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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 6  |  Issue : 2  |  Page : 111-114

Age at first pregnancy among primigravidae attending antenatal clinic at a Tertiary Hospital in Kano


Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria

Date of Web Publication30-Nov-2016

Correspondence Address:
Rabiu Ayyuba
Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, Kano
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.194984

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  Abstract 

Background: The first pregnancy marks a transition into motherhood and influences the number of children a woman bears throughout her reproductive period, and consequently the size, composition, and future growth of the population in a community. The aim of this survey was to determine the average age at first pregnancy among primigravidae attending antenatal clinic in Aminu Kano Teaching Hospital, Kano.
Patients and Methods: This was a retrospective study among women who booked for antenatal care at Aminu Kano Teaching Hospital over a 1 year period. Data were retrieved from case files and analyzed using the Statistical Package for the Social Sciences, version 17 (SPSS Inc., Chicago, IL, USA).
Result: The mean age at first pregnancy was 23.9 ± 4.27 years. Teenage women accounted for 10.2% of the total population. Majority of the women were Hausas (71.8%), Muslims (86.1%), unemployed (80.9%), and had formal education (92.4%). Ethnicity (Hausas versus other tribes), religion (Islam versus Christianity) and occupation (employed versus unemployed) were not statistically associated with the age at first pregnancy above teenage age group (X2= 2.578, P = 0.108; X2 = 1.788, P = 0.181; X2 = 3.350, P = 0.067, respectively). However, formal education was statistically associated with average age at first pregnancy (X2= 13.486, P = 0.001).
Conclusion: The age at first pregnancy was found to be 23.9 ± 4.27 years. This was within the recommended age of 20–35 years. Women with formal education were more likely to delay the age at first pregnancy until after teenage years. Formal education will certainly contribute to reducing maternal mortality and morbidity associated with teenage pregnancies.

Keywords: Age at first pregnancy, Kano, primigravidae


How to cite this article:
Ayyuba R, Sayyid A, Takai IU, Abubakar IS, Garba I. Age at first pregnancy among primigravidae attending antenatal clinic at a Tertiary Hospital in Kano. Arch Int Surg 2016;6:111-4

How to cite this URL:
Ayyuba R, Sayyid A, Takai IU, Abubakar IS, Garba I. Age at first pregnancy among primigravidae attending antenatal clinic at a Tertiary Hospital in Kano. Arch Int Surg [serial online] 2016 [cited 2019 Sep 20];6:111-4. Available from: http://www.archintsurg.org/text.asp?2016/6/2/111/194984


  Introduction Top


Pregnancy is defined as “the maternal condition of having a developing fetus in the body.”[1] It begins when a sperm fertilizes an ovum.[1] The first pregnancy marks the transition into motherhood. The age at first childbirth influences the number of children a woman bears throughout her reproductive period, which in turn influences the size, composition, and future growth of the population in a given community.[2] The recommended age for pregnancy is 20–35 years.[3] Women who become pregnant before the age of 20 years are at increased risk of intrauterine growth restriction (IUGR), having preterm labor, and preeclampsia.[4],[5] In contrast, those having children after 35 years are at risk of gestational diabetes mellitus, hypertension in pregnancy, stillbirth, and chromosomal abnormality in the fetuses.[6],[7],[8] Factors that can influence the age at first pregnancy include age at first marriage, religion, educational status, social status, occupational status, and cultural norms which differ from country to country.[9] Adolescents with at least 7 years of schooling (in developing countries) are likely to delay marriage until after the age of 18 years.[10]

The median age at first pregnancy in the year 2013 was 26 years in the United States of America [11] and 28.3 years in the United Kingdom.[12] In contrast, more than one-third of women in developing countries give birth before the age of 20 years.[2]

In Nigeria, the median age at first birth for women aged 25–49 years is 20.2 years.[13] Women living in urban areas have their first birth three years later (22.0 years) compared to women living in rural areas (19.0 years).[13] The median age at first birth increases with level of education; women with no education have their first birth four years earlier than women with secondary education (18.1 and 22.4 years, respectively).[13]

A good knowledge of the mean age of first pregnancy in a given community can help in planning health policies and health care services, especially those targeted in reducing maternal morbidity and mortality.

The aim of this survey was to determine the average age at first pregnancy among primigravidae attending antenatal care clinic in Aminu Kano Teaching Hospital, and to determine the relationship and effect of ethnicity, education, religion, and occupation on the age at first pregnancy.


  Patients and Methods Top


This was a retrospective study among primigravidae who booked for antenatal care at Aminu Kano Teaching Hospital over a 1 year period from 1st January to 31st December 2015. Their case notes were retrieved from the health record department. Information extracted from the files included their ages, marital status, ethnic group, religion, literacy level, and occupational status. During the period under review, 1013 women booked for antenatal care. Of these, only 859 files were retrieved from the health record department, which gave a retrieval rate of 84.8%.

In this study, the age at first pregnancy was taken as the age at which pregnancy was diagnosed for the first time, irrespective of the outcome of the pregnancy. Only primigravidae were included in the study, women with two or more pregnancies were excluded.

A proforma was designed and the data retrieved from patient's folders were entered. Data were analyzed by the Statistical Package for Social Sciences (SPSS) version 17 (SPSS Inc., Chicago, IL, USA). Chi-square tests were used to compare differences between categorical variables. P value was set at ≤5% (0.05) for consideration of statistical significance.


  Results Top


A total of 216 women met the inclusion criteria (were primigravidae). The ages of the women ranged between 17 and 43 years with mean age ± standard deviation (SD) at first pregnancy of 23.9 ± 4.27 years.

All 216 women (100%) were married. One hundred and eighty six (86.1%) were of the Islamic faith whereas 30 (13.9%) were Christians. Sixteen (7.6%) had no formal education, and majority, 174 (80.9%) were unemployed [Table 1].
Table 1: Socio-demographic characteristics

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Twenty two (10.2%) were teenagers whereas 4 (1.9%) were elderly primigravidae (35 years and older). Most women who first became pregnant during their teenage years were Hausas (86.4%) and were of Islamic faith (95.5%). Majority (72.7%) also had formal education and were largely unemployed (95.5%).

Similarly, majority who had their first pregnancies after 19 years of age were also Hausas, Muslims, had formal education, and were largely unemployed (70.1, 85, 94.7, and 79.3%, respectively). Ethnicity (Hausas versus other tribes), religion (Islam versus Christianity) and occupation (employed versus unemployed) were not statistically associated with the age at first pregnancy above teenage age group (X2 = 2.578, P = 0.108; X2 = 1.788, P = 0.181; X2 = 3.350, P = 0.067, respectively) [Table 2].
Table 2: Relationship between socio-demographic characteristics and age at first pregnancy(for teenage age)

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However, in this study, formal education was statistically associated with average age at first pregnancy above teenage age group (X2 = 13.486, P = 0.001).


  Discussion Top


The mean age at first pregnancy in this study was 23.9 years. This is slightly higher than that (22 years) found in the national demographic health survey in Nigeria in 2013.[13] This higher value may be due to the fact that the study was carried out in an urban center. This value was, however, lower than those from United Kingdom (28.3 years)[12] and United States of America (26 years).[11] This is within the recommended age at first pregnancy of 20–35 years.[3] Furthermore, only approximately one-fifth (10.2%) of the prospective mothers were teenagers, and this was in contrast with the findings of Rabbi and Kabir,[2] which showed that more than one-third of women in developing countries give birth before the age of 20 years.

The study showed that Hausas and Muslims were the majority. This may be attributed to the study location (Kano) where the major ethnic group and religion are Hausa and Islam, respectively.[14] Majority of teenage pregnant women (86.4%) were Hausas, however, this was not statistically significant (P = 0.108) as ethnicity (Hausa versus other ethnic groups) was not shown to have an effect on the age at first pregnancy (before 20 years of age); most Hausa women have their first pregnancy at or before the age of 24 (mean age at first pregnancy in this study) years (P < 0.001).

Women with no formal education (27.3%) are more likely to begin child bearing in their teenage years than those with formal education. This was similar to the report from the national demographic health review, which concluded that the median age at first birth increases with the level of education.[13] Salako et al.[10] also showed that adolescent with at least 7 years of education are likely to delay marriage (and consequently child birth) until after the age of 18 years. This study was conducted in a tertiary hospital situated in the city of Kano. Here, majority of the respondents (92.10%) attended and completed formal education till at least secondary school, as such, the average age at first pregnancy was 23.9 years. There was also statistically significant evidence from this study that education delays the age at first pregnancy (P < 0.001).

Women who were not employed or who were of Islamic faith were more likely to become pregnant before 20 years of age (95.5%) compared to those who were employed (4.5%) or of Christian faith (4.5%). However, these were not statistically significant (P = 0.067 and P = 0.181, respectively). This might have been significant had the study been carried out in a rural setting where majority of women have their first pregnancy during their teenage years.[13] Most of these women (those who were unemployed and of Islamic faith), however, had their first pregnancy on or before the age of 24 years (P < 0.001).

Limitations of the study

Retrospective study, difficulty in retrieving case records, and missing records.


  Conclusion Top


The age at first pregnancy was found to be 23.9 ± 4.27 years. This was within the recommended age of 20–35 years. Teenage mothers constituted only one-fifth (10.2%) of the study population. Women with formal education were more likely to delay the age at first pregnancy until after teenage years. Hence, formal education will certainly contribute to reducing maternal mortality and morbidity associated with teenage pregnancies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Bernstein HB. Normal pregnancy and prenatal care; Current Diagnosis and Treatment Obstetrics & Gynecology. 11th ed. New York: McGraw-Hill Companies; 2013. p. 149-52.  Back to cited text no. 1
    
2.
Rabbi AM, Kabir MH. Factors Influencing Age at First Birth of Bangladeshi Women- A Multivariate Approach. Am J Public Health Res 2013;1:191-5.  Back to cited text no. 2
    
3.
Campbell D. The best age to become a mother. Available at: www.theguardian.com/society/2010/dec/31/pregnancy-mothers-fertility-children. [Last accessed on 30 March 2016].  Back to cited text no. 3
    
4.
Gharoro EP, Igbafe AA. Maternal age at first birth and obstetric outcome. Nig J Clin Pract 2002;5:20-4.  Back to cited text no. 4
    
5.
Garba I, Adewale TM, Ayyuba R, Abubakar IS. Obstetric outcome of teenage pregnancy at Aminu Kano Teaching Hospital: A 3-year review. J Med Trop 2016;18:43-6.  Back to cited text no. 5
  Medknow Journal  
6.
Mayo Clinic: Pregnancy after 35; Healthy moms, healthy babies. Available at: http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/pregnancy/art-20045756. [Last accessed on 27 April 2016].  Back to cited text no. 6
    
7.
American College of Obstetricians and Gynecologists. Women's Health care Physicians. Having a baby after Age 35. Frequently asked Questions 060, September 2015. Available at: http://www.acog.org/-/media/For-Patients/faq060.pdf?dmc=1. [Last accessed on 29 March 2016].  Back to cited text no. 7
    
8.
Jonas O, Chan A, Roder DM, Macharper T. Pregnancy outcome in primigravid women aged 35 years and over in South Australia, 1986–1988. Med J Aust 1991;154:246-9.  Back to cited text no. 8
    
9.
Maxwell NL. Individual and aggregate influences on the age at first birth. Popul Res Policy Rev 1991;10:27-46.  Back to cited text no. 9
    
10.
Salako AA, Iyaniwura, CA, Jeminusi OA, Sofowora R. Sexual behaviour, contraception and fertility among in-school adolescents in Ikenne local government, south western Nigeria. Nig J Clin Pract 2006;9:26-36.  Back to cited text no. 10
    
11.
Surprising facts about birth in the United States. Available at: http://www.babycenter.com/0_surprising-facts-about-birth-in-the-united-states_1372273.bc. [Last accessed on 27 April 2016].  Back to cited text no. 11
    
12.
Office for National Statistics. Statistical bulletin: Live Births in England and Wales by Characteristics of Mother 1: 2013. The age and living arrangements of mothers based on birth registration data. Available at: http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/livebirthsinenglandandwalesbycharacteristicsofmother1/ 2014-10-16. [Last accessed on 27 April 2016].  Back to cited text no. 12
    
13.
National Population Commission [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. Rockville, Maryland, USA: National Population Commission and ICF International. Available at: http://dhsprogram.com/pubs/pdf/SR213/SR213.pdf. [Last accessed on 27 April 2016].  Back to cited text no. 13
    
14.
Federal Republic of Nigeria. Provisional results of the main findings of 2006 census. Official Gazette 2007;94:589-91. Government notice No. 3, B52, Lagos, Federal Republic of Nigeria.  Back to cited text no. 14
    



 
 
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