TEENAGE PREGNANCY IN RURAL EASTERN ETHIOPIA: PREVALENCE, FETO- MATERNAL OUTCOMES AND SOCIAL CONSEQUENCES

Abstract

Background: Teenage pregnancy, which is detrimental to mother and child health, is a common public health issue worldwide. It is a problem that affects nearly every society-developed and developing alike, and is a vital issue concerning women’s reproductive health. Assessing the prevalence, fetal, maternal, and social consequences of teenage pregnancy is essential to better understand, and design programs for interventions. However, the underlying causes and consequences of teenage pregnancy were not well understood in rural eastern parts of Ethiopia. Objective: This study aimed at determining the magnitude, factors associated, feto-maternal outcomes, and social consequences of teenage pregnancy in rural eastern Ethiopia. Methods: This study employed a mixed study design with quantitative and qualitative data collection methods. A cross-sectional design was used to assess the prevalence and factors associated with teenage pregnancy, a comparative cross-sectional design was used to evaluate the fetal and maternal outcomes of teenage pregnancy. A qualitative phenomenological method was used to explore the social consequences of teenage pregnancy. The Poisson regression model was used to examine factors associated with teenage pregnancy and maternal outcomes of teenage pregnancy. Log -binomial regression model was used to investigate the fetal outcomes of teenage pregnancy. Thematic analysis was utilized for the qualitative data. Results: The prevalence of teenage pregnancy was 30.2% (95% CI: 28.3, 32.1). Age, not attending school, lack of formal education, being married, parental divorce, having an elder sister with a history of teenage pregnancy, and not knowing the fertile period during the menstrual cycle were independently associated with teenage pregnancy. The comparative study on fatal outcomes showed adverse fetal outcomes among teenagers and adults (34.9% vs 21%). There were statistically significant differences in the proportion of low birth weight, preterm births, and low Apgar scores at 5 minutes in teenagers compared to adult women. Antenatal care attendance, eclampsia, pre-eclampsia, and wealth index (rich) were significantly associated with adverse fetal outcomes among teenage women. In contrast, intimate partner violence pre-eclampsia, antepartum hemorrhage, and hyperemesis gravidarum were significantly associated with adverse fetal outcomes among adult women. xiii The comparative study on maternal outcomes showed that the proportion of adverse maternal outcomes was 61.7% in teenagers and 35.3% in adult women. A higher proportion of teenage than adult women had pregnancy-induced hypertension, pre-eclampsia, eclampsia, premature rupture of membrane, cephalopelvic disproportion, obstructed labor, perineal tear, episiotomy, and caesarian section. Lack of formal education was associated with adverse maternal outcomes in teenage women; whereas, prima gravida, a prior history of abortion, and previous history of cesarean section delivery were independently associated with adverse maternal outcomes in adult women. The qualitative study identified the following as the significant social consequences of teenage pregnancy: bad feeling to the news of pregnancy, stigma, violence challenge in the maternal role, seeking support, and coping mechanisms. Conclusion: Teenage pregnancy resulted from multiple factors and was associated with a high rate of adverse fetal and maternal outcomes, with devastating social consequences. All responsible parties should collaborate in preventing teenage pregnancy to minimize both fetal and maternal effects. Early detection and treatment of risks during antenatal follow-up should be the mainstay.