Repeat adolescent pregnancies in Southwestern Uganda: A cross-sectional study

Womens Health (Lond). 2024 Jan-Dec:20:17455057241302449. doi: 10.1177/17455057241302449.

Abstract

Background: Pregnancy in adolescents continues to remain a significant public health challenge, with repeat pregnancies in this age group often receiving insufficient attention. In Uganda, repeat adolescent pregnancy varies between 26.1% and 55.6%. Evidence shows that repeat pregnancy in adolescence is more common in settings of high poverty, low educational attainment and low use of long-acting reversible contraceptives among others.

Objectives: The main aim of this study is to determine the underlying risk and protective factors of repeat adolescent pregnancy in Uganda.

Design: This was a cross-sectional study among adolescent girls and young women aged between 13 and 22 years with single and repeat pregnancies in four districts in Southwestern Uganda.

Methods: The questionnaire was administered on a portable PC to collect information on socio-demographic characteristics, sexual behaviours, sexual and reproductive health (SRH) knowledge, pregnancy outcome, experience of violence and mental health. Descriptive statistics and logistic regression were performed.

Results: A total of 115 girls with single and 93 with repeat pregnancies participated in the survey. Of these, 42 (20.2%) were 18 years and younger. The majority (92%) had dropped out of school, having achieved primary-level education (67%). The mean age of sexual debut (15.6 versus 16.4 years) and the mean age at first pregnancy (16.4 versus 17.3 years) were lower among those in repeat-pregnancy group compared to those in single-pregnancy group. The odds of having repeat pregnancy were higher among participants who engaged in risky behaviour (AOR 3; 95% CI (1.28-7.37)) and experienced any form of violence (AOR 4.67; 95% CI (1.5-16.56)). Being single, having the first pregnancy in older age (16 and above) and having a positive first pregnancy outcome (live birth) served as protective factors for repeat pregnancy.

Conclusions: Adolescents with repeat pregnancies have significantly more SRH risks compared to those with single pregnancies. These findings underscore the importance of multi-faceted and timely interventions for adolescent girls in this setting, with an emphasis on the mitigation of violence, and enhancing access to comprehensive sexuality education, and SRH services.

Keywords: Africa; Uganda; adolescent; repeat pregnancy.

Plain language summary

Repeat teenage pregnancies in UgandaStudy on factors contributing to repeat pregnancies in Ugandan adolescents.Why was the study done? Teen pregnancy is a major public health issue, and repeat pregnancies in adolescents are often overlooked. In Uganda, 26% to 56% of teen pregnancies are repeat pregnancies. These tend to happen more frequently in areas with high poverty, low education levels, and poor access to long-term contraceptives. Understanding the causes and factors that increase or decrease the likelihood of repeat pregnancies can help create more effective prevention strategies.What did the researchers do? We studied 208 adolescent girls and young women, aged 13 to 22, from four districts in Southwestern Uganda. We compared those with single pregnancies to those with repeat pregnancies. Data was collected on their backgrounds, sexual behaviors, knowledge of reproductive health, pregnancy outcomes, and experiences of violence.What did the study find? Out of 208 participants, 115 had a single pregnancy, while 93 had repeat pregnancies. The study found that:• Most of the girls (92%) had dropped out of school, and 67% had only completed primary education.• Girls with repeat pregnancies started having sex and got pregnant at younger ages than those with single pregnancies.• Those who engaged in risky behaviors or experienced violence were more likely to have a repeat pregnancy.• Protective factors included being single, having the first pregnancy after age 16, and having a positive outcome in the first pregnancy (a live birth).What do the findings mean? This study highlights the need for targeted interventions to reduce repeat pregnancies among Ugandan adolescents. These interventions should focus on preventing violence, improving access to education about sexual and reproductive health, and providing better health services to these young women.

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy in Adolescence* / statistics & numerical data
  • Reproductive Health / statistics & numerical data
  • Risk Factors
  • Sexual Behavior* / statistics & numerical data
  • Surveys and Questionnaires
  • Uganda / epidemiology
  • Young Adult