Adverse pregnancy outcomes among adolescent mothers in the Eastern Cape, South Africa
1
Center for Social Science Research, University of Cape Town, Cape Town, South Africa
2
Department of Social Policy and Intervention, Center for Evidence-Based Intervention, University of Oxford, Oxford, United Kingdom
3
Department of Infectious Disease Epidemiology,, London School of Hygiene and Tropical Medicine,, London, United Kingdom
4
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
5
HIV and Other Infectious Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa, South African Medical Research Council,, Cape Town, Western Cape, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3041
ABSTRACT
BACKGROUND:
Infants born to adolescent and young mothers (AYM) experience heightened biological and socioeconomic vulnerabilities, increasing their risk of being born small‑for‑gestational‑age (SGA), stunted, preterm, or low birth weight (LBW). Limited evidence examines how pregnancy experiences shape intrauterine growth and newborn size among this high-risk population.
AIM:
To examine the prevalence of SGA, stunting, and LBW, and to identify maternal factors associated with adverse newborn growth outcomes.
METHODS:
In this cross-sectional study, we used data from the HEY BABY cohort of AYM and their children from the Eastern Cape Province, South Africa. Anthropometry was obtained from Road to Health Booklet and classified using INTERGROWTH 21st newborn size standards. Outcomes included SGA (<10th centile), low birthweight (<2.5 kg) and stunting (length for gestational age <10th centile). Multivariable logistic regression was used to estimate adjusted associations between self-reported maternal factors and pregnancy outcomes.
RESULTS:
Among 700 newborns born mean age (SD) of 271.2±14.6 weeks, 18.6% were SGA and 31.4% were stunted. The prevalence of LBW was 12.8% (95% CI 10.6–14.9), with higher rates among girls 15.2% than boys 10.5%. Preterm birth (13.8%) was strongly associated with LBW (aOR = 20.98; 95% CI: 6.04–72.85; p < 0.001), while continuation of schooling during pregnancy was associated with increased odds of both LBW (aOR = 5.94; 95% CI: 1.88–18.76; p = 0.002) and SGA (aOR = 3.28; 95% CI: 1.38–7.77; p = 0.007). Maternal HIV acquisition was also associated with higher odds of SGA (OR = 1.64; 95% CI: 1.10–2.45; p = 0.014). In contrast, older maternal age (>18 years) was linked to significantly lower odds of stunting (aOR = 0.31; 95% CI: 0.14–0.68; p = 0.003).
CONCLUSIONS:
A substantial proportion of infants born to AYM exhibited intrauterine growth restriction, underscoring need for adolescent‑responsive antenatal care, strengthened nutritional support, and interventions to preventing preterm birth.
Infants born to adolescent and young mothers (AYM) experience heightened biological and socioeconomic vulnerabilities, increasing their risk of being born small‑for‑gestational‑age (SGA), stunted, preterm, or low birth weight (LBW). Limited evidence examines how pregnancy experiences shape intrauterine growth and newborn size among this high-risk population.
AIM:
To examine the prevalence of SGA, stunting, and LBW, and to identify maternal factors associated with adverse newborn growth outcomes.
METHODS:
In this cross-sectional study, we used data from the HEY BABY cohort of AYM and their children from the Eastern Cape Province, South Africa. Anthropometry was obtained from Road to Health Booklet and classified using INTERGROWTH 21st newborn size standards. Outcomes included SGA (<10th centile), low birthweight (<2.5 kg) and stunting (length for gestational age <10th centile). Multivariable logistic regression was used to estimate adjusted associations between self-reported maternal factors and pregnancy outcomes.
RESULTS:
Among 700 newborns born mean age (SD) of 271.2±14.6 weeks, 18.6% were SGA and 31.4% were stunted. The prevalence of LBW was 12.8% (95% CI 10.6–14.9), with higher rates among girls 15.2% than boys 10.5%. Preterm birth (13.8%) was strongly associated with LBW (aOR = 20.98; 95% CI: 6.04–72.85; p < 0.001), while continuation of schooling during pregnancy was associated with increased odds of both LBW (aOR = 5.94; 95% CI: 1.88–18.76; p = 0.002) and SGA (aOR = 3.28; 95% CI: 1.38–7.77; p = 0.007). Maternal HIV acquisition was also associated with higher odds of SGA (OR = 1.64; 95% CI: 1.10–2.45; p = 0.014). In contrast, older maternal age (>18 years) was linked to significantly lower odds of stunting (aOR = 0.31; 95% CI: 0.14–0.68; p = 0.003).
CONCLUSIONS:
A substantial proportion of infants born to AYM exhibited intrauterine growth restriction, underscoring need for adolescent‑responsive antenatal care, strengthened nutritional support, and interventions to preventing preterm birth.
| eISSN: | 2654-1459 |
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