Pregnancy outcome and exclusive breastfeeding status among adolescent mother in Matlab, Bangladesh: a retrospective cohort study

Abstract

Background: Sixteen million adolescents give birth each year, constituting 11% of all births world-wide, mostly in low- and middle- income countries. Exclusive breastfeeding (EBF) is an established subsidy for both mothers and infants but unfortunately the rate of breastfeeding among adolescent mothers is lowest worldwide. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes, ANC, facility delivery, practice of EBF in Matlab, Bangladesh. Methods: Total 5,774 adolescent mothers in the HDSS database between 2007 and 2015 were used as the study population. These data were used to examine trends in adolescent motherhood in the icddr,b service areas (ISA) and government service areas (GSA) between 2007 and 2015. Total 4,996 adolescent mothers were included in the analysis of perinatal and antenatal part. Chi-square tests and Binary logistic regression was used to document the statistical difference on outcome indicators in the two study areas. Results: The fertility rate was 27 in ISA and 20 in GSA per 1000 adolescent mothers, during the study period. The adjusted odds of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. The adjusted odds of an adolescent mother accessing 4+ ANC visits in the GSA was 0.57 relative to ISA and that of an adolescent mother accessing facility-based delivery in the ISA was 6.63 relative to GSA. The incidence of abortion among adolescent mothers was significantly 18% lower in ISA compared to GSA. The prevalence of continuing EBF was significantly lower for an adolescent mother residing in GSA compared to an adolescent mother residing in ISA. Conclusion: Lower perinatal death and abortion in ISA than GSA, and higher rates of 4+ ANC visits, facility delivery and EBF among adolescent mothers in ISA than GSA indicate that interventions initiated by icddr,b have been effective in improving maternal and newborn outcomes.