The impact of a dedicated antenatal clinic on the obstetric and neonatal outcomes in adolescent pregnant women

Abstract

This retrospective observational study was designed to study the impact of a dedicated antenatal clinic service on obstetric and neonatal outcomes among teenage mothers in the maternity unit of a district general hospital in the UK. Outcomes were measured to investigate improvement in obstetric and neonatal outcomes before, and 12 months after the establishment of dedicated clinic for teenage pregnant women. Significant improvement in the birth weight was observed p = 0.01. A modest decrease in neonatal admission to special care unit by 6% was observed. Rate of spontaneous vaginal deliveries increased p = 0.0009. There was significant uptake of contraception and continuation of breast-feeding in this group of young women (p < 0.0001).

Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature

“…The RCT of Group Antenatal Care found no significant difference on this outcome between the intervention and control groups, 31 which is surprising given that there were significantly higher numbers of preterm births in the control group. The two studies 33,34 of Young Women's Clinic that reported on this outcome found no significant difference.…”

“…Two studies of Young Women's Clinic reported on breastfeeding outcomes. The prospective cohort study 21 found no significant difference in rates of breastfeeding initiation while the retrospective study 34 reported higher rates of breastfeeding at 28 days postnatally for the intervention group. Future research of breastfeeding outcomes could measure longer-term breastfeeding data.…”

“…A total of four studies were retrieved, two of which were undertaken in the UK, 33,34 one in the USA 20 and one in Australia. 21 The four studies involved very different models of care.…”

“…A 2007 UK retrospective cohort study 34 used historical controls to compare the outcomes for young women aged 11-17 years who received standard antenatal clinic care in 2001 compared to young women who received care through the ''Young and Pregnant'' clinic. The intervention group received antenatal care from a named midwife and/or obstetrician in a community-based clinic compared to the intervention group who received standard antenatal care from staff in the hospital antenatal clinic.…”

Adolescent Pregnancy Guidelines

“…9 However, studies suggest that standard care misses psychosocial vulnerabilities, STI screening, 22 and postpartum issues such as breastfeeding, contraception, and school return. 23 Multidisciplinary adolescent-focused prenatal care leads to better outcomes than standard prenatal care in adolescents, 8,10,24 including reductions in PTB, 8,10 LBW, 10,25 and NICU admissions, 26 increased SVD, 10,26 and reduction in operative delivery. 8,10 Major cost savings related to infant and paediatric health could be realized by preventing preterm births.…”