Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea

Abstract

Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13–19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P < 0.001). About 14.4% of teenage mothers had never received prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P < 0.001). Teenage mothers more often experienced preterm delivery and perineal laceration (P < 0.001). Teenage mothers (<20 years) were 2.47 times more likely to have preterm delivery than older mothers (20–34 years; P < 0.001). Teenage mothers had higher risk of inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001).

Socioeconomic status can affect pregnancy outcomes and complications, even with a universal healthcare system

“…The findings that individuals with lower SES tend to receive prenatal care less frequently and are at higher risk for obstetric complications are consistent with the findings of previous studies [ 1 , 2 ]. Individuals with low SES tend to be disadvantaged in terms of medical service utilization [ 1 , 2 , 15 ]. Pregnant women with low SES have been shown to have adverse obstetric outcomes associated with inadequate prenatal visits [ 1 , 4 , 6 , 15 ].…”

“…Individuals with low SES tend to be disadvantaged in terms of medical service utilization [ 1 , 2 , 15 ]. Pregnant women with low SES have been shown to have adverse obstetric outcomes associated with inadequate prenatal visits [ 1 , 4 , 6 , 15 ]. The results of the current study that obstetric complications were poor in women in the MA group is consistent with the results of previous studies demonstrating that low SES is a risk factor for poor obstetric outcomes [ 1 – 6 ].…”

“…Socioeconomic status (SES) is one of the most important factors associated with medical outcomes. When SES is low, medical care is inadequate and this has been attributed to adverse outcomes [ 1 , 2 ]. In pregnant women, low SES can increase the risk of adverse pregnancy outcomes.…”

“…Previous studies have revealed that low SES is associated with pregnancy complications such as abortion, preterm delivery, preeclampsia, eclampsia, and gestational diabetes [ 3 – 6 ]. Inadequate prenatal care is associated with poor obstetric outcomes, including preterm delivery, preeclampsia, and stillbirth [ 1 , 4 – 7 ], and women with low SES are less likely to receive prenatal care [ 1 , 2 , 8 ]. In fact, the risk of preterm delivery, preeclampsia, and gestational diabetes increases with both inadequate prenatal care and low SES [ 3 – 5 ].…”

Obstetrical and Perinatal Complications in Young Primiparas

“…Возраст матери менее 15 лет имеет очень большое значение и обусловливает недоношенность и низкий вес ребенка при рождении [12,13]. Ранняя неонатальная смертность среди детей юных первородящих вдвое выше, чем среди детей от матерей в возрасте 25-29 лет [14,15].…”