Hypertension, hemorrhage and suicide most common causes of adolescent maternal deaths after adolescent deliveries, finds study

The World Health Organization (WHO) has recognized teenage pregnancy as a worldwide issue, with 12 million teenagers reported to have given birth in 2019. Pregnancy-related complications are the primary cause of death among adolescents aged 15-19 globally. The global adolescent birth rate (ABR) has been decreasing gradually, but sub-Saharan Africa had the highest ABR in 2022 at 97 per 1000 women per year. Recent study analyzed adolescent maternal deaths and deliveries in the Ekurhuleni Health District in South Africa over a nearly six-year period from July 2014 to March 2020. A total of 12,559 adolescent deliveries were documented, with the majority of deliveries and deaths occurring among women aged 15-19 years. Adolescent deaths (n=37) accounted for around 8% of total maternal deaths, with the main causes being hypertension (35%), hemorrhage (24%), and suicide (14%). Postpartum deaths were significantly higher than antepartum deaths, and most newborns were born alive (72.7%).

Challenges and Collaboration

The study highlighted challenges such as a high number of adolescent deliveries, repeat pregnancies, and preventable causes of death among adolescents. Multidisciplinary collaboration involving obstetricians, midwives, pediatricians, school health services, social workers, and psychologists was emphasized for comprehensive management and prioritizing pregnancy prevention in this vulnerable group. The study found that adolescents aged 10-14 years contributed about 3% of adolescent maternal deaths, which is a new and important finding compared to previous studies.

Findings and Recommendations

The research noted that hypertension was the most common cause of adolescent maternal death, followed by hemorrhage and suicide. The study revealed lower adolescent birth rates and mortality compared to previous reports from sub-Saharan Africa, indicating some positive trends. The study emphasized the need for innovative strategies such as dedicated adolescent clinics, home contraceptive services, and investments in adolescent-friendly health services to address the challenges identified. Overall, the study underscored the importance of further research on adolescent pregnancy in South Africa and sub-Saharan Africa to enhance healthcare prevention services for this vulnerable population.

Key Points

1. Adolescent maternal deaths and deliveries in the Ekurhuleni Health District in South Africa were analyzed from July 2014 to March 2020.

2. A total of 12,559 adolescent deliveries were recorded, with the majority occurring among women aged 15-19 years.

3. Adolescent deaths accounted for approximately 8% of total maternal deaths, with hypertension, hemorrhage, and suicide being the main causes.

4. Postpartum deaths were more prevalent than antepartum deaths, and the majority of newborns were born alive.

5. Challenges identified included a high number of adolescent deliveries, repeat pregnancies, and preventable causes of death, highlighting the need for multidisciplinary collaboration for comprehensive management.

6. Recommendations from the study included innovative strategies like dedicated adolescent clinics, home contraceptive services, and investments in adolescent-friendly health services to address the identified challenges and improve healthcare services for this vulnerable population.

Reference -

J. Basu et al. (2024). Adolescent Maternal Mortality At A District Health Services Over A Five Year Period In South Africa: A Retrospective Study.. *International Journal Of Gynaecology And Obstetrics: The Official Organ Of The International Federation Of Gynaecology And Obstetrics*. https://doi.org/10.1002/ijgo.15763