Obstetric Profile of Primi Teenage and Non-teenage mothers: A comparative study from Maharashtra, India Mohite RV*, Ganganhalli P, Mohite VR, Tondare MB, Kumbhar SM Abstract: Introduction: Early marriages and teenage pregnancies are important contributing factors for high maternal as well as neo-nat

Introduction: Early marriages and teenage pregnancies are important contributing factors for high maternal as well as neo-natal morbidity and mortality. Objectives: To assess the magnitude of obstetric profile of teenage and non-teenage primi mothers and to determine the association among them. Methodology: A cross-sectional study was conducted at OB/Gynac clinic Krishna hospital Karad over a period of first quarter of year 2012. 93 eligible teenage primi mothers and equal number of non-teenage primi mothers admitted to Krishna hospital for delivery were enrolled, interviewed and observed for socio-demographic, obstetric outcome and it’s complications by investigator according to predesigned structured proforma. Frequency percentage distribution and association was determined by applying tests of significance. Observations: Magnitude of teenage primi pregnancy was 6% during study period and most of them 92.50%, 76.30% and 46.20% were Hindus, housewives and belonged to lower class by religion, occupation and economically with mean age at marriage and delivery was 17.8 yrs and 18.8 yrs respectively. Max. 81.7% teenage primi mothers were anaemic and the percentage of obstetric complications like PIH, Oligohydramnios, PROM, Foetal distress among teenage primi mothers was 24%,8.6%, 1%, and 6.4% which was higher than nonteenage mothers. IUGR, cord prolapse, breech presentation and abruption placenta also reported among teenage primi mothers, however absent among non-teenage mothers. Max 55.9% teenage mothers were delivered before expected date of delivery and proportion of low birth weight baby was also high (39.8%) in teenage mothers than non-teenage mothers. Chance of delivery of male baby also increases as age at marriage increases. Conclusion: Adolescent pregnancy is an issue that calls for more education & support to encourage girls to delay motherhood until they are ready.

able contraceptive options.Teenage pregnancy is a fairly common occurrence in India, due to factors such as early marriage, poor education, lack of health care services, poverty, cultural factors etc [4][5] .Similarly due to environmental and geographical influences, girls reaching the puberty at younger age and high specific fertility rate in such age group observed.Save the Children found that, annually, 13 million children are born to women under age 20 worldwide and among them, >90% teenage deliveries mainly from developing countries 7 and the complications of pregnancy and childbirth are the leading cause of mortality among women between the ages of 15 and 19 in such areas 8 .In India teenage pregnancy rate varies from 8 -14%.The obstetric outcome of teenage pregnancy is influenced by factors such as socio-demographic, economic, health care and others.Maternal and perinatal morbidity & mortality in teenagers is influenced by medical complications like toxaemia, anaemia, cephalopelvic disproportion (CPD) and social problems viz.out of wedlock pregnancy, unwanted pregnancy etc 6 .In view of this, a study was organised to collect and provide the data to health care providers in respect to magnitude of teenage primi pregnancy, it's complications and outcome among the mothers residing in rural area and compare it with non-teenage primi mothers with age more than 20 yrs but less than 30 yrs from same area for decision on health of teenage pregnancy and making the farm policy to avoid it's bad influences on mother and child if any.

Material & Methods:
A Cross-sectional study was conducted at Ob/Gynac dept. of Krishna Hospital, Karad among primi teenage and non-teenage pregnant mothers during first quarter of year 2012.Total 93 teenage primi mothers admitted for delivery during study period and equal number of non-teenage primi mothers, age > 20 but < 30 yrs for the same without any systemic illness were enrolled for present study.After obtaining the permission from Medical Director Krishna hospital, data was collected from study subjects by using a pre tested, structured proforma after verbal consent.The proforma include socio-demographic, economic, reproductive as well as information related to complications of pregnancy and outcome of it.The data was collected by investigator from study subjects in the presence of female relatives in hospital by personal interview method and complications of pregnancy and its outcome was reported by per-sonal observation as well as case paper records under the supervision of treating Gynaecologist and Paediatrician.
Ethical considerion: Clearance for the study was taken from the Institute Ethical Committee and from the hospital authority.Informed verbal consent was taken from the subjects.Statistics: Data so collected was compiled into MS Excel & analysed by applying statistical software SPSS Version 17. Frequency percentage distribution, mean, SD was calculated.Student t test was applied to find out difference and chi-square test was applied to determine the association.

Results:
Total 93 teenage primi mothers were delivered at Krishna hospital, Karad during study period which came around 6% of total deliveries.Mean age at marriage and primi delivery was 17.8 and 18.8 yrs among teenage, however it was 20.5 and 21.9 yrs among non-teenage mothers.Majority of mothers were Hindu and housewives but 46.2% teenage were from low economic class (Modified B.G Prasad classification).Majority of mothers were literate however proportion of graduation was higher (22.6%) among non-teenage mothers whereas proportion of tobacco use was higher (23.65%) among teenage mothers.Significant difference was observed between age at marriage, age at primi delivery, education and use of tobacco among teenage and non-teenage mothers (Table 1).2).

Table 2: Anaemia and Obstetric Complications of pregnancy among teenage and non-teenage mothers
Max, 55.9% teenage mothers were delivered before EDD, whereas max, 50.5% non-teenage mothers were delivered on EDD and proportion of mode of delivery by LSCS was higher (36.6%) in teenage mothers as compared to non-teenage mothers (21.5%).The proportion of LBW was high (39.8%) in teenage mothers as compared to non-teenage mothers(16.1%),howeverproportion of delivery of male baby was high in nonteenage mothers(66.7%) as compared to teenage mothers(49.5%).The significant statistical association was existed between time of delivery, mode of delivery, gender and birth wt of baby among teenage and non-teenage primi mothers (Table 3).Present study found 39.8% babies born to teenage primi were having Low birth weight as compared to non-teenage and difference was significant( p<0.05).Study conducted by Ambadekar NN et al. 12 , Bhalerao AR et al. 6 and Sarkar CS et al. 13 observed proportion of LBW babies was 39.5% , 46.2% and 30% among teenage mothers and results were comparable with our study.Chance of delivery of male baby was increased as age at marriage and delivery increased and this was observed in our study (p < 0.05), however not a single study yet observed such finding.

Conclusion:
The teenage pregnancy is most important cause for high maternal complications during pregnancy and it also affects the outcome of delivery.Chance of delivery of male baby increases as age at marriage and delivery increases.Need to highlight the issues related with teenage pregnancy and develop a firm health policy to avoid morbidity and mortality associated with teenage pregnancy.