Outcomes of Neonates Born to Adolescent Mothers: a Hospital-based Cross-sectional Study at Kapenguria County Referral Hospital, West Pokot County.

Abstract

Background: Adolescent pregnancy is a high risk state that needs specialized care during the antenatal period for a quality outcome. Pregnancies among adolescents have been associated with unfavorable maternal and neonatal outcomes including maternal anemia, premature delivery, neonatal deaths, and low delivery weight. Most of these pregnancies occur in marginalized communities. Globally, adolescents (10-19 yrs) constitute 16 percent of the global population. Although a well-recognized public health problem, there is a paucity of local research on pregnancy outcomes of adolescent pregnancies. Objective: To determine neonatal outcomes and associated factors among babies born to adolescent mothers at Kapenguria County Referral Hospital. Methods: We conducted a retrospective hospital study of mothers who gave birth in Kapenguria County Referral Hospital. A sum of 1234 (617 adolescent and 617 non-adolescent mothers) participants were enrolled. The data was collected from the Maternal Services Health Facility Register (MoH 333) from January 2018 to December 2020 by trained personnel. Data was then entered into an excel spread sheet and analyzed using Statistical Package for Social Sciences. (SPSS v26). Results: Fewer adolescents 25% (n =137) compared to older mothers 46.9% (n =276) attended four or more ANC visits. The association was statistically significant (p<0.01). Premature births were significantly higher in older women (11%) compared to adolescents (6.5%) (OR = 1.8, 95%CI: 1.2, 2.7, p =0.003).The proportion of low birth weight was similar in adolescents compared to older women although the association was not significant (12% vs 12.5%, p = 0.435). There was a higher proportion of adolescents who had babies with a low Apgar score at 5 minutes 14 although the association was not significant, (7.3% vs 5.3%, p =0.179). The rates of neonatal deaths were comparable in adolescents (2.8%) and older women (2.8%). Conclusion: Adolescent mothers attended fewer ANC visits than non-adolescents. They had lower rates of premature births and higher rates of low Apgar score at 5 minutes. However, the rates of low birth weight and neonatal mortality were similar in adolescent and non-adolescent mothers. Thus, there is a need for intensification of public health interventions and campaigns to increase ANC visits for adolescent mothers. Additionally, there is a need for large population-based studies to be conducted as different hospital-based studies have yielded heterogeneous results.