Pregnancies in adolescents: fetal, neonatal and maternal outcome

We studied the perinatal morbidity and mortality among adolescent pregnancies in the semi-urban population of Gorakhpur. The number of eligible couples (females 15-44 yrs) were 24,000. Out of 430 adolescent married girls, 242 (56.3%) became pregnant during the study period. Nineteen (7.8%) of adolescent pregnancies were in the maternal age group less than 15 years and 110 (45.5%) and 113 (46.7%) pregnancies were in the age group 15-17 yrs and 17-19 yrs, respectively. The incidence of low birth weight babies was 67.3% of all live births. Infections during neonatal period, congenital anomalies and birth injuries were seen in 21.6, 8.6 and 13.1% newborns, respectively. Neonatal mortality rate was 136.2/1000 live births. Three adolescent mothers died during pregnancy or puerperium due to causes related to pregnancy. The incidence of LBW, neonatal and maternal morbidity and mortality associated with adolescent pregnancies were significantly higher.

JE virus encephalitis: 1988 epidemic at Gorakhpur

Gorakhpur region experienced the most serious outbreak of Japanese encephalitis (JE) in 1988 in which 875 children were admitted in the Department of Pediatrics, BRD Medical College, Gorakhpur. Children between 7-10 years age group constituted half (49.3%) of these cases, convulsions (83.8%), altered sensorium (78.2%), headache (68.8%) and hypertonia (77.0%) were the main presenting features. IgM against JE virus was demonstrated in 18/25 CSF and 27/53 sera collected from these children. Significant titres of HI antibodies against JE were present in 498/670 patients. Patients were managed symptomatically. Dexamethasone and dopamine were given to only 137 (15.7%) children admitted with shock and peripheral circulatory failure. Almost a third (31.8%) of the patients expired, 51.4% recovered completely and 10.7% recovered partially. Corticosteroids did not improve the outcome. Twenty four patients had recurrence of symptoms after excellent recovery from acute attack of whom two died and 5 developed neurological deficits.