Adolesan ve Erişkin Gebelikler Arasındaki Perinatal Sonuçların Karşılaştırılması: Retrospektif Kohort Çalışma

Yıl 2020, , 603 - 608, 09.11.2020

Engin Yurtçu , Sibel Mutlu Ayşe Çitil Vehbi Yavuz Tokgöz

https://doi.org/10.20515/otd.681440

Cited By: 2

Öz

Çalışmamızın amacı doğum yapan adolesan yaş grubundaki gebeler ile yetişkin yaş grubu gebeler arasında demografik özellikler ve maternal ve neonatal sonuçlar açısından fark olup olmadığını retrospektif olarak karşılaştırmaktır. Çalışmamız retrospektif olarak kurgulanmış, 2016-2018 yılları arasında Karabük Üniversitesi Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde doğumu gerçekleşmiş 207 adolesan gebe (15-19 yaş) ve kontrol grubu olarak yine aynı yıllar arasında doğum yapmış rastgele seçilen 226 yetişkin gebe kadın (20-35 yaş) dahil edilmiştir. Adolesan grubun yaş ortalaması 18.19±0.93 kontrol grubundaki gebelerin yaş ortalaması 27.09±3.75 idi. Eğitim düzeyi adolesan grubunda düşük saptandı. Sezaryen ile doğum oranı kontrol grubunda daha yüksek (%51.8'e karşın%35.7) epizyotomi ile normal vajinal doğum oranı ise adolesan grubunda yüksek (%93.2'e karşın %70.6) bulundu. Adolesan grubunda intrauterin gelişim geriliği ve oligohidroamnios birlikteliği daha sık saptandı (p=0.019). Kontrol grubunda gestasyonel diabet görülme sıklığı daha fazlaydı (%4 'e karşın %0.5, p=0.015). Adolesan grubunda fetal doğum ağırlığı kontrol grubuna kıyasla daha düşük saptandı (p=0.014). Adolesan grubunda birinci dakika Apgar skorları daha düşük bulundu (p=0.043). Preeklampsi, preterm doğum, erken membran rüptürü görülme sıklığı gruplar arasında benzerdi. Çalışmamızın sonuçlarına göre adolesan gebelikler kötü perinatal sonuçlarla birliktelik göstermektedir. Adolesan gebelikler bu nedenle yüksek riskli gebelikler gibi değerlendirilmelidir. Devlet ve eğitim kurumları adolesan gebelikleri ve onun kötü sonuçlarını önlemek için etkili eylem planları hazırlamalıdır.

Anahtar Kelimeler

Adolesan, gebelik, yenidoğan, perinatal komplikasyonlar

Comparison of Perinatal Outcomes Between Adolescent and Adult Pregnancies: A Retrospective Study

Öz

The aim of this study is to investigate adolescent pregnancies, sociodemographic characteristics of these pregnancies, maternal and neonatal outcomes and complications of adolescent pregnancies. We enrolled 207 adolescent pregnancies between ages of 15-19 years and adult pregnancies (after 19 years old) who were delivered at Karabuk University Hospital between 2016 and 2018. We compared the results within the groups retrospectively. The mean maternal age of the adolescent and control groups were 18.19±0.93 and 27.09±3.75 respectively (p<0.001). The educational status of adolescent group was lower than the control group. While cesarean section rate was higher in control group (51.8% vs 35.7%), vaginal delivery with episiotomy was higher in adolescent group (93.2% vs 70.6%). Intrauterine growth restriction with oligohydramnios was significantly higher in study group (p=0.019). The mean of birth weight and 1. minute APGAR score of adolescent group was significantly lower compared to the control group(p=0.014 and p=0.043 respectively). Gestational diabetes mellitus was significantly higher in control group (4% vs 0.5%, p=0.015). Rate of preeclampsia, preterm labor and premature rupture of membrane were similar the between the groups. In our study, adolescent pregnancies were associated with adverse fetal and maternal outcomes. So, adolescent pregnancies should be evaluated as a high risk pregnancy. Government and educational agencies should make an effective plan and take an action for preventing early pregnancies and poor reproductive outcomes among adolescents.

Kaynakça

• 1. World Health Organization (WHO). WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Outcome Among Adolescents in Developing Countries. Geneva: WHO; 2011. 2. Darroch J, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016. 3. WHO. Global health estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: WHO; 2016. 4. Chen CW, Tsai CY, Sung FC, Lee YY, Lu TH, Li CY, et al. Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan. Child Care Health Dev 2010; 36:232–40. 5. Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol 2007; 36:368–73. 6. Conde-Agudelo A, 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. 7. de Vienne CM, Creveuil C, Dreyfus M. Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: a cohort study. Eur J Obstet Gynecol Reprod Biol 2009;147:151–6. 8. Mukhopadhyay P, Chaudhuri RN, Paul B. Hospital-based perinatal outcomes and complications in teenage pregnancy in India. J Health Popul Nutr 2010; 28:494–500. 9. Harrison K, Rossiter C, Chong H. Relations between maternal height, fetal birth weight and cephalopelvic disproportion suggest that young Nigerian primigravidae grow during pregnancy. Br J Obstet Gynaecol 1985; 92(Suppl. 5):40–8. 10. Ganchimeg T, Mori R, Ota E, Koyanagi A, Gilmour S, Shibuya K, et al. Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study. BJOG 2013; 120:1622–33. 11. Granja AC, Machungo F, Gomes A, Bergstrom S. Adolescent maternal mortality in Mozambique. J Adolesc Health 2001; 28:303–6. 12. Loto O, Ezechi O, Kalu B, Loto AB, Ezechi LO, Ogunniyi S. Poor obstetric performance of teenagers: is it age- or quality of care-related? J Obstet Gynecol 2004; 24:395–8. 13. Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health 2006; 16:157-65 14. Türkiye İstatistik Kurumu, Doğum İstatistikleri. 2017. 15. UNFPA. Girlhood, not motherhood: Preventing adolescent pregnancy. New York: UNFPA; 2015. 16. Leppälahti 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; 19; 3(8): e003225. 17. Balayla J, Azoulay L, Assayag J, Benjamin A, Abenhaim HA. Effect of maternal age on the risk of stillbirth: a population-based cohort study on 37 million births in the United States. Am J Perinatol 2011; 28(8):643-50. 18. Briggs MM, Hopman WM, Jamieson MA. Comparing pregnancy in adolescents and adults: obstetric outcomes and prevalence of anemia. J Obstet Gynaecol Can, 2007; 29(7): 546–55. 19. Beard JL. Iron requirements in adolescent females. J Nutr, 2000; 130 (Suppl 2S): 440S–442S. 20. Olausson PO, Haglund B, Weitoft GR, Cnattingius S. Teenage childbearing and long-term socioeconomicconsequences: a case study in Sweden. Fam Plann Perspect. 2001; 33(2):70-4. 21. Moffitt TE. Teen-aged mothers in contemporary Britain. J Child Psychol Psychiatry. 2002; 43(6):727-42. 22. Harrykissoon SD, Rickert VI, Wiemann CM. Prevalence and patterns of intimate partner violence among adolescent mothers during the postpartum period. Arch Pediatr Adolesc Med. 2002;156(4):325-30.