Curse for the baby

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Adolescent girls are not physically mature enough to be pregnant because of i) restricted blood supply to the cervix and uterus, ii) low level of gonadal hormone, and iii) irregularity of ovulatory cycle. These increase the risk of abortion, premature delivery and excessive postpartum hemorrhage, preeclampsia, cephalopelvic disproportion and obstructed labour. Serious medical complications like significant anemia and malnutrition can also happen. All these lead to significant mortal effects on mothers as well as babies.
Moreover, the mother's cognitive immaturity manifests as lack of proper knowledge of taking care of her own health as well as of the baby. In Bangladesh the current neonatal mortality rate (NMR) is 32/1000 live births. Babies of adolescent mothers are a significant contributor to this high NMR. Most of the neonatal deaths occur within seven days of the delivery and the major causes are birth asphyxia, low birth weight, prematurity, sepsis, congenital anomalies, jaundice etc. Several studies show that these neonatal problems and deaths are higher among babies born to adolescent mothers.
The health problems related to adolescent motherhood are not only confined to newborn illness but also persist when the baby crosses the neonatal period. The lactation failure rate is higher and the chances of diarrhea, recurrent infections and malnutrition are higher among these babies.
Data suggests that many of these babies are at greater risk of a variety of development problems like blindness , deafness, mental retardation, cerebral palsy, dyslexia, and hyperactivity. They are also at greater risk of being a victim of child  abuse or neglect (and being placed in foster care). The negative effects on the cognitive development of children born to adolescent mothers are evident.
Therefore, to overcome these problems joint effort of government, NGO and professional bodies is essential through formulation of policies and programmes.
As its commitment to the UN Secretary General's Initiative Every Woman Every Child Bangladesh will reduce the rate of adolescent pregnancies through social mobilization, implementation of the minimum legal age for marriage, and upgrading one third of MNCH centres to provide adolescent friendly sexual and reproductive health services.

The writer is Professor, Dept. of Paediatrics, Dhaka Medical College & Hospital.