Adolescent Pregnancy and Outcomes: A Hospital-Based Comparative Study at a Tertiary Care Unit in Eastern Province, Sri Lanka

Background Adolescent pregnancy is a high-risk condition that can potentially lead to adverse perinatal and obstetric outcomes. It is a growing concern in developing countries including Sri Lanka. The main objective of this study was to evaluate obstetric and perinatal outcomes amongst adolescent pregnancies and compare them with outcomes of pregnancies of average maternal age (AMA) women. Method This was a prospective, cross-sectional study conducted at a tertiary care hospital in the Eastern province of Sri Lanka. A total of 795 primigravidae who had singleton pregnancies and delivered their live babies over a period of three months from February to April 2019 were selected for the study. The data were retrieved from Bed Head Tickets (BHTs) of those patients upon discharge from the postnatal ward. Results The majority of primigravida was AMA women and accounted for 83.4% (n=663) of the study population while primiparous adolescents comprised 16.6% (n=132). Among the 132 adolescent pregnancies, 81.1% (n=107) were associated with complications and the remaining 18.9% (n=25) were uncomplicated. The most common risk associated with adolescent pregnancy was the low birth weight (LBW; n=24, 18.2%), followed by preterm labour (n=10, 7.6%). An adolescent mother had a 1.3 times higher possibility of delivering an LBW baby than an AMA mother and the risk was statistically significant (p=0.04). The likelihood of delivering an intrauterine growth restriction (IUGR) baby was higher in adolescent mothers (6%) than in AMA mothers (5%). Adolescent mothers had a 1.2 times higher chance of delivering newborns with IUGR compared to AMA mothers; however, the difference of IUGR was not statistically significant (p>0.05). The incidence of foetal distress was less among adolescent mothers compared to AMA mothers. The majority of the babies (n=126, 95.5%) of adolescent pregnancies were healthy. Only 4.5% (n=6) babies needed neonatal intensive care unit (NICU) admissions; of those, four babies had very LBW and prematurity and the other two babies depressed at birth and developed respiratory distress. Conclusion Adolescent pregnancy carries a significant risk of obstetric complications including LBW and prematurity that should draw public and healthcare providers' attention. The effectiveness of a comprehensive antenatal and community-based program to prevent adolescent pregnancy and related adverse outcomes should further be evaluated.