Risk factors for teenage pregnancy during covid-19 in Pakwach district.

Abstract

Introduction: Teenage pregnancy has become a global public health problem. Teenage pregnancy remains the leading cause of death in girls aged 15-19. It is also a major barrier to education continuity and productivity among in-school girls. Its high rate signifies a major problem with the sexual and reproductive health of the country's youth. Limited data exists on risk factors for teenage pregnancies during the COVID-19 pandemic in Uganda. Therefore, we conducted a case-control study to investigate the risk factors and a cross-sectional study to generate data for a time series analysis of the effect of lockdown on this trend in Pakwach district. Methods: This was a mixed-design study of both a matched case-control design and a cross-sectional design to generate data for a time series data analysis. We recruited 362 teenage girls aged 10-19 years from Pakwach district and divided them into two groups in the ratio of 1:1(cases = 181 & controls =181). The study period was from March 2020 to January 2021 for the case-control arm, and for the ITSA, we analyzed data for 25 months starting from March 2019 to March 2021. Results: Pregnancies in adolescent girls, a global public health phenomenon during the COVID-19 lockdown was associated with teenage play description AOR [1.3, 95% CI = (0.5, 3.1)], having only girls as peers [AOR 3.0, (0.1, 104.4)] However, having a Radio/TV at home [AOR 0.2, CI= (0.1, 0.6)], age at first sexual encounter (15-19 years) [AOR 0.1, 95% CI= (0.03, 0.9)], describing teenage pregnancy as sexual abuse [AOR 0.1, CI= (0.02, 0.4)], feeling comfortable to ask questions during the consultation [AOR 0.5, 95% CI= (0.2, 1.3)], and having enough privacy during the consultation was associated with less likelihoods of pregnancy in adolescents. The ITSA analysis revealed an 8% increase in teenage pregnancies and an increasing trend compared to the period before during the COVID-19. Conclusion: In conclusion, the increase in teenage pregnancies during the COVID-19 pandemic in Pakwach district was primarily a result of the lockdown. The 8% increase shown by our data gives us the magnitude in Pakwach district. Therefore, we recommend that actions and interventions around teenage pregnancy the government and partnerships with NGOs focus on providing more information to adolescents to modify the behaviours that contributed to increased teenage pregnancies during the lockdown. Keywords: Case-control study, attending clinicians, COVID-19, teenage/adolescent pregnancy, interrupted time series analysis, and outcomes.