Pregnancy in Adolescence: Survival Analysis of Neonatal Outcome in Babies Born to Young Mothers in Dhanusha, Nepal

Karoline Tufte Lien, Norwegian Institute of Public Health
Naomi Saville, University College London and Mother and Infant Research Activities (MIRA), Nepal
Anthony Costello, University College London
David Osrin, University College London
Dharma S. Manandhar, Mother and Infant Research Activities (MIRA), Nepal
Bhim Shrestha, Mother and Infant Research Activities (MIRA), Nepal

This paper explores characteristics, risks and neonatal outcomes of adolescent pregnancies (AP) in Nepal, which has a high prevalence of adolescent pregnancies. The sample is 19535 pregnant women from a UCL-MIRA trial. Logistic regression was used for associations of AP, Cox regression estimated hazard ratios of neonatal mortality (NM). Potential confounders were included in a multivariate Cox regression model. Babies born to adolescents had a 47% higher hazard (p=0.002) of dying than babies born to women over 20. In the final model, controlling for literacy, age at marriage, primiparity, gestation length and multiple births, there is no longer an association between AP and NM. The initial association stems from adolescents being at risk of increased hazards related to first, not early childbearing. It illustrates the importance of a holistic approach to reducing NM - delaying early marriage, keeping girls in school, follow up primipara women and reducing preterm births.