Adverse obstetric outcomes in early and late adolescent pregnancy

Abstract

Adolescent pregnant women should be considered as a high risk patient group. The aim of our study is to compare pregnancies in adolescent with adult age group pregnancies and to evaluate maternal and fetal obstetric outcomes. Patients were admitted to Gynecology Department of Okmeydani Training and Research Hospital between January 1, 2015 and December 31, 2019. Pregnant women were divided into 3 groups as Group 1 (aged ≤16 years: n: 280), Group 2 (aged 17-19 years; n: 956) and Group 3 (aged 25-35 years; n: 656). Demographic characteristics of the patients and maternal and obstetric outcomes were recorded.In adolescent age groups,numbers of gravida, parity and abortus, and gestational age, fetal weight, and rates of cesarean delivery were found to be significantly lower relative to age group of 25-35 years Adolescents aged ≤16 years had a significantly lower risk than adults as for preeclampsia (AOR: 9,23 (6,36-11,82) p=0,001),had a significantly higher risk than adults as for low birth weight (AOR: 4,75 (2,26-9,21) p=0,001). and prematurity (AOR: 7,54 (5,12-9,43) p=0,001). Adolescents aged 17-19 years had a significantly higher risk than adults regarding small for gestational age (AOR: 4,48 (1,89-10,67) p=0,001), oligohidramnios (AOR: 2,29 (1,16-4,54) p=0,017), prematurity (AOR: 4,97 (3,1-7,97) p=0,0001) and LBW (AOR: 2,14 (2,71-9,74) p=0,0001).Our study was conducted with a large pregnant group, Since pregnant women in adolescent group are closely associated with preterm birth, delivery of small for gestational age and low birth weight infants, it is important to improve health services to reduce adverse pregnancy outcomes.

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021

“…Furthermore, due to the practice of defensive medicine in our nation, there was a high incidence of C-sections in patients of all age groups, leaving no clear, physiologically supported explanation for this observation. Despite the immaturity of their reproductive systems, the literature suggests that the lower C-section rates among adolescent pregnancies may be due to improved myometrial function and elasticity [ 44 , 53 ], increased connective tissue elasticity, decreased cervical compliance [ 44 ], lower fetal birth weight [ 47 ], physician preferences [ 33 ], and higher preterm delivery rates [ 54 ]. The lower incidence of C-sections among adolescents may be explained by the fact that the findings of our study are compatible with some of the above-mentioned aspects.…”

Mode of Delivery and Neonatal Outcome in Adolescent Pregnancy (13–16 Years Old) Associated with Anemia

“…The World Health Organization (WHO) defines adolescence as the life time between 10 and 19 years [1,2]; this represents a transition period from childhood to adulthood and includes biological, psychological, and social changes [3,4]. Adolescent pregnancy has a serious impact on maternal and neonatal status, but it also has side-effects on society, economics, and the next generations.…”

“…Newborns from adolescent patients have a higher risk of perinatal death, preterm delivery, low birth weight (LBW), and/or congenital anomalies. Regarding the obstetrical complications associated with adolescent pregnancy, maternal death, anemia, or preeclampsia are known to be more frequent [3,7,8]; in addition, since adolescents have biological and physiological immaturity, pregnancy increases their nutritional needs, so the anemia may be more accentuated [3].…”

“…As we talk about anemia, WHO defines it as the hemoglobin (Hb) concentration of less than 11 g/dL during pregnancy [3,9]. The geographical, ethnic, cultural, socio-economic, dietary, and methodological differences explain the large variation in the prevalence of anemia in pregnant teenagers in the various studies; thus, the overall prevalence of anemia in pregnant adolescent women ranges from 25% to 41.27%, with the highest values recorded in India at 70-76% [3,[10][11][12][13].…”

“…As we talk about anemia, WHO defines it as the hemoglobin (Hb) concentration of less than 11 g/dL during pregnancy [3,9]. The geographical, ethnic, cultural, socio-economic, dietary, and methodological differences explain the large variation in the prevalence of anemia in pregnant teenagers in the various studies; thus, the overall prevalence of anemia in pregnant adolescent women ranges from 25% to 41.27%, with the highest values recorded in India at 70-76% [3,[10][11][12][13]. Another study that analyzed 235 pregnant patients with anemia found that the highest incidence of anemia was in patients under 20 years, with a rate of 39.5% [14]; also, a research that included over 850,000 women aged under 25 years shows that the incidence of anemia is higher as the age decreases, such that patients aged 15 years or younger had an almost 40% increased risk of anemia compared with women between 20 and 24 years [10,14].…”