Co-morbidities, Maternal and Fetal Outcome of Teenage Pregnancy at Tertiary Care Hospital, Nepal.

Background Teenage pregnancies constitute a serious health and social problem worldwide. World estimates in 2008 report about 16 million births to adolescent mothers, most of them occurring in low and middle income countries. Objective To assess pregnancy co-morbidities and outcome of teenage pregnancy. Method A cross-sectional study was conducted at obstetrics and gynecological department of Dhulikhel Hospital. Study was conducted for 18 month period from 1-07-2013 to 30-12-2014. All teenage pregnancy cases admitted at the time of study period were enrolled. Purposive sampling technique was used. Data were collected by face to face interview using clinical Performa and through record file of the patient. Collected data were analyzed in SPSS version 21.0. Result Total of 527 teenage mothers of varying age group (15 to 19 years ) were enrolled in the study. Teenagers who had never been to school were 3.0%; 66.2% of them were from low socioeconomic background , and 58.6% were from rural areas. Pregnancy co-morbidities detected were, Urinary tract infection (UTI) 18.4%, threatened preterm 12.9% followed by ante partum hemorrhage 4.7%. However, other major co-morbidities such as hypertensive disorder, gestational diabetes found to be very less such as, hypertension 0.8% and gestational diabetes found in only one woman. Conclusion Maternal and newborn outcome and co-morbidities among teenage pregnant women found less compare to other studies. Major pregnancy related morbidities such as hypertension, pre-eclampsia and diabetes were found very less. Most common maternal morbidity found was urinary tract infection during pregnancy but statistically not significant. Similarly, newborn mean weight was more than 2.5 kg and neonatal death found very less. However, teenage pregnancy is significantly associated with low economic status, illiteracy status, willingness to marriage by teenagers and ethnicity.

Risk Factors and Clinical Profile of Preterm Deliveries at Dhulikhel Hospital, Kathmandu University Hospital.

Background Preterm delivery is one of the major determinants of neonatal morbidity and mortality and has long term adverse health outcomes. Objective To study the risk factors of preterm deliveries and the clinical profile of preterm births presenting to a tertiary center in Kavre district. Method A hospital based prospective study was carried out in the Department of Pediatrics and Department of Obstetrics and Gynaecology, Dhulikhel Hospital, Kavre from 1st April 2016 to 31st October 2017. Result Study included 152 babies born premature and attending Dhulikhel Hospital. There were 5.26% babies less than 1000 grams and the least weight being 700 grams. Majority of the premature babies were male (57.24%). Most of the babies were in the gestational age of 28 to 32 weeks (60%). Steroids were given to 42.10% of the cases. Mode of delivery was vaginal route (60.53%) followed by cesearean section in 37.50%. Hyperbilirubinemia (53.29%), neonatal sepsis (46.05%) and respiratory distress syndrome (43.42%) were the commonest morbid conditions. Among the 152 cases, mortality was seen in 13.82%. The minimum weight to have survived was 900 grams. The most common modifiable risk factors responsible for preterm birth in mother were inadequate antenatal visits (29.60%), history of premature rupture of membranes (28.29%), history of urinary tract infection (21.05%) and weight less than 45 kg (14.47%). The non modifiable risk factors were mothers with blood group A (33.55%) and height of less than 145 cm (20.40%). Conclusion The modifiable risk factors such as inadequate antenatal visits, history of premature rupture of the membranes and urinary tract infection and under weighing mothers can be corrected by early interventions and preventive measures which will help in reducing perinatal morbidity and mortality.