Characteristics and Adverse Outcomes of Chinese Adolescent Pregnancy Between 2012 and 2019: An Observational Study of 438 Health Facilities

Abstract

We aimed to describes characteristic of adolescent pregnancy, determines its effect on adverse maternal and perinatal outcomes and explores whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. 2,366,559 women aged 10-24 years who had singleton pregnancies between 2012 and 2019 from 438 hospitals were included in the study. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effect. Women aged 20-24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 despite common-law marriage in rural areas have improved. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57~2.23), severe anaemia (aOR 1.18, 95% CI 1.09~1.28), maternal near miss (aOR 1.24, 95% CI 1.12~1.37), and small-for-gestational-age (aOR 1.30, 95% CI 1.28~1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent fertility and to avoid adverse fertility outcomes among adolescent women in China at a time when adolescent fertility is rebounding.