Complications in adolescent pregnancy: systematic review of the literature

Abstract

Sexual activity during adolescence can lead to unwanted pregnancy, which in turn can result in serious maternal and fetal complications. The present study aimed to evaluate the complications related to adolescent pregnancy, through a systematic review using the Medical Subject Headings: “pregnancy complication” AND “adolescent” OR “pregnancy in adolescence”. Only full original articles in English or Portuguese with a clearly described methodology, were included. No qualitative studies, reviews or meta-analyses, editorials, case series, or case reports were included. The sample consisted of 15 articles; in that 10 were cross-sectional and 5 were cohort studies. The overall prevalence of adolescent pregnancy was 10%, and among the Brazilian studies, the adolescent pregnancy rate was 26%. The cesarean delivery rate was lower than that reported in the general population. The main maternal and neonatal complications were hypertensive disorders of pregnancy, prematurity and low birth weight, respectively. Adolescent pregnancy is related to increased frequency of neonatal and maternal complications and lower prevalence of cesarean delivery.

Vulnerability in adolescence: a case report of attempted abortion and sexual violence

“…Adolescents have priority in public health policies in Brazil 12,17 and are considered vulnerable by the age group (under 14 years) and also by social and emotional dependence 2,19,20 and it is the joint responsibility of health managers 2,7 to facilitate access to safe abortion services in cases of pregnancy resulting from rape, when there is no other way to save the mother's life 18 , as well as increase social awareness 4,16 . Veiled sexual violence 11,20 in childhood and adolescence is related to unsafe abortion 7,17 . In Brazil, there is a report of sexual violence against female children and adolescents 12,16,17 with consequent unplanned pregnancies 20 followed by violence.…”

“…In Brazil, there is a report of sexual violence against female children and adolescents 12,16,17 with consequent unplanned pregnancies 20 followed by violence. The abortion 7,15 remains a clandestine practice, especially in the context of Latin America 21,22 . The reduction in the incidence of unsafe abortion is associated with the reduction in the incidence of sexual violence especially from the intimate partner 17,23 .…”

“…Thus, information and awareness 19 about various methods of post-abortion contraception 16 and especially the facilitation of specialized services in women's health should be promoted 9,21 . The benefits of legalizing abortion in Brazil in the cases provided by law 18,20 show a reduction in the number of hospitalizations in public hospitals due to complications of abortion over the years and a reduction in maternal mortality 7,25,26 . This occurs in developed and developing countries especially when associated with a set of measures that guarantee knowledge about legalization in the population.…”

“…In Brazilian public health, this has a negative effect on the economy, which can vary up to 2% of GDP (gross domestic product) 2 , as well as maternal consequences related to the morbidity and mortality of our women [3][4][5] . Unsafe abortion appears as an alternative to unwanted pregnancies 1,6,7 , mainly in cases related to physical violence, sexual violence, usually caused by an intimate or known partner. In such cases, abortion would be provided by law in some countries 3,6 , but patients who suffer violence do not report or hide for various vulnerabilities -age, social and institutional [8][9][10] .…”

“…In such cases, abortion would be provided by law in some countries 3,6 , but patients who suffer violence do not report or hide for various vulnerabilities -age, social and institutional [8][9][10] . Sexual abuse 11 during adolescence is a traumatic experience that complicates young women's psycho-social development at the threshold of adulthood 2 , resulting in consequences associated with sexually transmitted diseases, pregnancy followed by violence, unwanted pregnancies, psychosocial repercussions 7 and negative sequel e that compromise reproductive health and sexual 1 . The association between violence and unsafe abortion causes a risk of death 2,5 in young women, related to infections, 40% of which reaches the upper genital tract J Hum Growth Dev.…”