Characteristics and Pregnancy Outcomes of Teenage Mothers at Kabale Regional Referral Hospital, Uganda: A Cross-Sectional Study

Background: Teenage pregnancy remains a critical public health challenge in sub-Saharan Africa, with significant implications for maternal and neonatal health outcomes. In Uganda, teenage pregnancies account for 18-28% of maternal deaths, yet facility-specific evidence remains limited. This study assessed the characteristics and pregnancy outcomes of teenage mothers at Kabale Regional Referral Hospital (KRRH) and identified predictors of adverse maternal outcomes. Methods: We conducted a hospital-based cross-sectional study at KRRH from January to April 2025. Using consecutive sampling, we recruited 222 consenting teenage mothers aged 13-19 years. Data were collected through structured interviews and complemented by in-depth interviews with midwives. We used descriptive statistics to summarize characteristics and binary logistic regression to identify predictors of adverse maternal outcomes, defined as delivery-related complications requiring medical intervention. Results: The median age was 19 years (IQR: 18-19), with 88.3% (n=196) aged 18-19 years. Most participants were married (71.6%, n=159), resided in rural areas (67.1%, n=149), and were primigravida (86.0%, n=191). While 99.1% (n=220) attended antenatal care, only 57.2% (n=127) completed the recommended four visits. Maternal complications occurred in 33.3% (n=74) of deliveries, with obstructed labour being most prevalent (48.6% of complications, n=36). Referral from lower-level facilities was the strongest independent predictor of adverse outcomes (adjusted OR=3.77, 95% CI: 1.53-9.28, p=0.004). Conclusions: Despite high antenatal care attendance, teenage mothers at KRRH experienced substantial obstetric complications, particularly obstructed labour. The association between referral status and adverse outcomes highlights critical gaps in the referral system. Strengthening early risk identification, emergency obstetric care capacity, and referral pathways is essential for improving outcomes among teenage mothers in southwestern Uganda.