Peer-reviewed article

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

Rupa Ramachandran, Shakillah Namatovu, Daniel Atwine, Jackline Tumuhairwe, Viola N. Nyakato et al. · 1 Aug 2024

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.