Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study
Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study
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DOI：
10.1136/bmjopen-2016-011783
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Ramharter, Michael
中科院分区：
文献类型：
--
作者：
Mombo-Ngoma, Ghyslain;Mackanga, Jean Rodolphe;Ramharter, Michael
非洲最重要的挑战之一是改善产妇和新生儿健康。查明不良妊娠结果风险最高的群体对于制定和实施有针对性的预防方案至关重要。本研究评估了在撒哈拉以南非洲地区的孕妇中，青春期少女是否构成不良出生结局风险增加的群体。设置数据是前瞻性收集的，作为评估妊娠期疟疾间歇性预防治疗的大型随机对照临床试验（NCT 00811421 Clinical www.example.com）的一部分Trials.gov，该试验于2009年9月至2013年12月在贝宁、加蓬、在4749名参与者中，收集了4388例分娩的妊娠结局，其中4183例活产，包括83例多胎妊娠。在4100名单胎活产的母亲中，百分之二十四（975/4100）为青少年（19岁）和6%主要和次要结局指标主要结局为早产和低出生体重儿。结果低出生体重儿和早产的总患病率为10%，（371/3851）和4%（159/3862）。16岁以下的母亲分娩低出生体重儿的风险较高（OR：1.96; 95%CI 1.35 - 2.83）。同样，早产与年轻母亲年龄相关（16岁; OR：2.62; 95%CI 1.59 - 4.30）。在仅限于经产妇女的亚组分析中：早产，OR 4.28; 95% CI 2.05 ~ 8.93;低出生体重，OR 1.29; 95% CI 0.82 ~ 2.01。结论在撒哈拉以南非洲地区，年轻母亲年龄增加不良妊娠结局的风险，是低出生体重和早产的较强预测因子。这一发现强调了改善撒哈拉以南非洲青少年生殖健康的必要性。试验注册号NCT 00811421;后结果。
Objectives One of Africa's most important challenges is to improve maternal and neonatal health. The identification of groups at highest risk for adverse pregnancy outcomes is important for developing and implementing targeted prevention programmes. This study assessed whether young adolescent girls constitute a group at increased risk for adverse birth outcomes among pregnant women in sub-Saharan Africa.Setting Data were collected prospectively as part of a large randomised controlled clinical trial evaluating intermittent preventive treatment of malaria in pregnancy (NCT00811421Clinical Trials.gov), conducted between September 2009 and December 2013 in Benin, Gabon, Mozambique and Tanzania.Participants Of 4749 participants, pregnancy outcomes were collected for 4388 deliveries with 4183 live births including 83 multiple gestations. Of 4100 mothers with a singleton live birth delivery, 24% (975/4100) were adolescents (19years of age) and 6% (248/4100) were aged 16years.Primary and secondary outcome measures Primary outcomes of this predefined analysis were preterm delivery and low birth weight.Results The overall prevalence of low birthweight infants and preterm delivery was 10% (371/3851) and 4% (159/3862), respectively. Mothers aged 16years showed higher risk for the delivery of a low birthweight infant (OR: 1.96; 95% CI 1.35 to 2.83). Similarly, preterm delivery was associated with young maternal age (16years; OR: 2.62; 95% CI 1.59 to 4.30). In a subanalysis restricted to primiparous women: preterm delivery, OR 4.28; 95% CI 2.05 to 8.93; low birth weight, OR: 1.29; 95% CI 0.82 to 2.01.Conclusions Young maternal age increases the risk for adverse pregnancy outcomes and it is a stronger predictor for low birth weight and preterm delivery than other established risk factors in sub-Saharan Africa. This finding highlights the need to improve adolescent reproductive health in sub-Saharan Africa.Trial registration number NCT00811421; Post-results.