Indrani DUTTA, Anand KISHORE, Tania PAN
The Turkish Journal of Pediatrics - 2026;68(5):765-775
Background. Adolescent pregnancy remains a major public health challenge among tribal populations, where social, educational, and healthcare-related disadvantages frequently coexist and contribute to adverse maternal and neonatal outcomes. This study examined the sociodemographic profile, vulnerability factors, maternal and fetal outcomes, and the impact of cumulative vulnerability among pregnant tribal adolescents in Jharkhand. Methods. A cross-sectional, hospital-based descriptive study was conducted among 197 pregnant adolescents aged 13-19 years belonging to Scheduled Tribes in Jharkhand, recruited through purposive sampling at the point of hospital admission for delivery between December 2023 and November 2025. Data were collected through structured interviews during hospital admission for delivery, supplemented by available hospital records. Sociodemographic characteristics, established risk factors including family dysfunction and educational barriers, maternal complications, and neonatal outcomes were assessed. An exploratory study-specific composite vulnerability score was developed using seven predefined vulnerability indicators and categorized as <4 or >=4. Associations between vulnerability score and maternal-fetal outcomes were evaluated using unadjusted bivariate analysis. Results. Most participants were aged 13-15 years (83.8%), illiterate (79.7%), primigravida (87.8%), and had received no antenatal care (73.6%). Poor socioeconomic conditions and lack of sexual and reproductive health information were reported by all participants, while school dropout (81.7%), sexual pressure from peers (71.6%), and family addiction history (38.6%) were also common. Maternal complications included anaemia (65.5%) and pregnancy-induced hypertension (32.5%). Low birth weight (63.5%) was the most frequent neonatal complication, followed by feeding difficulty (20.3%), prematurity (13.2%), and intrauterine fetal demise (4.1%). More than two-thirds of participants (71.1%) had a composite vulnerability score >=4. Higher vulnerability scores were significantly associated with anaemia (p<0.001), pregnancy-induced hypertension (p=0.004), low birth weight (p<0.001), and prematurity (p=0.016). Conclusion. This study reveals a marked clustering of poverty, illiteracy, family disruption, and healthcare exclusion among pregnant tribal adolescents accessing institutional delivery in this region of Jharkhand, and an association between the cumulative burden of these vulnerabilities and adverse maternal and neonatal outcomes.
