Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy

Abstract

BACKGROUND: Adolescent pregnancy, defined as a pregnancy in girls aged 10 to 19 years. Adolescent mothers are at high risk for maternal and neonatal complications.
 AIM: To compare maternal, perinatal and neonatal outcomes in adolescents and adult women aged 20-24 years.
 MATERIAL AND METHODS: This retrospective cohort study included all singleton pregnancies during a three-year period (January 2016-December 2018) who gave birth in a Clinical Hospital in Tetovo, Republic of Macedonia. After exclusion criteria, a total of 932 cases were reviewed and divided into two groups: one of the teenage mothers (< 19 years old) (115 women) and the other of adult mothers (20-24 years old) (817 women).
 RESULTS: Of the total number of 5643 births, 128 (2.27%) were from adolescent pregnancies. Of them, nulliparous adolescent women were 115 (2.04%). Adolescents compare to adult mothers had a higher rate of urinary tract infections (33% vs. 22%), increased rate of maternal anemia (26% vs. 15%), preterm birth, small for gestational age newborns (25.2% vs. 17.1%), lower high school attendance (0 vs. 21.9%) and inadequate prenatal care. Spontaneous labour was more common in adolescents (73% vs 63.5%), while Caesarean sections were less common than in women aged 20-24 years (25.2% vs 33.5%). The rate of other perinatal outcomes was not significantly different between the 2 groups.
 CONCLUSIONS: The results of the study showed that the frequencies of some maternal, perinatal and neonatal complications were considerably higher in adolescent mothers.
 nal and perinatal complications were considerably higher in adolescent mothers.

Maternal Characteristics and Obstetric and Neonatal Outcomes of Singleton Pregnancies Among Adolescents

“…In fact, given that mothers of the adolescent mothers in the current study were also in adolescent age during their first pregnancy, our finding suggests consideration of adolescent marriage and pregnancy as normal by the families of the participating adolescent women. Similarly, high adolescent birth rates among certain populations have been linked to the practice of child marriage to remain prevalent in these communities, where girls often have no choice but to follow tradition, leave school and get married in young age, thus perpetuating a cycle of poor education, poverty and early childbirth [3,27,28].…”

“…Low educational level and low employment rate of adolescent mothers in our cohort also support data from Turkey Population and Health Research in 2013 revealed a reverse association of adolescent pregnancy with both welfare and level of education, and an increase in the rate of adolescent pregnancies with decrease in the socioeconomic level of the family (from 3.0% to 6-8%) as well as with poorer educational level of women (17% versus 8%) [12]. Notably, some studies indicated not only early marriage in some traditional rural communities but also low educational level and low level of sexual education and contraceptive use and high rate of poverty amongst the important factors in the rate of adolescent pregnancy [3,33]. Hence, given that nearly 15% of adolescent women were pregnant for the second time during the study period and none reported previous education about sexuality or use of any contraceptive methods, our findings support the consideration of prevention of early marriage as well as postnatal family planning information and service provision as critical measures in prevention of adolescent pregnancy [5,34].…”

“…Indeed, while, especially unintended adolescent pregnancies are considered likely to carry a greater risk of adverse consequences in developing countries with limited health resources and restrictive abortion laws [3], poor rates of sufficient antenatal care, as strongly associated with the possible complications, has been reported in adolescent pregnancies, even for a desired pregnancy [8,26,34,35]. In a recent study the average gestational age to start antenatal follow-up was reported to be nearly 3 weeks late for adolescents than adult women, while authors emphasized the central role of female education and women empowerment in improved antenatal care utility among adolescents [34].…”

“…Adolescent pregnancy, a pregnancy in women aged between 10-19 years, is considered a prevalent social problem with serious implications on maternal and child health, particularly in developing countries [1][2][3]. Pregnancies that take place during adolescent age, when neither the biological nor the psychosocial maturation process is yet completed, adversely affect obstetric and neonatal outcomes due to biological immaturity, inadequate antenatal care, malnutrition, bad habits, stress, and mood-state disorders [4,5].…”

Adequação da atenção pré-natal e restrição do crescimento intrauterino na coorte de nascimento de Ribeirão Preto de 2010 (Coorte BRISA)

“…Entre esses estudos, Coimbra, et al (2003) encontraram no índice APNCU apenas 10% de adequação, enquanto para o novo índice proposto a adequação foi de 49,6%. Ao contrário, no estudo de Leal, et al (2014) (NETO, et al, 2012;VIELLAS, et al, 2014;GUIMARÃES, et al, 2018 Apesar da tendência crescente na redução da gravidez na adolescência observada em todas as regiões brasileiras (BURATTO, et al, 2019), ainda assim é um problema de saúde pública, e está associada com maior frequência às complicações maternas e neonatais (REXHEPI, et al, 2019;NGUYEN, et al, 2019), ao pior acesso aos serviços de saúde, bem como ao baixo comparecimento para o acompanhamento pré-natal. Além disso, deve-se considerar e compreender o cenário social e econômico em que as adolescentes estão inseridas.…”