Obstetrical and Perinatal Outcomes of Adolescent Pregnancies in Cameroon: A Retrospective Cohort Study at the Yaoundé General Hospital

Jean Dupont Kemfang Ngowa^1,2*, Jean Marie Kasia^1,2, Walter Dobgima Pisoh², Anny Ngassam², Cyrille Noa²

¹Obstetrics and Gynecology Unit, Yaoundé General Hospital, Yaoundé, Cameroon.
²Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

DOI: 10.4236/ojog.2015.52012                

Abstract

Background: Adolescent pregnancy is a serious health and social problem worldwide as well as in Cameroon. The aim of this study was to determine the obstetrical and perinatal outcomes of nulliparous adolescent pregnancies in a reference hospital in Cameroon. Methods: A retrospective cohort study to compare the outcomes of nulliparous adolescent pregnancies to those of nulliparous women aged 20 to 25 years was carried out at the Yaoundé General Hospital between January 1993 and December 2012. Results: Adolescent deliveries represented 2.84% (331 deliveries) of all deliveries registered during the study period. The adolescent mothers had a significantly higher incidence of preeclampsia/eclampsia, preterm delivery and low birth weight babies (<2500 g) when compared to the control group (OR, 3.46; CI 95%, 1.46 - 8.18; OR, 1.94 CI 95%, 1.34 - 2.79; OR, 1.98, CI 95%, 1.39 - 2.46, respectively). However, placenta previa, abruptio placenta, episiotomy, cesarean section, vaginal instrumental delivery, perineal tears and post partum hemorrhage were not significantly different in the two groups. Furthermore, there was no statistically significant difference between the two groups regarding fetal distress, low Apgar score (<7 at the 1^st and 5^th minutes), the rate of admission in the neonatal intensive care unit, stillbirth and neonatal death. Conclusion: Adolescent pregnancy is associated with an increased risk of preeclampsia/ eclampsia, preterm birth and low birth weight.

Keywords

Adolescent Pregnancy, Perinatal and Obstetrical Outcome, Preterm Birth, Low Birth Weight

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Health Organization (2009) Adolescent Pregnancy: A Culturally Complex Issue. Bulletin of the World Health Organization, 87, 410-411. http://dx.doi.org/10.2471/BLT.09.020609
[2]	Chahande, M.S., Jadhao, A.R., Wadhva, S.K. and Udhade S. (2002) Study of Some Epidemiological Factors in Teenage Pregnancy; Hospital Based Case Comparison Study. Indian Journal of Community Medicine, 27, 1-5.
[3]	Vundule, C., Maforah, F., Jewkes, R. and Joradn, E. (2001) Risk Factors for Teenage Pregnancy among Sexually Active Black Adolescents in Cape Town: A Case-Control Study. South African Medical Journal, 91, 73-80.
[4]	Mahavarkar, S.H., Madhu, C.K. and Mule, V.D. (2008) A Comparative Study of Teenage Pregnancy. Journal of Obstetrics & Gynaecology, 28, 604-607. http://dx.doi.org/10.1080/01443610802281831
[5]	Papamicheal, E., Pillai, R. and Yoong, W. (2009) Children Having Children: Outcome of Extreme Teenage Pregnancies (13 - 15 Years). Acta Obstetricia et Gynecologica Scandinavica, 88, 1284-1287. http://dx.doi.org/10.3109/00016340903229427
[6]	Gilbert, W.M., Jandial, D., Field, N.T., Bigelow, P. and Danielsen, B. (2004) Birth Outcome in Teenage Pregnancies. The Journal of Maternal-Fetal & Neonatal Medicine, 16, 265-270. http://dx.doi.org/10.1080/jmf.16.5.265.270
[7]	Chandra-Mouli, V., Alma, V.C. and Michaud, P.A. (2013) WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Outcomes among Adolescents in Developing Countries. Journal of Adolescent Health, 52, 517-522. http://dx.doi.org/10.1016/j.jadohealth.2013.03.002
[8]	WHO (2012) Early Marriages, Adolescent and Young Pregnancies. WHO, Geneva.
[9]	Tebeu, P.M., Kemfang, J.D., Sandjong, D.I., Kongnyuy, E., Halle, G. and Doh, A.S. (2010) Geographic Distribution of Childbirth among Adolescents in Cameroon from 2003 to 2005. Obstetrics and Gynecology International, 2011, Article ID 805165.
[10]	Iloki, L.H., Koubaka, R., Itoua, C. and Mbemba Moutounou, G.M. (2004) Grossesse et accouchement chez l’adolescente au Congo. A propos de 276 cas au CHU de Brazzaville. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 33, 37-42. http://dx.doi.org/10.1016/S0368-2315(04)96310-7
[11]	Tsafack, M. and Kengne, S. (2004) DHS Cameroon 2004. Planification Familiale. (Monograph on the Internet) http://www.measuredhs.com/pubs/pdf/FR163/05chapitre05.pdf
[12]	Jolly, M.C., Sebire, N., Harris, J., Robinson, S. and Regan, L. (2000) Obstetric Risks of Pregnancy in Women Less Than 18 Years Old. Obstetrics & Gynecology, 96, 962-966. http://dx.doi.org/10.1016/S0029-7844(00)01075-9
[13]	Menacker, F., Martin, J.A., MacDorman, M.F. and Ventura, S.J. (2004) Births to 10 - 14 Year-Old Mothers, 1990-2002: Trends and Health Outcomes. National Vital Statistics Reports, 53, 1-18.
[14]	Conde-Agudelo, A., Belizan, J.M., and Lammers, C. (2005) Maternal-Perinatal Morbidity and Mortality Associated with Adolescent Pregnancy in Latin America: Cross-Sectional Study. American Journal of Obstetrics & Gynecology, 192, 342-349. http://dx.doi.org/10.1016/j.ajog.2004.10.593
[15]	Chen, X.K., Wen, S.W., Fleming, N., Demissie, K., Rhoads, G.G. and Walker, M. (2007) Teenage Pregnancy and Adverse Birth Outcomes: A Large Population Based Retrospective Cohort Study. International Journal of Epidemiology, 36, 368-373. http://dx.doi.org/10.1093/ije/dyl284
[16]	Kongnyuy, E.J., Nana, P.N., Fomulu, N., Wiysonge, S.C., Kouam, L. and Doh, A.S. (2008) Adverse Perinatal Outcomes of Adolescent Pregnancies in Cameroon. Maternal and Child Health Journal, 12, 149-154. http://dx.doi.org/10.1007/s10995-007-0235-y
[17]	De Vienne, C.M., Creveuil, C. and Dreyfus, M. (2009) Does Young Maternal Age Increase the Risk of Adverse Obstetric, Fetal and Neonatal Outcomes: A Cohort Study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 147, 151-156. http://dx.doi.org/10.1016/j.ejogrb.2009.08.006
[18]	Nadarajah, S. and Leong, N.K. (2000) Adolescent Pregnancies Managed at KK Hospital. Singapore Medical Journal, 41, 29-31.
[19]	Raatikainen, K., Heiskanen, N., Verkasalo, P.K. and Heinonen, S. (2006) Good Outcome of Teenage Pregnancies in High Quality Maternity Care. European Journal of Public Health, 16, 157-161. http://dx.doi.org/10.1093/eurpub/cki158
[20]	Bukulmez, O. and Deren, O. (2000) Perinatal Outcome in Adolescent Pregnancies: A Case-Control Study from a Turkish University Hospital. European Journal of Obstetrics & Gynecology and Reproductive Biology, 88, 207-212. http://dx.doi.org/10.1016/S0301-2115(99)00145-1
[21]	Hedegaard, M., Henriksen, T.B., Sabroe, S. and Secher, N.J. (1993) Psychological Distress in Pregnancy and Preterm Delivery. British Medical Journal, 307, 234-239. http://dx.doi.org/10.1136/bmj.307.6898.234
[22]	Lamont, R. and Fisk, N. (1993) The Role of Infection in the Pathogenesis of Preterm Labour. In: Studd, J.W.W., Ed., Progress in Obstetrics and Gynaecology, Churchill Livingstone, Edinburgh, 135-158.
[23]	Bacci, A., Manhica, G.M., Manchungo, F., Buglho, A. and Cuttini, M. (1993) Outcome of Teenage Pregnancy in Maputo, Mozambique. International Journal of Gynecology & Obstetrics, 40, 19-23. http://dx.doi.org/10.1016/0020-7292(93)90767-Q
[24]	Oboro, V.O., Tabowei, T.O., Jemikalajah, J.J., Bosah, J.O. and Agu, D. (2003) Pregnancy Outcomes among Nulliparous Teenagers in Suburban Nigeria. Journal of Obstetrics and Gynaecology, 23, 166-169. http://dx.doi.org/10.1080/0144361031000074718
[25]	Safid, B.A., Catalano, P.M., Dierker, I.J. and Mann, L.I. (1996) Birth to Teenagers. Obstetrics and Gynecology, 87, 668-689. http://dx.doi.org/10.1016/0029-7844(96)00007-5
[26]	WHO (1995) Expert Committee Report. Physical Status: The Use and Interpretation of Anthropometry. Technical Report Series 854, World Health Organization, Geneva.
[27]	Lao, T.T. and Ho, L.F. (1998) Obstetric Outcome of Teenage Pregnancies. Human Reproductive, 13, 3228-3232. http://dx.doi.org/10.1093/humrep/13.11.3228
[28]	Ziadeh, S. (2001) Obstetric Outcome of Teenage Pregnancies in North Jordan. Archives of Gynecology and Obstetrics, 265, 26-29. http://dx.doi.org/10.1007/s004040000121