Nutritional status and birth outcomes of adolescent pregnant girls in Morogoro, Coast, and Dar es Salaam regions, Tanzania.

OBJECTIVE: Studies that link adolescence pregnancies, nutritional status, and birth outcomes in Tanzania are scarce. We examined the nutritional status and birth outcomes of pregnant adolescent girls from rural and urban areas of three regions in Tanzania.
METHODS: The study was carried out in the regions of Dar es Salaam (Chamazi and Gezaulole dispensaries and Round Table Maternity Home), Coast (Tumbi Regional Hospital and Mlandizi Health Center), and Morogoro (Regional Hospital, Uhuru Clinic, and Mlali Health Center). One hundred eighty pregnant adolescent girls ages 15 to 19 y were recruited and interviewed, and their nutritional status measurements were taken at the seven health facilities. Information concerning date of birth, marital status, educational status, sex education, and income status was collected with a structured questionnaire. Height, weight, and mid-upper arm circumference were measured according to standard techniques. Hemoglobin concentration was measured with a hemoglobinometer and the HemoCue technique. Nutritional status was assessed by body mass index, and hemoglobin concentration was determined by cutoff points of the World Health Organization. Suitable statistical analysis was done with SPSS 9.0. Weekly weight gain during pregnancy was measured in 123 subjects who kept their appointments and reported back after 2 wk. Fifty-seven subjects did not keep their appointments and were lost to follow-up. Records of infants' birth weights and mode of delivery were obtained from 50 subjects who delivered at the study sites.
RESULTS: The height of about 54% of the subjects was shorter than 151 cm, suggestive of short maternal height. Severe wasting was observed in 27% of subjects. Mean weekly weight gain during pregnancy was 317 +/-110 g (-500 to 500 g). No significant differences were observed between rural and urban settings. Mean infant birth weight was 2600 +/- 480 g. About 48% of infants had low birth weight (<2500 g) and only 14% of infants had birth weight greater than 3000 g. About 14% of infants were born by cesarean section. Nearly 86% of the pregnant adolescent girls were anemic. A hemoglobin concentration below 7 g/dL was observed in 5% of subjects. Most subjects (55%) had hemoglobin concentrations from 7 to lower than 10 g/dL. There was a weak correlation between infant birth weight and weekly weight gain of the girls during pregnancy (r = 0.36, P < or = 0.01). However, a strong correlation was observed between birth weight and hemoglobin level of adolescent girls during pregnancy (r = 0.67, P = 0.01). Short stature was observed to contribute toward cesarean delivery (P = 0.05) because more cesarean deliveries were performed in short girls (<151 cm tall).
CONCLUSIONS: The nutritional status of pregnant adolescent girls in the study areas was poor and resulted in poor pregnancy outcome. Girls should be educated about reproductive health at the primary level of education.