The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China

Abstract

Background The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact, especially in developing countries. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnant women in Hebei Province, China.Methods There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10-19 years) and adult group (aged 20-34 years), the adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years). The information that was collected included sociodemographic characteristics, obstetric history, place and mode of delivery, pregnancy outcome, complications during pregnancy. We compared the risk of adverse pregnancy outcomes between the two groups and two subgroups using univariate and multivariate Logistic regression. Results Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95% CI: 0.41-0.73). The women aged 10-19 years had higher risk of preterm birth (aRR: 1.76, 95% CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95% CI: 1.08-1.30), stillbirth (aRR: 2.58, 95% CI: 1.83-3.62), neonatal death (aRR: 2.63, 95% CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 4.83, 95% CI: 2.86-8.14) and neonatal death (aRR: 6.35, 95% CI: 3.16-12.77) compared with the women aged 20-34 years, but there was no association with the risk of incidence of GDM (aRR: 1.03, 95% CI: 0.63-1.68) and SGA (aRR: 1.11, 95% CI: 0.89-1.39). Conclusions The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm birth, stillbirth and neonatal death, especially in younger adolescent pregnancies (aged 10-17 years).