Abstract
BACKGROUND: Adolescents differ from adults in biological, social, and psychological characteristics, which can impact maternal health outcomes during pregnancy and childbirth. Research suggests that adolescents are at a higher risk of experiencing adverse maternal outcomes. However, the extent to which these differences are driven by various mediating factors-such as biological, lifestyle, or socioeconomic conditions-remains unclear. This study aimed to compare adverse maternal outcomes between adolescent and adult mothers in public hospitals in North Wollo Zone, northern Ethiopia, while adjusting for potential confounders such as healthcare access, antenatal care, and pregnancy intentions. METHODS: A comparative cross-sectional study was conducted from November 2022 to February 2023 involving 488 mothers. Data were collected through interviews and clinical chart reviews and then entered into EpiData version 4.6.6.0 and analyzed using SPSS version 26. Descriptive statistics were used to summarize the data, and logistic regression was applied to identify significant variables (p < 0.05). To correct for multiple testing, the false discovery rate method, using the Benjamini-Hochberg procedure, was applied with a threshold of adjusted p-values <0.1. RESULTS: Adolescent mothers exhibited significantly higher rates of adverse outcomes compared to adult mothers, including preterm labor (7.0% vs. 2.0%, p = 0.04), antepartum hemorrhage (11.9% vs. 4.9%, p = 0.014), anemia (19.3% vs. 10.2%, p = 0.006), pregnancy-induced hypertension (11.9% vs. 7.0%, p = 0.047), malpresentation (9.0% vs. 2.5%, p = 0.008), cephalopelvic disproportion (6.1% vs. 1.2%, p = 0.046), major perineal tears (8.6% vs. 3.3%, p = 0.016), and cesarean delivery (16.0% vs. 9.8%, p = 0.04). CONCLUSION: Adolescent pregnancy was strongly linked to a range of adverse maternal outcomes, including preterm labor, antepartum hemorrhage, malpresentation, oligohydramnios, anemia, major perineal tears, and an increased likelihood of cesarean delivery. To mitigate these risks, it is crucial to implement targeted community and health facility-based interventions that focus on preventing adolescent pregnancies and addressing contributing factors, ultimately improving maternal health outcomes among adolescents.