Online Journal of Health & Allied Sciences (Nov 2023)
Prevalence, Indications and Evolution of Caesarean Sections Among Adolescent Girls at Lubao General Reference Hospital, The Democratic Republic of Congo: A Comparative Study with Adult Women
Abstract
Introduction: Adolescence is a period of psychological and somatic growth and development. Pregnancy and childbirth during this period expose women to medical and cognitive risks. The aim of this study was to determine the prevalence, indications, evolution and factors associated with the risk of caesarean section among adolescent and adult women. Methods: This was a cross-sectional, analytical study conducted at Lubao General Referral Hospital. Data covered the period from 2018 to 2022. Epi Info 7.2.4 and Jamovi 2.3.21 software were used for data analysis. The p-value and Odd ratio were used to determine the association between the variables. Results: Caesarean sections accounted for 15.3% of deliveries (375 out of 2444). The prevalence of caesarean sections was 78.0% (64 out of 82 deliveries) among adolescent women and 13.2% (311 out of 2362 deliveries) among adult women. The risk of caesarean section was 23.44 times higher among adolescents (OR 23.44; [IC95% 13.71-40.09]; p-0.0000). Fetal macrosomia and acute fetal distress were the main indications in both groups. Bone dystocia was found only among adolescents. Occupation (OR 39.04 [CI95% 5.34-285.27]; p=0.0000), being single (OR 43.26 [CI95% 9.54-196.10]; p=0.0000), mechanical dystocia (OR 2.08 [CI95% 1.11-3.87]; p=0.0190) and parity ≤ three (p=0.0000) were associated with the indication for caesarean section among the adolescents studied. Maternal and early neonatal outcome were not associated with maternal age. Conclusion: Adolescents present a very high risk of caesarean section. Raising parents' awareness of the risks of early marriage, educating girls in favour of sex education in schools, churches and youth clubs, and combating sexual exploitation and abuse and even sexual violence are all solutions that should be considered.