Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy

Abstract

Study Objective To investigate the outcomes of adolescent pregnancy. Design Retrospective cohort study from the Consortium on Safe Labor between 2002 and 2008. Setting 12 clinical centers with 19 hospitals in the United States. Participants 43,537 nulliparous women <25 years, including 1,189 younger adolescents (age ≤15.9), 14,703 older adolescents (age 16–19.9)], and 27,645 young adults (age 20–24.9). Interventions aOR with 95%CI were calculated, controlling for maternal characteristics and pregnancy complications (young adults as a reference group). Main outcome Measure Maternal, neonatal outcomes, cesarean indications, and length of labor. Results Younger adolescents had increased risk of maternal anemia (aOR=1.25; 95%CI=1.07–1.45), preterm delivery <37 weeks of gestation (aOR=1.36; 95%CI=1.14–1.62), postpartum hemorrhage (aOR=1.46; 95%CI=1.10–1.95), preeclampsia/HELLP syndrome (aOR=1.44; 95%CI= 1.17–1.77) but had decreased risk of cesarean delivery (aOR=0.49; 95%CI= 0.42–0.59), chorioamnionitis (aOR=0.63; 95%CI=0.47–0.84), and neonatal intensive care unit (NICU) admission (aOR=0.80; 95%CI=0.65–0.98). Older adolescents had increased risk of maternal anemia (aOR=1.15; 95%CI= 1.09–1.22), preterm delivery at <37 weeks of gestation (aOR=1.16; 95%CI=1.08–1.25), and blood transfusion (aOR=1.21; 95%CI=1.02–1.43), but had decreased risk of cesarean delivery (aOR=0.75; 95%CI= 0.71–0.79), chorioamnionitis (aOR=0.83; 95%CI=0.75–0.91), major perineal laceration (aOR=0.82; 95%CI= 0.71–0.95), and NICU admission (aOR=0.89; 95%CI=0.83–0.96). Older adolescents were less likely to have cesarean for failure to progress or cephalopelvic disproportion (aOR=0.89; 95%CI 0.81–0.98). For adolescents who entered spontaneous labor, second stage of labor was shorter (P<.01). Conclusion Adolescents were less likely to have cesarean delivery. Failure to progress or cephalopelvic disproportion were decreased in older adolescents. Adolescents who entered spontaneous labor had shorter second stage of labor.

Adolescent pregnancies: complications, birth outcomes and the possible solutions

“…Similarly, our study preterm birth rate (≤ 37 weeks) is found to be relatively high (p < 0.001) [2,[6][7][8].…”

“…A literature review indicates that the neonatal outcomes in adolescent pregnancies are similar to non-adolescent pregnancies. The overall rate of congenital abnormality, newborn intensive care requirement or neonatal death is very low [2,6,7]. In our study, Apgar score and newborn intensive care requirement is also very low and no neonatal death is recorded.…”

Maternity in adolescents and its association with caesarean labor

“…The indications for which they decided to terminate pregnancy via cesarean section were: arrest dilation and / or descent, 13 …”

“…Upon bivariate analysis through hypothesis testing, it was found that maternal age is not a risk factor for low birth Apgar 0.47). It is show in table 3 and 4. the health of mother and child and their implications biopsychosocial level; include the perpetuation of the cycle of poverty, the difficulties in achieving higher levels of education, disruption of the family unit and the presence of subsequent pregnancies, among others (13)(14).…”

Mecanismos de Defesa Utilizados por Adolescentes com Bebês Prematuros em UTI Neonatal1

“…From the biomedical point of view, some studies have associated pregnancy in adolescence with an increased risk for the occurrence of premature labor (Kawakita et al, 2016;Kirbas, Gulerman, & Daglar, 2016;Minjares-Granillo, RezaLópez, Caballero-Valdez, Levario-Carrillo, & Chávez-Corral, 2016;Thomazini, Wysocki, da Cunha, da Silva, & Ruiz, 2016). In one multicentric study on perinatal results among adolescent mothers, including 29 countries of Latin America, Asia, Africa and the Middle East, the babies presented the highest risk for severe neonatal conditions (Ganchimeg et al, 2014).…”