The nutrition and health risks faced by pregnant adolescents: Insights from a cross-sectional study in Bangladesh

Little is known about nutrition and well-being indicators of pregnant adolescents and the availability and use of nutrition interventions delivered through maternal, newborn, and child health (MNCH) programs. This study compared the differences between pregnant adolescents and adult pregnant women in services received, and in maternal and child nutrition and health conditions. A survey of 2,000 recently delivered women with infants <6 months of age was carried out in 20 sub-districts in Bangladesh where MNCH program is being implemented. Differences in service use and outcomes between pregnant adolescents and adult women were tested using multivariate regression models. The coverage of antenatal care and nutrition services was similar for adolescent and adult mothers. Compared to adult mothers, adolescent mothers had significantly fewer ownership of assets and lower decision making power. Adolescent mothers weighed significantly less than adult women (45.8 vs 47.1 kg, p = 0.001), and their body mass index was significantly lower (19.7 vs 21.3, p = 0.001). Adolescents recovered later and with greater difficulty after childbirth. Infants of adolescent mothers had significant lower height-for-age z-score (-0.89 vs -0.74, p = 0.04), lower weight-for age z-score (-1.21 vs -1.08, p = 0.02) and higher underweight prevalence (22.4% vs 17.9%, p = 0.04) compared to infants of adult women. In conclusion, this study confirms that adolescent pregnancy poses substantial risks for maternal and infant outcomes, and emphasizes that these risks are significant even where services during pregnancy are available and accessed. A focus on preventing adolescent pregnancy is imperative, while also strengthening health and nutrition services for all pregnant women, whether adult or adolescent.

目前学界对青春期妊娠女性的营养与健康福祉指标，以及通过母婴健康（Maternal, Newborn, and Child Health, MNCH）项目提供的营养干预措施的可及性与使用情况，尚且所知甚少。本研究对比了青春期妊娠女性与成年妊娠女性在接受服务、母婴营养与健康状况方面的差异。本研究在孟加拉国20个正在实施MNCH项目的次级行政区中，针对2000名近期分娩且婴儿月龄不足6个月的女性开展了问卷调查。研究采用多元回归模型，检验了青春期妊娠女性与成年女性在服务使用情况与妊娠结局方面的差异。结果显示，青春期妊娠母亲与成年母亲的产前保健与营养服务覆盖率相近。与成年母亲相比，青春期妊娠母亲拥有的资产显著更少，决策话语权也更低。青春期妊娠母亲的体重显著低于成年女性（45.8 vs 47.1 kg，p=0.001），其身体质量指数（Body Mass Index, BMI）也显著更低（19.7 vs 21.3，p=0.001）。青春期妊娠女性在产后恢复的速度更慢，恢复难度也更高。与成年母亲所育婴儿相比，青春期母亲所育婴儿的年龄别身高Z评分显著更低（-0.89 vs -0.74，p=0.04）、年龄别体重Z评分更低（-1.21 vs -1.08，p=0.02），且低体重患病率更高（22.4% vs 17.9%，p=0.04）。综上，本研究证实青春期妊娠对母婴结局存在显著风险，并强调即便妊娠期间已有可及的保健服务，此类风险依然不容忽视。因此，亟需将预防青春期妊娠作为工作重点，同时为所有妊娠女性——无论成年或青春期女性——强化健康与营养服务供给。