An as­sess­ment of preg­nancy out­comes at JDWNRH with an em­pha­sis on an early age preg­nancy

Bhutan Times - - Front Page - Sonam Pen­jor

An early preg­nancy re­mains a grow­ing public health con­cern in Bhutan and in the re­cent years, the preg­nan­cies among young women which in­cludes both mar­ried and un­mar­ried are in­creas­ingly de­scribed as a sen­sa­tional sub­ject.

Ac­cord­ing to the Sex­ual and Re­pro­duc­tive Health of Ado­les­cents and Youth in Bhutan, mono­graph se­ries num­ber seven which was com­plied by Na­tional Sta­tis­tics Bureau, states that this was par­tic­u­larly due to new laws that pro­scribe sex­ual ac­tiv­i­ties at young age and the in­creased aware­ness of the med­i­cal im­pli­ca­tions of an early age preg­nancy.

Ac­cord­ing to the re­port, in the con­texts where the coun­try is in tran­si­tional stage, where ur­ban­iza­tion is grow­ing fast, and sex­ual norms are chang­ing, it is im­por­tant to as­sess the mag­ni­tude of an early age preg­nancy and child­bear­ing and their out­comes.

No known stud­ies ex­ist in Bhutan that ex­am­ine the ex­tent and de­ter­mi­nants of the early age preg­nan­cies and the mag­ni­tude of the early preg­nan­cies based on the ac­tual hos­pi­tal records. The stud­ies were an at­tempt to de­ter­mine the ex­tent of the early age preg­nan­cies and mainly its med­i­cal out­comes, states the re­port.

It also states that the data does not al­low the ex­am­i­na­tion of the de­ter­mi­nants of early preg­nan- cies and iden­ti­fi­ca­tion of whether the de­liv­er­ies were as­so­ci­ated with un­in­tended preg­nan­cies or not.

The de­liv­er­ies and their out­comes were com­piled from the med­i­cal records of Jigme Dorji Wangchuck Na­tional Re­fer­ral Hos­pi­tal (JDWNRH). The data were based on the hos­pi­tal de­liv­er­ies and dis­charge dates from Jan­uary 2005 to Septem­ber 2014, states the re­port.

It added that, JDWNRH‘s data was cho­sen, firstly be­cause of its easy ac­cess, se­condly, the hos­pi­tal records were main­tained in the ICD-10 for­mat, and thirdly, the JDWNRH is the na­tional re­fer­ral hos­pi­tal that is vis­ited by the peo­ple across the coun­try for its bet­ter health fa­cil­i­ties, a com­par­a­tively higher pro­fes­sional ca­pac­ity and bet­ter ser­vices. The cen­tral ques­tion the anal­y­sis at­tempted to an­swer was is an early age preg­nancy as­so­ci­ated with a higher ad­verse re­pro­duc­tive out­come.

The bureau uses the method to get out­come those two lev­els of com­par­i­son was made. First, com­par­isons of out­comes be­tween young moth­ers (15-19 years) and older moth­ers (20-40 years) were done. These com­par­isons in­cluded to­tal num­bers of cases and di­ag­noses and data com­par­isons that re­lied on chang­ing per­cent­ages of each block of di­ag­noses, states the re­port.

Through­out the anal­y­sis, an ef­fort was made to con­sider data from the pa­tients in the 10-14 age groups. UNFPA‘s 2013 Re­port State of World Pop­u­la­tion‘ notes that though data from the 15-19 age group is im­por­tant and has tra­di­tion­ally been the fo­cus of de­vel­op­ment agen­cies, girls with the great­est vul­ner­a­bil­i­ties with the great­est risk of com­pli­ca­tions and death from preg­nancy are 14 and younger. In or­der to not over­look this pop­u­la­tion, the anal­y­sis of ado­les­cents (10-14) was done sep­a­rately from that of young moth­ers (15-19). This also con­forms to the tra­di­tional age groups that con­sti­tute teenagers so that com­par­isons might be made to other hos­pi­tals, states the re­port.

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