing awareness of pregnant adolescentsabout importance of providing antenatal, intranatal and postnatal care; conducting more research studies are needed to address the other aspects of this public health problem in order to minimize its incidence and complications.