Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

Abstract

Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low-and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Adolescent pregnancy is defined as pregnancy in girls aged less than 20 years. It is estimated that 16 million 15-19 yearold women give birth every year, accounting for approximately 11% of all births worldwide (1). In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1-16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17-22). However, the previous studies had conflicting findings regarding whether the effect of young maternal age on adverse pregnancy outcomes were caused by their biological immaturity or poor social, economic and behavioral factors (17)(18)(19)(20)(21)(22). ConclusionThe aim of the present study was to investigate whether there is an association between young maternal age and poor maternal and perinatal outcomes independent of possible confounding factors.

Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy

“…In our study pregnancy comorbidities placenta praevia, placental abruption, PROM, IUFD, occurred similarly across age groups. These results for placenta praevia and placental abruption support the findings of most authors [10], [32], [46] in the previous studies. More frequent preterm birth in adolescents was also found in other studies.…”

“…Studied from Slovenia, Oman and India reported for high rate of anemia in adolescent women (p = 0.012, 0.005, 0.001, respectively) [28], [37], [38]. In the present study a high prevalence of urinary tract infections in pregnant adolescents (33% vs 22% in adults), also is reported in other studies from Finland, Turkey, Romania and North-West Russia (OR 2.5, 0.72, 1.10, 1.17 respectively) [23], [32], [39], [40].…”

“…The mechanisms responsible for preterm birth are still unclear: the immaturity of cervical blood supply in young mothers stimulates prostaglandin production that could lead to preterm birth [28]. The other explanation of preterm delivery for adolescents is that short cervix (< 25mm) and small uterine volume may also be more common among younger mothers [32]. Furthermore, competition between the fetus and adolescent mother for nutrition, and relative nutritional deprivation of both the fetus and adolescent mother may explain the risk of maternal anaemia, low birth weight, and preterm delivery [49].…”

“…The incidence of uterine curettage after childbirth was lower among teenagers, but differences were non-significant. Some authors reported for the higher incidence in the teenage group [32], but others did not find a significant difference between both groups [6], [55].…”

Assessment of Serum Lipid and Uric Acid Levels in Women with Normal Pregnancy and Pre-Eclampsia

“…In the study conducted by Khurshid R 2016 18 , mean age of the women with pre-eclampsia and normal pregnancy were in similar range as found in our study. Another study supported the findings showing increase prevalence of pre-eclampsia in age group between 20-34 years 19 . Increased levels of TG have been associated with increased risk of pre-eclampsia 20 .…”