Trends and birth outcomes in adolescent refugees and migrants on the Thailand-Myanmar border, 1986-2016: an observational study

<ns4:p><ns4:bold>Background:</ns4:bold> Currently there are more adolescents (10-19 years old) and young adults (20-24 years old) than ever. Reproductive health among this age group is often overlooked, although it can have a profound impact on the future. This is especially the case in conflict zones and refugee settings, where there is a heightened need for reproductive health care, and where both the resources and possibility for data collation are usually limited.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> Here we report on pregnancies, birth outcomes and risk factors for repeat pregnancies among adolescent and young adult refugees and migrants from antenatal clinics on the Thailand-Myanmar border across a 30 year time span.</ns4:p><ns4:p> <ns4:bold>Results:</ns4:bold> Pregnancy and fertility rates were persistently high. Compared with 20-24-year-olds, 15-19-year-olds who reported being unable to read had 2.35 (CI: 1.97 – 2.81) times the odds for repeat pregnancy (gravidity &gt;2). In primigravidae, the proportion of small for gestational age (SGA) and preterm births (PTB), and neonatal deaths (NND) decreased with increasing maternal age (all p &lt;0.001). After adjustment, this association retained significance for PTB (cut-off point, ≤18 years) but not for SGA and NND.</ns4:p><ns4:p> <ns4:bold>Conclusions:</ns4:bold> There is considerable room for improvement in adolescent pregnancy rates in these border populations, and educational opportunities may play a key role in effective interventions.</ns4:p>