The profile of adolescent patients presenting to a tertiary maternal mental health clinic

Abstract

Background: Between March 2021 and April 2022, there were 90 037 documented adolescent pregnancies in South Africa. Statistics SA reports that this number is growing. Pregnancy places adolescents at greater risk of psychiatry-related morbidity and may have far-reaching consequences for their children. To date, there is no published data describing the patient profile of adolescent pregnancies in Gauteng Province, South Africa.

Aim: To describe the patient profile (demographics, schooling history and type of accommodation), pregnancy-related factors, substance use habits and contraceptive use in pregnant adolescents seen at a tertiary care maternal mental health clinic (MMHC).

Setting: The MMHC at Chris Hani Baragwanath Academic Hospital, Soweto, Johannesburg, South Africa.

Methods: A retrospective file review of all pregnant adolescents referred to the MMHC between January and June 2022.

Results: The mean age of the patients was 15.2 years; 72% attended school and 97.4% planned to return. Most pregnancies were unplanned (97.9%), wanted (84%) and presented in the second (41.24%) and third (51.55%) trimesters. Most did not report using substances (76.7%). Fifty percent of the participants met the criteria for a major depressive disorder. Repeating a grade was an identifiable risk factor for an increased Edinburgh depression score. An unplanned pregnancy was associated with a higher risk factor assessment.

Conclusion: Pregnant adolescents represent a vulnerable population group. A greater understanding of this patient profile may inform early psychiatric and psychosocial interventions, improved service delivery and help-seeking behaviour.

Contribution: This study gives significant insights into the challenges faced, as well as the health and social needs of pregnant adolescents. This contributes to wholistic care and opportunities for early intervention, including awareness of contraceptive use and the risks of substance use and adolescent pregnancy on mental health, benefiting all South African adolescents.

Keywords: adjustment disorder peripartum mental illness; adolescent pregnancy; education; major depressive disorder; maternal mental health; substance use.

FIGURE 1

The relationship between grades repeated and low and high-risk factors in the Risk Factor Assessment < 3 = low; ≥ 3 = high) and Edinburgh Depression Scale (< 13 = low; ≥ 13 = high).

FIGURE 2

The relationship between whether the pregnancy was wanted or unwanted and low and high-risk factors in the Risk Factor Assessment (< 3 = low; ≥ 3 = high) and Edinburgh Depression Scale (< 13 = low; ≥ 13 = high).