Prevalence, Maternal Characteristics and Outcomes of Repeat Teenage Pregnancy Among Teenage Mothers Admitted in Kenyatta National Hospital and Pumwani Maternity Hospital; a Comparative Cross-sectional Study

Abstract

Background: Teenage motherhood is a major public and social health concern associated with poor medical, psychological and socio-economic consequences. According to report by United Nation Population Fund (UNFPA, 2022), girls with their first birth below 14 years and 15-17 years had an average of 2.2 and 1.5 births, respectively, before 20 years(1). Lack of autonomy, information gaps and misconceptions among teenagers increases their risk for RTP. RTP has been associated with increased risk of poor maternal and fetal outcomes. Objectives: determine the prevalence, maternal characteristics and pregnancy outcomes of repeat teenage pregnancy among teenagers admitted in Kenyatta National Hospital and Pumwani Maternity Hospital Methodology: Study Design and study site: descriptive cross-sectional study with sub-group analysis conducted in Kenyatta National Hospital and Pumwani Maternity Hospital. Study Participants: Teenage mothers admitted in Kenyatta National Hospital and Pumwani Maternity Hospital between January 2020- December 2021. Sample Size: A total of 381 teenage mothers where 229 and 152 teenage mothers were recruited from Pumwani Maternity Hospital and Kenyatta National Hospital, respectively. Systematic random sampling technique was employed until an adequate sample was achieved. A semi-structured abstraction tool was used to collect the data from the participant’s records. Data analysis: Data was analyzed both descriptively and inferentially. Categorical data was analyzed using frequencies and percentages while continuous data was analyzed using mean and standard deviation. Student t-test was used to determine the relationship between the continuous variables while chi-square test was applied for categorical variables for the bivariate analysis with 95% CI. Results: The prevalence of repeat teenage pregnancy among the study population was 13.6% (52/381). Repeat teenage pregnancy was associated with marriage (AOR= 4.05 95% CI 1.97-20.85 p- 0.005) and receiving partner support (AOR= 3.11 95% CI 1.18-5.21 p-0.018). Majority of the repeat teenage mothers were above 18 years with the median age at first pregnancy 16.5 yrs (IQR 16-17years). Bad obstetric outcome in the previous pregnancy was associated with repeat teenage pregnancy. Previous use of contraceptives prior to pregnancy was associated RTP (COR= 4.18,95% CI 2.26-7.74). Interval between menarche and 1st pregnancy was 2-4yrs (AOR=0.18 (00.5-0.62 p 0.007). Conclusion and recommendations: The prevalence for RTP among teenagers who delivered in PMH and KNH was 13.6%. Early marriages and perceived partner support contributed to RTP. RTP was associated with APH, pre-eclampsia, PPH, ICU admission, eclampsia, and PROM. There is need to implement comprehensive and evidence-based sex education programs in schools that provide accurate information about contraception, sexually transmitted infections (STIs), and healthy relationships.