International journal of multidisciplinary and current research | 2019
Prévalence et risque fœto-maternel de la maternité précoce dans la province duLualaba en République Démocratique du CongoPrevalence and risk fetal-maternal of early motherhood in Lualaba Province, Democratic Republic of Congo
Abstract
Contexte : La maternite precoce est la survenue d’une grossesse chez une femme dont l’âge est inferieur a 19 ans pour\nles uns et inferieur a 21 ans pour les autres au moment de la naissance de son bebe. Elle presente de nombreuses\ncomplications fœto-maternelles et demeure une preoccupation sociale et sanitaire majeure. Cependant, la survenue\nd une maternite pendant cette periode et surtout a l adolescence est consideree par nombre de gynecologues\nobstetriciens comme non recommandable et devant etre prevenue.\nMethodologie : Nous avons mene une etude transversale a visee analytique. Notre milieu d’etude a ete fait de 5 zones\nde sante de la Province du Lualaba (2 urbaines et 3 rurales). Les registres de maternite ont ete consultes dans ces\nstructures. 25815 accouchements ont ete enregistres dont 3550 etaient de survenue precoce.\nResultats : La prevalence des maternites precoces etait de 13,8% (IC 95% : 13,4 ; 14,2. Les prevalences elevees ont ete\nenregistrees dans les structures rurales que celles urbaines (65,2% Vs 34,8%). L’âge moyen aux maternites precoces\netait de 17,1 ans avec une deviation standard de 0,82. Les extremes etaient de 13 ans et de 18 ans. Les meres des\nvillages ont presente un risque OR=5,65 de ne pas suivre la CPN face a celles de la ville et Bidonville. Comparee a la\ntranche d’âge de 15-18 ans, la tranche de 13 a 15 ans a presente un risque eleve des consequences d’accouchement\ndont : 3,41 [2,42 ; 4,79] pour les dechirures des parties molles et de 6,57 [4,38 ; 9,82] pour les hemorragies du post\npartum. Sur les 1,4 % de nouveaux nes de faible poids de naissance, le risque etait eleve chez les meres de 13-15 ans\nOR= 3,96 [1,68 ; 9,0]. Celles du milieu rural comprises dans la tranche d’âge de 13-15 ans ont presente le risque de faible\npoids de naissance estime a OR= 5,39[1,21 ; 20,58], contre celles de la ville et Bidon ville OR= 3,983 de s’accoucher des\nenfants de faible poids a la naissance. Le deces avant 8 jours a ete vecu dans 12,2% chez les victimes de maternites\nprecoces. Le risque etait eleve chez celles de 13 a 15ans. OR=1,61 [1,10; 2,56] pour le deces des enfants avant le 8eme\njour de vie. Les faibles poids de naissance ont couru un risque 33,45 fois plus eleve de deceder avant le 8eme jour de vie\nOR=33,45 [15,41 ; 74,91].\nConclusion : Les maternites precoces dans la province du Lualaba sont presentes avec des consequences semblables a\ncelles du reste du monde. Ces consequences entrainent les risques pathologiques lies a l’immaturite des organes\ngenitaux de la jeune mere (dechirure perineale), cesarienne, sejours prolonges dans les hopitaux. L’etude permet\nd’appuyer les strategies internationales decourageant les maternites precoces a cause des effets nefastes en matiere de\nsante reproductive aboutissant aux graves complications et deces maternels.\nSummary\nContext: Early motherhood is the occurrence of a pregnancy in a woman whose age is less than 19 years for some and\nless than 21 years for others at the time of birth of her baby. It presents numerous feto-maternal complications and\nremains a major social and health concern. However, the occurrence of maternity during this period and especially in\nadolescence is considered by many gynecologists obstetricians as not recommendable and to be prevented. \nKasongo Kayembe Aime et al Prevalence et risque fœto-maternel de la maternite precoce dans la province du Lualaba en..\n314 | Int. J. of Multidisciplinary and Current research, Vol.7 (May/June 2019)\nMethodology: We did an analytical cross-sectional study. Our study area was made of 5 health zones of Province of\nLualaba (2 urban and 3 rural). Maternity records were consulted in these structures. 25815 births were recorded, of\nwhich 3550 were early births.\nResults: The prevalence of early motherhood was 13.8% 95% CI [13.4; 14.2]. High prevalence have been recorded in\nrural structures as urban ones (65.2% vs 34.8%). The average age for early motherhood was 17.1 years with a standard\ndeviation of 0.82. The extremes were 13 and 18. Mothers in villages have ran a risk estimated to OR = 5.65 of not\nfollowing the NHC during this pregnancy in the face of the city and slums. Compared to the age group of 16-18, the age\ngroup 13 to 15 years has a high risk of childbirth. Consequences whose risks were estimated as follows: The tears of the\nsoft parts OR = 3.43 [2.50; 4, 71]; the postpartum hemorrhage OR = 2.64 [1.68; 4.17]. Of the 1.4% of low birth weights\nexperienced, the risk was high for mothers aged 13-15 years OR = 4.15 [1.99; 8.65]. Those in rural areas included in the\nage group 13-15 years ran, the risk of low birth weight estimated at OR = 7.15 [2.32; 22,04]. Against those of the city\nand in the slums OR = 3.78 [1.25; 9.78] to give birth to children of low birth weight. The death before 8 days was\nexperienced in 12.2% among the victims of early maternity. The risk was high for those aged 13 to 15 years OR = 1.72\n[1.16; 2.53] for death of children before 8th day of life. In 12.2% among the victims of early maternity. The risk was high\namong those aged 13 to 15 years OR = 1.72 [1.16; 2.53]. For the death of children before the 8th day of life, the birth\nwith low weights ran a risk estimated OR = 32.50 [16.15; 65, 39] to die before the 8th day of life. ORaMH = 1.64. There\nwere 817 maternal deaths per 100,000 live births.\nConclusion: Early maternity in the province of Lualaba is present with consequences similar to those of the rest of the\nworld. These consequences result to pathological risks associated with the immaturity of the young mother s genitalia\n(perinea tear), cesarean section, and extended stays in hospitals. The study supports international strategies that\ndiscourage early motherhood due to adverse reproductive health effects leading to severe complications and maternal\ndeaths.