PREVALENCE AND PERINATAL OUTCOMES OF TEENAGE PREGNANCY IN KILIFI COUNTY, KENYA

Abstract

Teenage (10 to 19 years) pregnancy is a worldwide challenge. Despite major efforts made to reduce the burden of teenage pregnancy, the burden is still high especially in low and middle income countries with the highest burden in sub-Saharan Africa. Teenage pregnancy is associated with adverse perinatal outcomes with 50% of babies born by teenage mothers likely to die in-utero or within the first week of life. Studies done in low and middle income countries have shown varied prevalence of preterm labor/birth, low birth weight, low Apgar scores, perinatal death and modes of delivery. The overall aim of the study was to determine the prevalence and perinatal outcomes of teenage pregnancies in Kilifi County, Kenya. The study adopted a retrospective descriptive review of data from the Kenya Demographics and Health Survey 2014 database and the Kilifi Perinatal and Maternity research project database. For the analysis of perinatal outcomes, all the primigravida teenagers who delivered at Kilifi county hospital during the study period were included in the study. Descriptive analysis was applied in this study. The prevalence of teenage pregnancy was 22% in Kilifi County. Results also indicated that 60% of mothers who were in their reproductive age had their first pregnancy while teenagers in Kilifi County. Teenage mothers were either uneducated (34%) or had incomplete primary school level of formal education (39%), were married (73%) and nearly half (44%) of them were unemployed. Antenatal care attendance during pregnancy in teenage mothers was lower than recommended with only 60% attending the minimum 4 recommended antenatal care clinic visits. Late initiation of antenatal care (starting of antenatal care clinic visits after first trimester) was common (85%). More than 50% of teenage pregnancies’ deliveries were conducted at home. On perinatal outcomes, teenage mothers had the following proportions of outcomes: preterm birth (31%), underweight (23%), low tenth minute Apgar score (2%) and stillbirth (3%). Caesarian delivery was done in 13.3% of all teenage deliveries with the commonest indication being poor progress of labor. 26% of all teenagers who delivered vaginally had perineal tears. The proportion of teenage deliveries at Kilifi county hospital increased all through the study period from 8.3% in 2011 to 11.1% in vi 2016 with a peak in 2013 where it rose to 13.6%.The trend of teenage pregnancy significantly increased over the study period with a proportional trend p-value of 0.029. Kilifi has been on the limelight in relation to high prevalence of teenage pregnancies. This study will provide a platform for further discussion on the state of teenage pregnancies, their outcomes and contribute to the ongoing discussion on potential interventions. Our findings suggest need for consideration of measures on reducing early marriage, standard antenatal care and increase in level of education among teenagers.