Factors associated with first pregnancy among adolescent and post adolescent women at Banadir Hospital, Mogadishu, Somalia

Abstract

Background Adolescent pregnancy is defined as, pregnancy occurring in young female aged10 to 19 years. It is a complex issue and challenge to families, health care professionals, educators, government authorities and the youth themselves. Several studies report that adolescent pregnancy is associated with adverse maternal and perinatal outcomes and is a contributing factor to maternal and neonatal mortality. Objective To compare factors associated with first pregnancy among adolescent versus post-adolescent women. Methodology A case control study was conducted at Banadir hospital, Mogadishu, Somalia, using structured questionnaires. Information was obtained through participants’ interview. The inclusion criteria were adolescent women aged 10 to 19 years with first pregnancy and post-adolescent women more than 20 years who become pregnant. The study period was between March 2016 and June 2016. Data analysis was done using SPSS version 18.0. Results: A total of 348 participants were recruited including 174 adolescent and 174 post-adolescent mothers. The mean ages of adolescent and post-adolescent mothers were 17.5 (SD ± 1.5) years and 23.2 (SD ± 3.1) years, respectively. There were no significant differences in terms of marital status (p = 0.466) and residence (p = 0.541) of adolescent and post-adolescent women. There was a significant association between first pregnancy among adolescent and post-adolescent mothers and the mothers’ contraceptive use (p = 0.001), contraceptive knowledge (p = 0.01), type of marriage (p < 0.001). Adolescent first time mothers were less likely to have ever used contraceptives, OR = 0.21, 95% CI 0.08-0.51, and were also less likely to know a method that protects from both pregnancy and STI, OR 0.46, 0.26-0.83. Forced marriages were more likely among adolescent first time mothers, OR = 2.38, 1.51-3.76. In the adjusted analysis never having used contraceptive was the factor that showed significant association with first time adolescent pregnancy. Conclusion Among the three group of factors that were explored for association with first time adolescent pregnancy namely demographic risk factors, socio-economic risk factors and reproductive health and knowledge it was evident that reproductive health and knowledge showed the strongest association with adolescent pregnancy. This study is a necessary first step in addressing the public health problem faced by adolescent mothers in Somalia, a country with limited access to high quality obstetrical care and a setting in which most deliveries occur at home.