title: Adolescence as risk factor for adverse pregnancy outcome in Central Africa--a cross-sectional study.
abstract: BACKGROUND
  Sub-Saharan Africa has the highest rates of maternal and neonatal mortality worldwide. Young maternal age at delivery has been proposed as risk factor for adverse pregnancy outcome, yet there is insufficient data from Sub-Saharan Africa. The present study aimed to investigate the influence of maternal adolescence on pregnancy outcomes in the Central African country Gabon.
  
  
  RESULTS
  Data on maternal age, parity, birth weight, gestational age, maternal Plasmodium falciparum infection, use of bednets, and intake of intermittent preventive treatment of malaria in pregnancy were collected in a cross-sectional survey in 775 women giving birth in three mother-child health centers in Gabon. Adolescent women (≤16 years of age) had a significantly increased risk to deliver a baby with low birth weight in univariable analysis (22.8%, 13/57, vs. 9.3%, 67/718, OR: 2.9, 95% CI: 1.5-5.6) and young maternal age showed a statistically significant association with the risk for low birth weight in multivariable regression analysis after correction for established risk factors (OR: 2.7; 95% CI: 1.1-6.5). In further analysis adolescent women were shown to attend significantly less antenatal care visits than adult mothers (3.3±1.9 versus 4.4±1.9 mean visits, p<0.01, n = 356) and this difference accounted at least for part of the excess risk for low birth weight in adolescents.
  
  
  CONCLUSIONS
  Our data demonstrate the importance of adolescent age as risk factor for adverse pregnancy outcome. Antenatal care programs specifically tailored for the needs of adolescents may be necessary to improve the frequency of antenatal care visits and pregnancy outcomes in this risk group in Central Africa.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
authors.forename: Florian
authors.initials: F
authors.lastname: Kurth
authors.forename: Sabine
authors.initials: S
authors.lastname: Bélard
authors.forename: Ghyslain
authors.initials: G
authors.lastname: Mombo-Ngoma
authors.forename: Katharina
authors.initials: K
authors.lastname: Schuster
authors.forename: Ayola A
authors.initials: AA
authors.lastname: Adegnika
authors.forename: Marielle K
authors.initials: MK
authors.lastname: Bouyou-Akotet
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
mesh_terms: D000293:Adolescent; D000328:Adult; D000350:Africa, Central; D003430:Cross-Sectional Studies; D005260:Female; D005681:Gabon; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors