Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study

Abstract

Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide.
 Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications.
 Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and third pregnancy groups was 96 and 47, respectively.
 Results: There was a significant risk of preeclampsia in the first pregnancy group (p = 0.01). Low birth weight, five-min Apgar score < 7, and neonatal intensive care unit admission were the most significant neonatal outcomes in the first pregnancy group. In the third pregnancy group, significant predictors of neonatal complications included very young age in the first pregnancy (≤ 15 yr), an inter-pregnancy interval < 2 yr, current anemia, and history of obstetric and/or neonatal complications in previous pregnancies.
 Conclusion: Based on the results, teenagers with their first pregnancy had comparable obstetric outcomes (except for preeclampsia) as teenagers with their third pregnancy, whereas neonatal complications occurred more frequently in the first pregnancy group. Overall, we can predict high-risk neonates in the third pregnancy, based on the abovementioned parameters.
 Key words: Teenage pregnancy, Complications, Neonate.

Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad

“…The rate of CS in our adolescent study sample was very high (80.7%) and is much higher than local and international figures ( 8 , 14 ). This may be in part due to the tertiary referrals received in our center, including risky adolescent obstetric cases and repeated requests of ECS in parallel with the beliefs of our population who prefer CS over TL to avoid labor pain ( 8 , 15 ).…”

“…Although LBW was more common in TL compared to ECS women, this was not significantly different and was high in both groups, as birth weight is commonly affected in adolescent pregnancy ( 8 , 16 ).…”

“…The term adolescent pregnancy is used when the pregnant woman is aged ≤19 years. The rate of adolescent pregnancy is increasing now throughout the world including the United States and Europe, and not limited to the third world and developing populations ( 2 , 3 ). In general, there are increasing rates of adolescent pregnancy reaching as high as 27%, while different cultures and different countries may report some variation in the incidence ( 4 ).…”

“…Risk of comorbidities in TL, especially uterine rupture, still constitutes a major concern. Contrasting opinions are offered, either to encourage or discourage TL in resource-limited settings due to the expected complications of the pregnant women and their newborns ( 5 , 7 , 8 ).…”

“…Since we have a high local rate of first CS in adolescents (48.96%) ( 8 ), we planned to examine if concerns regarding TL were justified in adolescent pregnant women having a single prior delivery with CS in comparison to an elective cesarean section (ECS) approach in Baghdad city by evaluating maternal and neonatal outcomes.…”