Birth outcomes in adolescent pregnancy in an area with intense malaria transmission in Tanzania

Background. Although the effects of malaria for the mother and young baby are well described in developing countries, there is very little data on the consequences for adolescent pregnancies. This paper analyses birth outcome in adolescent pregnancy in an area of Tanzania with intense malaria transmission. Methods. A cross-sectional descriptive analysis of 528 adolescents and 1,156 adults, malaria prevalence, and birth-weight outcomes for women delivering in Kilosa Hospital between June 2001 and October 2002. Results. This area has high malaria transmissions with some seasonality. Adolescent primigravidae had higher parasite prevalence than adolescent secundigravidae (41.3% versus 28.1%, p > 0.05), and than adult primigravidae (41.3% versus 31.5%, p = 0.007). Low birth weight prevalence was highest among adolescents delivering during the malaria season (odds ratio 1.7, 95% CI 1.1-2.6, p = 0.02), and was double that of adult primigravidae (31.5% versus 15.9%, p = 0.021). The prevalence of parasitemia (p = 0.003) and low birth weight (p = 0.033) declined with increasing age amongst adolescent primigravidae. Adjusted logistic regression showed a 1.4-fold increased risk of low birth weight amongst adolescents (95% CI, 0.98-1.96). Conclusions. Failure to prioritize adolescent malaria will seriously limit the success of malaria control programs in pregnancy.