Indication for caesarean section in adolescent girls and maternal and neonatal prognosis in the town of Isiro, Democratic Republic of Congo

Adolescent caesarean section remains one of the major contributors to maternal and child mortality and contributes to the cycle of ill health and family poverty. Nearly 16 million adolescent girls aged between 13 and 18 give birth every year. Most of these births take place in developing countries where incomes are low or intermediate. The aim of this study was to determine the indications and maternal and neonatal prognosis of caesarean sections among adolescents in the town of Isiro. This was a cross-sectional and analytical study from 01 September to 25 February 2025 (6 months), covering caesarean sections performed on adolescents aged 13 to 18 years in the obstetrics and gynaecology department of the Isiro General Referral Hospital. Non-probability sampling was used for this study and the sample size was 68 adolescent caesareans. Among the indications for caesarean section in adolescents, we have low weight (less than 35 kg) exposes 24 times adolescent mothers aged 13-15 years to the risk of caesarean section (0R= 24 IC95% [3.385-170.929] p=0.001). Adolescent girls of educational level (No education and primary) run 18 times the risk of caesarean section (0R= 18 IC95% [1, 860-189,480] p=0,013). Fetal distress exposes these adolescents to the risk of caesarean section (0R= 8 IC95% [1,456-50,739] p=0,018). Adolescents who have given birth to macrosomia run 7 times the risk of caesarean section (0R= 7 IC95% [1,050-50,629] p=0,045). The problems found in the adolescent girls in our series were mainly due to their sociodemographic and clinical vulnerability, their morphological immaturity (shrunken pelvis), their low level of education, the precocity of sexual relations, early childbearing, and the poor quality and quantity of prenatal follow-up, which leads to a poor prognosis in adolescent girls.