Later life outcomes of women by adolescent birth history: analysis of the 2016 Uganda Demographic and Health Survey

Dinah Amongin, Anna Kagesten, Ozge Tuncalp, A. Nakimuli, Mary Nakafeero, Lynn Atuyambe, Claudia Hanson, Lenka Benova

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OBJECTIVES: To describe the long-term socioeconomic and reproductive health outcomes of women in Uganda by adolescent birth history.

DESIGN: Cross-sectional study.

SETTING: Uganda.

PARTICIPANTS: Women aged 40-49 years at the 2016 Uganda Demographic and Health Survey.

OUTCOME MEASURES: We compared socioeconomic and reproductive outcomes among those with first birth <18 years versus not. Among those with a first birth <18 years, we compared those with and without repeat adolescent births (another birth <20 years). We used two-sample test for proportions, linear regression and Poisson regression.

FINDINGS: Among the 2814 women aged 40-49 years analysed, 36.2% reported a first birth <18 years and 85.9% of these had a repeat adolescent birth. Compared with women with no birth <18 years, those with first birth <18 years were less likely to have completed primary education (16.3% vs 32.2%, p<0.001), more likely to be illiterate (55.0% vs 44.0%, p<0.001), to report challenges seeking healthcare (67.6% vs 61.8%, p=0.002) and had higher mean number of births by age 40 years (6.6 vs 5.3, p<0.001). Among women married at time of survey, those with birth <18 years had older husbands (p<0.001) who also had lower educational attainment (p<0.001). Educational attainment, household wealth score, total number of births and under-5 mortality among women with one adolescent birth were similar, and sometimes better, than among those with no birth <18 years.

CONCLUSIONS: Results suggest lifelong adverse socioeconomic and reproductive outcomes among women with adolescent birth, primarily in the category with repeat adolescent birth. While our results might be birth-cohort specific, they underscore the need to support adolescent mothers to have the same possibilities to develop their potentials, by supporting school continuation and prevention of further unwanted pregnancies.

Original languageEnglish
Article numbere041545
JournalBMJ Open
Issue number2
Number of pages10
Publication statusPublished - 2021


  • obstetrics
  • reproductive medicine
  • public health
  • sexual medicine

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