PREGNANCY IN ADOLESCENCE: IS IT REALLY A CONCERN?

CORRESPONDING AUTHOR:
Dr. Prachi Saurabh Koranne,
Address: Akshata, Shankar Nagar,
Ghatole Layout, Jatharpeth,
Akola- 444005, Maharashtra.
Email: prachibs81@gmail.com
             Prachi_koranne@yahoo.com

ABSTRACT: BACKGROUND: Adolescence means a transitional stage of physical and mental human development, involving biological, social and psychological changes. It occurs between 10-19 years of age as The World Health Organization (WHO) suggested. Pregnancy in this transitional stage is a common public health problem and social phenomenon with medical consequences worldwide. In this context adolescent pregnancy has been a problem with adverse obstetric and neonatal outcomes being influenced by biological immaturity, unintended pregnancy, inadequate perinatal care, poor maternal nutrition and stress. Socio-economic, cultural, geographic and racial factors are also associated with teenage pregnancy. Due to increasing awareness and effects of media there has been increase in the use of contraception but the problem of teenage pregnancy is very much prevalent as child marriages are still prevalent in Indian community. Early marriage and confinement are contributing factors to high maternal, peri-natal mortality and morbidity. A female can become pregnant as early as two weeks before menarche, although rare, but usually occurs after menarche. The World Health Organization estimates that the risk of death following pregnancy is twice as great for women between 15 and 19 years than for those between the ages of 20 and 24yrs. The maternal mortality rate can be up to five times higher for girls aged between 10 and 14yrs than for women of about twenty years of age. Illegal abortion also holds many risks for teenage girls. OBJECTIVE: To assess the magnitude of the problem of teenage pregnancy. To study the risk and complications faced during pregnancy and labour. MATERIALS AND METHODS: A hospital-based cohort study was undertaken over2 years from January 2012 to December 2013 among women attending outpatient department and in indoor clinics at a tertiary care hospital in Akola Maharashtra. The study cohort comprised of teenage mothers between 15-19 years old and a control cohort of mothers between 20-30 years old. Data included demographic variables, available medical records and complications viz. anemia, preterm delivery and low birth weight. Anemia was defined as a hemoglobin level below 10 gm% during the last trimester of pregnancy, preterm delivery was defined as occurring within 37 weeks of gestation and low birth weight was defined as babies weighing less than 2500 grams at birth. Patients were followed in delivery and up to 6weeks in puerperium. RESULT: Teenage pregnancy comprised 24.17% of total pregnancies occurring in the hospital during the study period. The study group had 232 subjects and the control group had 364 subjects. The prevalence of anemia was significantly higher (P<0.05) in the women in the teenage group (62.96%) than in the women in the control group (43.59%). However, severe anemia with a hemoglobin level below 8 gm% was only found in the control group. Preterm delivery occurred significantly more (P<0.001) in the study group (51.72%) than in the control group (25.88%). The incidence of low birth weight was significantly higher (P<0.0001) among the group of teenagers (65.52%) than among the women in the control group (26.37%). Not a single newborn was above 3kgs in the study group, while none were below 1.5kgs in the control group. The mean birth weight was 2.36kgs in the study group and 2.74kgs in the control group; the difference was strongly significant (P<0.001). CONCLUSION: The study shows that anemia, preterm delivery, and low birth weight were more prevalent among teenagers than among women who were 20-30 years old. This indicates the need for enhancing family welfare measures to delay the age at first pregnancy, thereby reducing the multiple complications that may occur in the young mother and her newborn baby. The delivery should be conducted in a hospital under trained medical person.

KEYWORDS: Anemia, complications, low birth weight, preterm delivery, teen pregnancy.