Assessment of the effect of malnutrition on adverse pregnancy outcomes on adolescent pregnant women in Mchinji District: A cross sectional study Version 2.0
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Date
2020-06-10
Authors
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Journal ISSN
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Publisher
Kamuzu University of Health Sciences
Abstract
Malawi’s teenage pregnancy rate is at 29%[1] and Mchinji district ranks third in the country
with teenage pregnancy rate of 37.5% only superseded by Machinga ( 41.1%) and Nsanje
(38.8%) [1]. Adolescent pregnancies comprise 25% of all births and 20% of maternal
deaths[2]. On the other hand, 7.2% of women of child bearing age (15-49) in Malawi are thin
for their height (Body Mass Index (BMI) <18.5), and the situation is worse for adolescent
girls aged between 15-19years amongst whom 13% are thin for their height[1].
Problem Studies have shown that in Malawi adolescent pregnancies comprise 25% of all births and contributes
20% of maternal deaths[2]. The country has one of the highest maternal mortality ratios globally,
currently estimated at 574 maternal deaths per 100,000 live births[2]. Furthermore, Adolescent
pregnancy is associated with higher risks of adverse pregnancy outcomes including neonatal
complications such as prematurity, low or very low birth weight, and perinatal mortality[6]. It is also
associated with major maternal complications such as hypertensive pregnancy disorders, abortion,
urinary infections, and premature rupture of the fetal membranes[6].
Some other studies have further shown that failure to achieve normal delivery is directly related to the
height of the mother which is influenced by nutritional status in childhood and adolescence[10]. This
could imply that in Malawi, where stunting in under five children is estimated at 37% [1], a
substantial percentage of women do not reach their potential height hence difficult to achieve normal
delivery. Pregnancy prevention strategies and the improvement of healthcare interventions are crucial
to reduce adverse pregnancy outcomes among adolescent women in low‐ and middle‐income
countries[7].
Objectives
Broad Objectives
To determine the effect of malnutrition (wasting- MUAC (Mid Upper Arm Circumference) <22 cm)
on pregnancy outcome in adolescent women in Mchinji.
Specific Objectives
Specifically, the study will address the following objectives:
To describe the prevalence of wasting in adolescent pregnant women receiving antenatal
services at Mchinji district hospital from December 2018 to December 2019.
To describe the prevalence of adverse pregnancy outcomes among adolescent girls receiving
maternity services at Mchinji district hospital from December 2018 to December 2019.
To compare the proportion of adverse pregnancy outcomes (Miscarriage, preterm birth,
stillbirth and low birth weight) among wasted and well-nourished adolescent girls receiving
maternity services at Mchinji district hospital from December 2018 to December 2019.
This will be a cross sectional study based on routinely collected facility data that is recorded
in the antenatal, supplementary feeding and maternity registers.
Type of Study and Methodology
A cross sectional study design will be used. The routinely collected facility data for antenatal,
supplementary feeding and maternity services will be collected then analysed. Data will be
collected from service registers focusing on data from December 2018 to December 2019.
Data will be collected using a case report forms (CRF).
Data will be analysed using Stata version 14.0. Categorical response variables will be
presented using proportions and will be analysed using Chi- square. For objective three, Chisquare test will be done to check whether there is association between nutrition status and
proportions of adverse pregnancy outcome. Logistic regression will be run to adjust for
confounders affecting the relationship between nutrition status and proportion of adverse
pregnancy outcome.
Expected results
It is expected that there will be significant differences in proportion of adverse pregnancy
outcome between malnourished and well-nourished adolescent mothers. Dissemination
The results from this study will be shared with COMREC, Mchinji district hospital and
College of Medicine through the Research Dissemination Meeting.