The Effect of Counseling on some Outcomes of Pregnancy in Teenage Women: Randomized Controlled Clinical Trial

Abstract

Abstract: Introduction: Considering the health of pregnant mothers is one of the health priorities of any country. One of the causes of high risk pregnancy is pregnancy in adolescents associated with maternal and neonatal outcomes; Therefore, the aim of this study was to determine the effect of counseling on the hemoglobin, hematocrit and weight gain (primary outcomes) and some outcomes of childbirth, neonatal and postpartum depression (secondary outcomes) in teenage pregnant women. Method: This randomized, controlled clinical trial was conducted on the 120 teenage women aged 11-19 years old with gestational age of 20 -24 weeks referred to Ardabil health centers in 2016-2017. Participants were assigned to two groups of counselling (n = 60) and control group (n = 60) through random blocking. Counseling on self-care, signs and risks of teenage pregnancy and prevention methods, were given in 5 sessions of 60 minutes for the intervention group accompany with a booklet. The control group received routine care of pregnancy. Hemoglobin and hematocrit levels, weight at the beginning of pregnancy and during labor, neonatal outcomes, mean depression score, delivery outcomes, length of stages of labor, intensity of pain in the active phase, postpartum outcomes and number of visits during pregnancy were evaluated. Chi square, independent t-test ,mann-whitney and ANCOVA were used for data analysis. Results: There was no significant difference between two groups of counseling and control in terms of social-demographic characteristics except for maternal age variable (P <0.05). Based on ANCOVA and control of baseline and age variables, there was no statistically significant difference between groups for hemoglobin during labor (P= 0.710)، hematocrit during labor (P= 0.747)، weight gain during pregnancy (P= 0.931), neonatal outcomes (weight P=0.249, height P= 0.269, head circumference P=0.249, first minute APGAR P=0.565, fifth minute APGAR P=.175), postpartum depression (P = 0.777), delivery outcomes (Preterm delivery P = 0.053, Cesarean section P = 0.058), length of delivery stages (active phase of labor, P = 0.942), pain intensity in active phase (dilatation of 6 centimeter, P = 0.163), Postpartum outcomes (exclusive breastfeeding, P=1.0, pregnancy prevention methods, P = 1.0) and visits number during (P = 0.163). The difference between two groups for second stage of delivery (P = 0.005) and Pain intensity in the active phase (dilatation of 8 centimeter, P=0.012( were significant. Conclusions: The results of this study showed that counseling with teenage women during pregnancy had no effect on hemoglobin, hematocrit, and weight gain during pregnancy, neonatal outcomes, mean of depression score during pregnancy and eight weeks after delivery, delivery outcomes, active phase of labor, pain intensity in active phase, postpartum outcomes and visits number during pregnancy, but the length of second stage of labor and pain intensity in 8 centimeter of cervix dilatation were statistically different in two groups