Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy
DOI:
https://doi.org/10.3889/oamjms.2019.210Keywords:
adolescent pregnancy, maternal complications, perinatal outcomesAbstract
BACKGROUND: Adolescent pregnancy, defined as a pregnancy in girls aged 10 to 19 years. Adolescent mothers are at high risk for maternal and neonatal complications.
AIM: To compare maternal, perinatal and neonatal outcomes in adolescents and adult women aged 20-24 years.
MATERIAL AND METHODS: This retrospective cohort study included all singleton pregnancies during a three-year period (January 2016-December 2018) who gave birth in a Clinical Hospital in Tetovo, Republic of Macedonia. After exclusion criteria, a total of 932 cases were reviewed and divided into two groups: one of the teenage mothers (< 19 years old) (115 women) and the other of adult mothers (20-24 years old) (817 women).
RESULTS: Of the total number of 5643 births, 128 (2.27%) were from adolescent pregnancies. Of them, nulliparous adolescent women were 115 (2.04%). Adolescents compare to adult mothers had a higher rate of urinary tract infections (33% vs. 22%), increased rate of maternal anemia (26% vs. 15%), preterm birth, small for gestational age newborns (25.2% vs. 17.1%), lower high school attendance (0 vs. 21.9%) and inadequate prenatal care. Spontaneous labour was more common in adolescents (73% vs 63.5%), while Caesarean sections were less common than in women aged 20-24 years (25.2% vs 33.5%). The rate of other perinatal outcomes was not significantly different between the 2 groups.
CONCLUSIONS: The results of the study showed that the frequencies of some maternal, perinatal and neonatal complications were considerably higher in adolescent mothers.
nal and perinatal complications were considerably higher in adolescent mothers.
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Yuce T, Aker SH, Seval MM, Kalafat E, Soylemez F. Obstetric and neonatal outcomes of adolescent pregnancy. North Clin Istanbul. 2015; 2(2):122-127. https://doi.org/10.14744/nci.2015.86158
Mukhopadhyay P, Chaudhuri RN, Paul B. Hospital-based perinatal outcomes and complications in teenage pregnancy in India. J Health Popul Nutr. 2010; 28(5):494-500. https://doi.org/10.3329/jhpn.v28i5.6158 PMid:20941901 PMCid:PMC2963772
World Health Organization. WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Health Outcomes Among Adolescents in Developing Countries. Geneva: WHO, 2011. (Accessed March 1, 2016).
World Bank Group. Adolescent fertility rate (births per 1000 women ages 15-19); http://data.worldbank.org/indicator/SP.ADO.TFRT.order=wbapi-data-value-2016.
Ezegwui HU, Ikeako LC, Ogbuefi F. Obstetric outcome of teenage pregnancies at a tertiary hospital in Enugu, Nigeria. Niger j Clin Pract. 2012; 15(2):147-50. https://doi.org/10.4103/1119-3077.97289 PMid:22718161
Lee SH, Lee SM, Lim NG, Kim HJ, Bae SH, Ock M, Kim UN, Lee JY, Jo MW. Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea. Medicine. 2016; 95(34):e4630. https://doi.org/10.1097/MD.0000000000004630 PMid:27559960 PMCid:PMC5400327
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Bommarito K, Madden T, Olsen MA, Subramaniam H, Peipert JF, Bierut LJ. Maternal age and risk of labor and delivery complications. Matern Child Health J. 2015; 19(6):1202-1211. https://doi.org/10.1007/s10995-014-1624-7 PMid:25366100 PMCid:PMC4418963
Azevedo WF, Diniz MB, da Fonseca ES, de Azevedo LM, Evangelista CB. Complications in adolescent pregnancy: systematic review of the literature. Einstein. 2015; 13(4):618-25. https://doi.org/10.1590/S1679-45082015RW3127 PMid:26061075 PMCid:PMC4878642
Minjares-Granillo RO, Reza-Lopez SA, Caballero-Valdez S, Levario-Carrillo M, Chavez-Corral DV. Maternal and perinatal outcomes among adolescents and mature women: a hospital-based study in the North of Mexico. J Pediatr Adolesc Gynecol. 2016; 29(3):304-11. https://doi.org/10.1016/j.jpag.2015.11.005 PMid:26620384
Fleming N, Ng N, Osborne C, Biederman S, Yasseen AS, Dy J, Rennicks WR, Walker M. Adolescent pregnancy outcomes in the province of Ontario:a cohort study. J Obstet Gynaecol Can. 2013; 35(3):234-245. https://doi.org/10.1016/S1701-2163(15)30995-6
Black AY, Fleming NA, Rome ES. Pregnancy in adolescents. Adolesc Med State Art Rev. 2012; 23:123-38. PMid:22764559
Kingston D, Heaman M, Fell D, Chalmers B. Maternity Experiences Study group of the Canadian Perinatal Surveillance System. Public Health Agency of Canada. Comparison of Adolescent, young adult, and adult women's maternity experiences and practices. Pediatrics. 2012; 129:1228-37. https://doi.org/10.1542/peds.2011-1447 PMid:22529278
Kawakita T, Wilson K, Grantz k, Landy HJ, Huang Ch, Lobo VG. Adverse maternal and neonatal outcomes in adolescent pregnancy.J Pediatr Adolesc Gynecol. 2016; 29(2):130-136. https://doi.org/10.1016/j.jpag.2015.08.006 PMid:26327561 PMCid:PMC4886236
Timofeev J, Reddy UM, Huang CC, et al. Obstetric complications, neonatal morbidity, and indications for cesarean delivery by maternal age. Obstet Gynecol. 2013; 122:1184-1195. https://doi.org/10.1097/AOG.0000000000000017 PMid:24201681 PMCid:PMC4189107
WHO. Adolescent Pregnancy. Issues in Adolescent Health and Development; WHO: Geneva, Switzerland, 2004.
Kalinderi K, Delkos D, Kalinderis M, Athanasiadis A, Kalogiannidis I.Urinary tract infection during pregnancy:current concepts on a common multifaceted problem. J Obstet Gynaecol. 2018; 38(4):448-453. https://doi.org/10.1080/01443615.2017.1370579 PMid:29402148
Sun D, McLeod A, Gandhi S, Malinowski AK, Shehata N. Anemia in Pregnancy: A Pragmatic Approach. Obstet Gynecol Surv. 2017; 72(12):730-737. https://doi.org/10.1097/OGX.0000000000000510 PMid:29280474
Menon R, Richardson LS. Preterm prelabor rupture of the membranes: A disease of the fetal membranes. Semin Perinatol. 2017; 41(7):409-419. https://doi.org/10.1053/j.semperi.2017.07.012 PMid:28807394 PMCid:PMC5659934
Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics, 24e. Mcgraw-hill, 2014.
Fan D, Wu S, Liu L, Xia Q, Wang W, Guo X, Liu Z. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis. Scientific reports. 2017; 7:40320. https://doi.org/10.1038/srep40320 PMid:28067303 PMCid:PMC5220286
WHO. International Statistical Classification of Diseases and Related Health Problems (ICD-10) 10th Revision, 4th ed; WHO. Geneva, Switzerland, 2011; 2.
Da Silva FT et al. Stillbirth: Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data, Vaccine. 2016; 34(49):6057–6068. https://doi.org/10.1016/j.vaccine.2016.03.044 PMid:27431422 PMCid:PMC5139804
Leppalahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population –based study in Finland, from 2006 to 2011. BMJ Open 2013; 3:e003225. https://doi.org/10.1136/bmjopen-2013-003225 PMid:23959755 PMCid:PMC3753503
Sedgh G, Finer L, Bankole A, Eilers M, Singh S. Adolescent pregnancy, Birth and Abortion Rates Across Countries: Levels and Recent Trends. J Adolesc Health. 2015; 56(2):223-230. https://doi.org/10.1016/j.jadohealth.2014.09.007 PMid:25620306 PMCid:PMC4852976
United Nations Population Fund (UNFPA), https://eeca.unfpa.org/…/Adolescent Pregnancy in Eastern Europe and Central Asia, 30 October 2013.
Yurdakul M. Perceived social support in pregnant adolescents in Mersin area in Turkey. Pak J Med Sci. 2018; 34(1):115-120. https://doi.org/10.12669/pjms.341.14221 PMid:29643890 PMCid:PMC5856994
Kuo CP, Lee SH, Wu Wy, Liao WC, Lin SJ, Lee MC. Birth outcomes and risk factors in adolescent pregnancies: result of a Taiwanese national survey. Pediatr Int. 2010; 52(3):447-52. https://doi.org/10.1111/j.1442-200X.2009.02979.x PMid:19863752
Korencan S, Pinter B, Grebenc M, Verdenik I. The Outcomes of Pregnancy and Childbirth in Adolescents in Slovenia. Zdr Varst. 2017; 56 (4):268-275. https://doi.org/10.1515/sjph-2017-0036
Segregur J, Segregur D. Antenatal characteristics of Roma female population in Virovitica-Podravina County, Croatia. Zdr Varst. 2017; 56. https://doi.org/10.1515/sjph-2017-0007
Hotchkiss DR, Godha D, Gage AJ, Cappa C. Risk factors associated with the practice of child marriage among Roma girls in Serbia. BMC Int Health Hum Rights. 2016; 16(1):6. https://doi.org/10.1186/s12914-016-0081-3 PMid:26831893 PMCid:PMC4736708
Pergialiotis V, Vlachos DE, Gkioka E, Tsotra K, Papantoniou N, Vlachos GD. Teenage pregnancy antenatal and perinatal morbidity: results from tertiary centre in Greece. J Obstet Gynaecol. 2015; 35(6):595-9. https://doi.org/10.3109/01443615.2014.991285 PMid:25526508
Demirci O, Yilmaz E, Tosun O, Kumru P, Arinkan A, Mahmutoglu D, Selcuk S, Dolgun ZN, Arisoy R, Erdogdu E, Tarhan N. Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from Tertiary Center in Turkey. Balkan Med J. 2016; 33:344-9. https://doi.org/10.5152/balkanmedj.2015.150364 PMid:27308080 PMCid:PMC4898995
McCall SJ, Bhattacharya SI, Okpo E2, et al. Evaluating the social determinants of teenage pregnancy: a temporal analysis using a UK obstetric database from 1950 to 2010. J Epidemiol Common Health. 2015; 69:49-54. https://doi.org/10.1136/jech-2014-204214 PMid:25227769
Kirbas A, Gulerman HC, Daglar K. Pregnancy in adolescence: is it an obstetrical risk?. Journal of pediatric and adolescent gynecology. 2016; 29(4):367-71. https://doi.org/10.1016/j.jpag.2015.12.010 PMid:26762668
Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. The Journal of nutrition. 2013; 143(4):486-92. https://doi.org/10.3945/jn.112.169987 PMid:23365107 PMCid:PMC4745881
Linhares AO, Juraci AC. Folic acid supplementation among pregnant women in Southern Brazil: Prevalence and factors associated. Ciencia Saide Coletiva. 2017; 22:535-542. https://doi.org/10.1590/1413-81232017222.06302016
Al-Haddabi R, Al-Bash M, Al-Mabaihsi N, Al-maqbali N, Al-Dughaishi T, Abu-Heija A. Obstetric and Perinatal Outcomes of Teenage Pregnant Women Attending a Tertiary Teaching Hospital in Oman. Oman Medical Journal. 2014; 29(6):399-403. https://doi.org/10.5001/omj.2014.108 PMid:25584155 PMCid:PMC4289491
Dutta I, Joshi P. Maternal and perinatal outcome in teenage vs. Vicenarian primigravidae – a clinical study. J Clin Diagn Res. 2013; 7(12):2881-84. https://doi.org/10.7860/JCDR/2013/7265.3783
Socolov DG, Iorga M, Carauleanu A, Ilea C, Blidaru I, Boiculese L, Socolov RV. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe. Biomed Res Int. 2017; 9205016. https://doi.org/10.1155/2017/9205016
Usynina AA, Postoev V, Odland JO, Grjibovski AM.Adverse Pregnancy Outcomes among Adolescents in Northwest Russia: A Population Registry–Based Study. J Environ Res Public Health. 2018; 15:261-272. https://doi.org/10.3390/ijerph15020261 PMid:29401677 PMCid:PMC5858330
Conde AA, Belizan JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. Am J Obstet Gynecol. 2005; 192:342-9. https://doi.org/10.1016/j.ajog.2004.10.593 PMid:15695970
Masoumi SZ, Kashanian M, Arab E, Sheikhansari N. A comparison between pregnancy outcome in women in 15 to 19 and 20 to 35 years' age group. Med J Islam Repub Iran. 2017; 32:3. https://doi.org/10.14196/mjiri.31.140
Ergen EB, Yayla CA, Sanverdi I, Ozkaya E, Kilicci C, Kocakusak CK. Maternal-fetal outcome associated with adolescent pregnancy in a tertiary referral center: a cross-sectional study. Ginekologia polska. 2017; 88(12):674-8. https://doi.org/10.5603/GP.a2017.0120 PMid:29303225
Moraes AN, Likwa RN, Nzala SH. A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: the case of Luapula Province, Zambia. Matern Health Neonatol Perinatol. 2018; 4:20. https://doi.org/10.1186/s40748-018-0088-y PMid:30349732 PMCid:PMC6192102
Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, Yamdamsuren B, Temmerman M, Say L, Tuncalp O, Vogel JP. WHO Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014; 121(Suppl 1):40-8. https://doi.org/10.1111/1471-0528.12630 PMid:24641534
Traisrisilp K, Jaiprom J, Luewan S, Tongsong T. Pregnancy outcomes among mothers aged 15 years or less. J Obstet Gynaecol Res. 2015; 41(11):1726-31. https://doi.org/10.1111/jog.12789 PMid:26311210
Mayo Ja, Shachar BZ, Stevenson DK, Shaw GM. Nulliparous teenagers and preterm birth in California. J Perinat Med. 2017; 45(8):959-967. https://doi.org/10.1515/jpm-2016-0313 PMid:28343179
Keskinoglu P, Bilgic N, Picakciefe M, Giray H, Karakus N, Gunay T. Perinatal outcomes and risk factors of Turkish adolescent mothers. J Pediatr Adolesc Gynecol. 2007; 20(1):19-24. https://doi.org/10.1016/j.jpag.2006.10.012 PMid:17289512
Gibbs CM, Wendt A, Peters S, et al.The impact of early age at first childbirth on maternal and infant health. Pediatr Perinat Epidemiol. 2012; 26:259-84. https://doi.org/10.1111/j.1365-3016.2012.01290.x PMid:22742615 PMCid:PMC4562289
Ganchimeg T1, Mori R, Ota E, Koyanagi A, Gilmour S, Shibuya K, Torloni MR, Betran AP, Seuc A, Vogel J, Souza JP. Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study. BJOG. 2013; 120(13):1622-30. https://doi.org/10.1111/1471-0528.12391 PMid:23924217
Santos GH, Martins Mda G, Sousa Mda S, Batalha Sde J. Impact of maternal age on perinatal outcomes and mode of delivery. Rev Bras Ginecol Obstet. 2009; 31(7)326-34. PMid:19838577
Beyer DA, Amari F, Diedrich K, Bohlmann MK, Weichert J, Hornemann A. Teenage deliveries in Northern Germany: always a risk factor for higher surgical delivery rates? Arch Gynecol Obstet. 2011; 284(3):535-8. https://doi.org/10.1007/s00404-010-1679-7 PMid:20862589
Torvie AJ, Callegari LS, Schiff MA and Debiec KE. Labor and delivery outcomes among young adolescents. American journal of obstetrics and gynecology. 2015; 213(1):95el-95e8.
Usta IM, Zoorob D, Abu-Musa A, Naassan G, Nassar AH. Obstetric outcome of teenage pregnancies compared with adult pregnancies. Acta Obstet Gynecol Scand. 2008; 87(2):178-83. https://doi.org/10.1080/00016340701803282 PMid:18231885
Shah N, Rohra DK, Shuja S, Liagat NF, Solangi NA, Kumar K, Kumar K, Ahuja KL, Azam SI, Khan N. Comparison of obstetric outcome among teenage and non-teenage mothers from three tertiary care hospitals of Sindh, Pakistan. J Pak Med Assoc. 2011; 61(10):963-7. PMid:22356027
Tyrberg RB, Blomberg M, Kjølhede P. Deliveries among teenage women - with emphasis on incidence and mode of delivery: A Swedish national survey from 1973 to 2010, BMC Pregnancy Childbirth. 2013; 13:204. https://doi.org/10.1186/1471-2393-13-204 PMid:24207112 PMCid:PMC3833297
Sagili H, Pramya N, Prabhu K, Mascarenhas M and Reddi Rani P. Are teenage pregnancies at high risk? A comparison study in a developing country. Arch Gynecol and Obstet. 2012; 285(3):573-7. https://doi.org/10.1007/s00404-011-1987-6 PMid:21789518
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