Adverse birth outcomes and associated factors among adolescent mothers in Nabdam District, Ghana: a retrospective cross-sectional study

OBJECTIVE: Pregnancy and childbirth among adolescents have a higher risk of adverse outcomes than among older women. Adolescent mothers often lack physiological, psychological, social and financial capabilities, risking adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW), asphyxia and stillbirth. We investigated birth outcomes and associated factors among adolescent mothers in the Nabdam District of Ghana. DESIGN: Retrospective, health facility-based, cross-sectional study. SETTING: 12 health facilities in Nabdam District, January 2021 to December 2022. PARTICIPANTS: Census of all 373 births recorded in the maternity registers of the selected health facilities. OUTCOME MEASURES: and binary logistic regression models were used. RESULTS: 141 (37.8%) of the adolescent mothers in the selected health facilities had at least one adverse birth outcome: PTB (78, 20.9%), newborn with asphyxia (56, 15.0%), LBW (55, 14.7%) and stillbirth (1, 0.3%). Adolescents in the Pelungu subdistrict were 2.95 times (95% CI 1.44 to 6.05) more likely to have an adverse birth outcome compared with those in the Zanlerigu subdistrict. Lower odds of adverse birth outcomes were found among adolescents aged 16-19 years (adjusted OR (aOR) 0.26, 95% CI 0.08 to 0.89) and those with eight or more antenatal care (ANC) visits (aOR 0.30, 95% CI 0.10 to 0.96) compared with those younger than 16 years and those with fewer than eight ANC visits, respectively. CONCLUSIONS: Adverse birth outcomes were common among adolescent mothers in the district and were more likely among younger adolescents, those living in disadvantaged subdistricts and those with fewer ANC visits. These findings indicate the urgent need for targeted interventions and support for this vulnerable population, as well as those directed towards improving access to comprehensive prenatal care, promoting proper nutrition during pregnancy and enhancing the overall well-being of adolescent mothers in resource-limited settings, in order to facilitate the attainment of Sustainable Development Goals 3.1 and 3.2 on reducing maternal mortality and improving foetal health outcomes.