Pregnancy in Adolescence: Is It an Obstetrical Risk?

Study Objective: Adolescent pregnancy is an important public health problem worldwide. It is associated with increased risk of maternal and fetal complications. We aimed to investigate whether adolescent pregnancies have an increased risk for perinatal complications. We focused primarily on the relationship between adolescent pregnancy and preterm delivery. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We used records of 38,646 women who gave birth at our hospital, between January 2008 and December 2009. Five hundred eighty-two randomly selected pregnant adolescents and 2,920 healthy parity and body mass index matched pregnant women 20-34 years of age were included the study. Perinatal outcomes were compared between the groups.

Results: The mean gestational ages of the adolescent and control groups at the first prenatal visit were 11.2 (range, 8-31) and 8.5 (range, 7-28) weeks, respectively (P < .001). The risks of preterm delivery (odds ratio, 2.46; 95% confidence interval, 1.80-3.37; P < .001) and preeclampsia (odds ratio, 2.14; 95% confidence interval, 1.30-3.51; P = .002) were significantly greater among the adolescent mothers. In both groups, the most frequent reason was spontaneous preterm delivery.

Conclusion: As shown in this study, pregnant adolescents present to hospitals for prenatal care at a much more advanced gestational age compared with adults. At the time they present to the hospital, and particularly in the first trimester, they must be advised to undergo an ultrasound scan to determine the gestational age. As such, it would be reasonable to increase the frequency of examinations after the second trimester, because of the increased risk of preterm labor and preterm birth.