Abstract
Objectives
To compare the risk of severe adverse maternal outcomes (SMO) and neonatal outcomes (SNO) and analyse their maternal correlates in adolescent mother-newborn and young mother-newborn dyads in secondary and tertiary care users in Latin America.
Methods
We performed a secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health database in 83 secondary and tertiary hospitals in seven countries in Latin America. We constructed a composite indicator of both SMO and SNO and estimated odds ratios (OR) comparing adolescent mothers (aged 12–19) with young mothers (aged 20–24). Our unit of analysis was the mother-newborn dyad.
Results
We found that the combination of SMO and SNO was three times more likely in adolescent mother as compared to young mother dyads (OR 3.56; 95% CI 1.67–7.59). SNO either alone or in combination with SMO were more likely in adolescents aged 12 to 16 than in young women (OR 1.27 and 4.87, respectively).
Conclusions for Practice
Adolescent mothers and their newborns are at an increased risk of severe adverse outcomes during child birth and in the first week postpartum compared to young mother dyads, especially young adolescents. Focusing on the dyad as a whole may facilitate a step towards integrated care which maximizes the health benefits of both mother and newborn. Continued efforts are needed to improve health care and prevention initiatives directed towards adolescent women and their newborns in Latin America.
Similar content being viewed by others
Data Availability
Analytical dataset available upon request.
Code Availability
Available upon request.
References
Althabe, F., Moore, J. L., Gibbons, L., Berrueta, M., Goudar, S. S., Chomba, E., Derman, R. J., Patel, A., Saleem, S., Pasha, O., Esamai, F., Garces, A., Liechty, E. A., Hambidge, K., Krebs, N. F., Hibberd, P. L., Goldenberg, R. L., Koso-Thomas, M., Carlo, W. A., … McClure, E. M. (2015). Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network’s Maternal Newborn Health Registry study. Reproductive Health, 12(Suppl 2), S8. https://doi.org/10.1186/1742-4755-12-S2-S8
Barrera-de Leon, J. C., Higareda-Almaraz, M. A., Barajas-Serrano, T. L., Villalvazo-Alfaro, M., & Gonzalez-Bernal, C. (2014). Comparison of perinatal clinical profiles in newborns of adolescent and non-adolescent mothers. Gaceta Médica De México, 150(Suppl 1), 67–72. Comparacion del perfil clinico perinatal de recien nacidos de madres adolescentes y no adolescentes.
Bhutta, Z. A., Das, J. K., Bahl, R., Lawn, J. E., Salam, R. A., Paul, V. K., Sankar, M. J., Blencowe, H., Rizvi, A., Chou, V. B., Walker, N., Lancet Newborn Interventions Review Group, Lancet Every Newborn Study Group. (2014). Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet, 384(9940), 347–370. https://doi.org/10.1016/s0140-6736(14)60792-3
Cluet de Rodríguez, I., Rossell-Pineda, M., Álvarez de Acosta, T., & Rojas Quintero, L. (2013). Factores de riesgo asociados a la prematuridad en recién nacidos de madres adolescentes. Revista De Obstetricia y Ginecología De Venezuela, 73(3), 157–170.
Conde-Agudelo, A., Belizan, J. M., & Lammers, C. (2005). Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. American Journal of Obstetrics and Gynecology, 192(2), 342–349. https://doi.org/10.1016/j.ajog.2004.10.593
Dias, M. A., Domingues, R. M., Schilithz, A. O., Nakamura-Pereira, M., Diniz, C. S., Brum, I. R., Martins, A. L., Theme Filha, M. M., Gama, S. G., & Carmo, L. M. (2014). Incidence of maternal near miss in hospital childbirth and postpartum: Data from the birth in Brazil study. Cadernos De Saúde Pública, 30(Suppl 1), S1-12. https://doi.org/10.1590/0102-311x00154213
Fernández Cantón, S. B., Gutiérrez Trujillo, G., & Viguri Uribe, R. (2012). Principales causas de mortalidad infantil en México: Tendencias recientes. Boletín Médico Del Hospital Infantil De México, 69, 144–148.
Ganchimeg, T., Ota, E., Morisaki, N., Laopaiboon, M., Lumbiganon, P., Zhang, J., Yamdamsuren, B., Temmerman, M., Say, L., Tunçalp, Ö., Vogel, J. P., Souza, J. P., Mori, R., WHO Multicountry Survey on Maternal Newborn Health Research Network. (2014). Pregnancy and childbirth outcomes among adolescent mothers: A World Health Organization multicountry study. BJOG, 121(Suppl 1), 40–48. https://doi.org/10.1111/1471-0528.12630
GBD 2017 Causes of Death Collaborators. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7
Geller, S. E., Koch, A. R., Garland, C. E., MacDonald, E. J., Storey, F., & Lawton, B. (2018). A global view of severe maternal morbidity: Moving beyond maternal mortality. Reproductive Health, 15(Suppl 1), 98. https://doi.org/10.1186/s12978-018-0527-2
Guzman, E., Ludmir, J., & DeFrancesco, M. (2015). High cesarean section rates in Latin America, a reflection of a different approach to labor? Open Journal of Obstetrics and Gynecology, 5, 433–435. https://doi.org/10.4236/ojog.2015.58062
Igras, S. M., Macieira, M., Murphy, E., & Lundgren, R. (2014). Investing in very young adolescents’ sexual and reproductive health. Global Public Health, 9(5), 555–569. https://doi.org/10.1080/17441692.2014.908230
Jeha, D., Usta, I., Ghulmiyyah, L., & Nassar, A. (2015). A review of the risks and consequences of adolescent pregnancy. Journal of Neonatal-Perinatal Medicine. https://doi.org/10.3233/NPM-15814038
Lima, H. M., Carvalho, F. H., Feitosa, F. E., & Nunes, G. C. (2017). Factors associated with maternal mortality among patients meeting criteria of severe maternal morbidity and near miss. International Journal of Gynaecology and Obstetrics, 136(3), 337–343. https://doi.org/10.1002/ijgo.12077
Lira, J., Oviedo, H., Zambrana, M., Ibargüengoitia, F., & Ahued, R. (2005). Implicaciones perinatales del embarazo en la mujer adolescente. Ginecología y Obstetricia De México, 73(8), 407–414.
Loredo-Abdalá, A., Vargas-Campuzano, E., Casas-Muñoz, A., González-Corona, J., & Gutiérrez-Leyva, C. J. (2017). Adolescent pregnancy: Its causes and repercussions in the dyad. Revista Médica Del Instituto Mexicano Del Seguro Social, 55(2), 223–229.
Mason, E., McDougall, L., Lawn, J. E., Gupta, A., Claeson, M., Pillay, Y., Presern, C., Lukong, M. B., Mann, G., Wijnroks, M., Azad, K., Taylor, K., Beattie, A., Bhutta, Z. A., Chopra, M., Lancet Every Newborn Study Group, Every Newborn Steering Committee. (2014). From evidence to action to deliver a healthy start for the next generation. The Lancet, 384(9941), 455–467. https://doi.org/10.1016/S0140-6736(14)60750-9
Mendoza Tascón, L. A., Arias Guatibonza, M. D., Peñaranda Ospina, C. B., Mendoza Tascón, L. I., Manzano Penagos, S., & Varela Bahena, A. M. (2015). Influencia de la adolescencia y su entorno en la adherencia al control prenatal e impacto sobre la prematuridad, bajo peso al nacer y mortalidad neonatal. Revista Chilena De Obstetricia y Ginecología, 80, 306–315.
Mikolajczyk, R. T., Zhang, J., Betran, A. P., Souza, J. P., Mori, R., Gulmezoglu, A. M., & Merialdi, M. (2011). A global reference for fetal-weight and birthweight percentiles. The Lancet, 377(9780), 1855–1861. https://doi.org/10.1016/S0140-6736(11)60364-4
Neal, S., Channon, A. A., & Chintsanya, J. (2018). The impact of young maternal age at birth on neonatal mortality: Evidence from 45 low and middle income countries. PLoS ONE, 13(5), e0195731. https://doi.org/10.1371/journal.pone.0195731
Norr, K. L., Block, C. R., Charles, A. G., & Meyering, S. (1980). The second time around: Parity and birth experience. The Journal of Vitaminology, 9(1), 30–36. https://doi.org/10.1111/j.1552-6909.1980.tb01302.x
Peacock, J. L., Marston, L., Marlow, N., Calvert, S. A., & Greenough, A. (2012). Neonatal and infant outcome in boys and girls born very prematurely. Pediatric Research, 71(3), 305–310. https://doi.org/10.1038/pr.2011.50
Pileggi-Castro, C., Camelo, J. S., Jr., Perdoná, G. C., Mussi-Pinhata, M. M., Cecatti, J. G., Mori, R., Morisaki, N., Yunis, K., Vogel, J. P., Tunçalp, Ö., Souza, J. P., WHO Multicountry Survey on Maternal and Newborn Health Research Network. (2014). Development of criteria for identifying neonatal near-miss cases: Analysis of two WHO multicountry cross-sectional studies. BJOG, 121(Suppl 1), 110–118. https://doi.org/10.1111/1471-0528.12637
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., Silva, D. R., Downe, S., Kennedy, H. P., Malata, A., McCormick, F., Wick, L., & Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3
Rodrigues, D. P., Dodou, H. D., Lago, P. N. D., Mesquita, N. S., Melo, L. P. T. D., & Sousa, A. A. S. D. (2014). Care for both mother and child immediately after childbirth: A descriptive study [postpartum period; rooming-in care; delivery of health care]. Online Brazilian Journal of Nursing, 13(2), 12. https://doi.org/10.5935/1676-4285.20144231
Roos, N., & von Xylander, S. R. (2016). Why do maternal and newborn deaths continue to occur? Best Practice & Research: Clinical Obstetrics & Gynaecology, 36, 30–44. https://doi.org/10.1016/j.bpobgyn.2016.06.002
Souza, J. P., Gülmezoglu, A. M., Vogel, J., Carroli, G., Lumbiganon, P., Qureshi, Z., Costa, M. J., Fawole, B., Mugerwa, Y., Nafiou, I., Neves, I., Wolomby-Molondo, J. J., Bang, H. T., Cheang, K., Chuyun, K., Jayaratne, K., Jayathilaka, C. A., Mazhar, S. B., Mori, R., … Say, L. (2013). Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): A cross-sectional study. The Lancet, 381(9879), 1747–1755. https://doi.org/10.1016/s0140-6736(13)60686-8
Souza, M. A. C. D., Souza, T. H. S. C. D., & Gonçalves, A. K. D. S. (2015). Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica. Revista Brasileira De Ginecologia e Obstetrícia, 37, 498–504.
Suárez-López, L., Hubert, C., de la Vara-Salazar, E., Villalobos, A., de Castro, F., Hernández-Serrato, M. I., & Ávila-Burgos, L. (2022). Continuum of care for maternal, newborn and child health: Evidence from a national survey in Mexico. Sexual & Reproductive Healthcare, 31, 100690. https://doi.org/10.1016/j.srhc.2021.100690
Tan, P. C., Suguna, S., Vallikkannu, N., & Hassan, J. (2008). Predictors of newborn admission after labour induction at term: Bishop score, pre-induction ultrasonography and clinical risk factors. Singapore Medical Journal, 49(3), 193–198.
Tembo, T., Koyuncu, A., Zhuo, H., Mwendafilumba, M., & Manasyan, A. (2020). The association of maternal age with adverse neonatal outcomes in Lusaka, Zambia: A prospective cohort study. BMC Pregnancy and Childbirth, 20(1), 684. https://doi.org/10.1186/s12884-020-03361-5
UNICEF. (2016). A fair chance for every child. United Nations Children’s Fund (UNICEF).
Verdura, M., Raimundo, M., Fernandez Coutinho, M., & Gerometta, R. (2011). Bajo peso al nacer y prematurez en hijos de madres adolescentes de un centro maternoneonatal de la Ciudad de Corrientes. Revista De Posgrado De La VIa Cátedra De Medicina, 205, 6–9.
Vrouenraets, F. P., Roumen, F. J., Dehing, C. J., van den Akker, E. S., Aarts, M. J., & Scheve, E. J. (2005). Bishop score and risk of cesarean delivery after induction of labor in nulliparous women. Obstetrics and Gynecology, 105(4), 690–697. https://doi.org/10.1097/01.AOG.0000152338.76759.38
WHO. (1996). Mother-baby package: Implementing safe motherhood in countries: Practical guide. World Health Organization. Retrieved from May 2, 2022, https://apps.who.int/iris/handle/10665/63268
Acknowledgements
We would like to thank the WHO for making available the Latin American data of the WHO Multicountry Survey on Maternal and Newborn Health database. We are grateful to all members of the WHO Multicountry Survey on Maternal and Newborn Health Research Network, particularly to the country coordinators, data collection coordinators, facility coordinators, data collectors, and all staff of the participating facilities in Latin America. We thank Dr Juan Carlos Aranda-Neri for his advice to interpret results from a clinical point of view and Dr Franz Castro for his editorial assistance.
Funding
This study was partially funded by the National Institute of Public Health of Mexico through the National Strategy to Prevent Adolescent Pregnancy Fund (Anexo-13-E022-630).
Author information
Authors and Affiliations
Contributions
LS-L and EO-P conceptualised and performed the analysis. LS-L, EV-S, DG-H and LC wrote the first draft. GC revised the manuscript for important intellectual content. All authors contributed to the interpretation of the results and development of the article. All authors read and approved the final version of the article. LS-L and EO-P are the guarantors of the article.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest to disclose.
Ethical Approval
The Special Programme of Research, Development and Research Training in Human Reproduction (HRP) Specialist Panel on Epidemiological Research reviewed and approved the study protocol for technical content. The World Health Organization Multicountry Survey on Maternal and Newborn Health study protocol was approved by the World Health Organization Ethical Review Committee and the relevant ethical clearance mechanisms in all participant countries (ID: A65661; date: 27 October 2009).
Consent to Participate
We used de-identified routinely collected data, thus consent from participants is not applicable.
Consent for Publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Suárez-López, L., González-Hernández, D., de la Vara-Salazar, E. et al. Severe Adverse Maternal and Neonatal Outcomes in Adolescent Mother-Newborn Dyads: A Multicentre Study in Latin America. Matern Child Health J 26, 2079–2089 (2022). https://doi.org/10.1007/s10995-022-03474-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-022-03474-7