RISK FACTORS ASSOCIATED WITH ADVERSE PREGNANCY OUTCOMES AMONG ADOLESCENTS AND YOUNG PERSONS IN IBADAN METROPOLIS

Abstract

BACKGROUND: Adverse pregnancy outcomes are those pregnancy outcomes other than normal live birth which are the major causes of neonatal morbidity, mortality and long term physical and psychological problems. Although substantial studies have been carried out in order to determine the prevalence and determinants of adolescent pregnancy, research to investigate the risk factors associated with adolescent pregnancy outcomes has been few and far between especially in Ibadan and its environs. This study was aimed at determining the knowledge of adverse pregnancy risk factors, identifying the adverse pregnancy outcomes, and the risk factors associated with adverse pregnancy outcomes among adolescents in Ibadan. METHOD: The study was a descriptive cross – sectional study in which 186 adolescent mothers who gave birth within three months before the commencement of the study in the selected health facilities were recruited. Data was collected using an author formulated semi – structured questionnaire that was interview administered. Obstetric records of the respondents was extracted from the case notes by the nurses who were recruited into the study as research assistants. Knowledge of pregnancy risk factors of the respondents was also tested, of which those that scored below the mean had poor knowledge and those that scored above the mean had good knowledge of pregnancy risk factors. Statistics such as frequencies, percentages, bivariate analysis, and logistic regressions were used in the analysis of the data. RESULT: Of the 186 respondents recruited into the study, 163 (87.6%) of them were aged between age group 15 – 19 years with 100 (53.8%) of them being Christians, 101 (54.3%) single, 117 (62.9%) of them self – employed, 92 (52.2%) of them secondary school leavers and 131 (70.4%) primipara. Knowledge of the adolescents on pregnancy related risk factors were also tested and scored. 54.3% of them had good knowledge of risk factors while 10.8% had poor knowledge of the risk factors. Most commonly reported maternal adverse pregnancy outcome were PROM 19 (10.2%), and post – partum haemorrhage 22 (11.83%). Common perinatal outcomes observed in the study were LBW 43 (23.1%), preterm delivery 52 (28.0%), and cord around the neck 3 (1.6%). Chi – square and logistic regression analysis was carried out to test the association between risk factors and adverse pregnancy outcomes, and preterm birth had factors such as age (OR=7.926, p value 0.009), ANC attendance <4 (OR=3.224, p value 0.019), and non – prescription drug usage (OR=0.297, p value 0.035). ANC attendance (OR=5.150, p value 0.044), parity (OR=0.024, p value 0.003), antepartum haemorrhage (0.276, 0.039), and preterm birth (OR=15.886, p value 0.000) were significantly associated with LBW. PROM was significantly associated with age (11 – 19 years) (OR=0.139, p value 0.014), PIH (OR=4.434, p value 0.033), and non – prescription drug usage (OR=5.164, p value 0.045). CONCLUSION: This research has been able to show that adolescent mothers, though, have a high knowledge of the adverse pregnancy risk factors, only few of them know the main outcomes of most of these risk factors, and as such need more education regarding pregnancy risk factor and outcomes.