Adölesan gebelik gerçekten bir risk faktörü müdür?

Öz

Amaç: Bu çalışmada bir üniversite hastanesinde gerçekleşen doğum verilerine göre adölesan, yetişkin ve ileri yetişkin olmak üzere 3 farklı yaş grubunun kötü maternal ve neonatal sonuçlar ile ilişkisi araştırılmıştır. Yöntem: Çalışmamız Ocak 2010 - Aralık 2014 tarihleri arasını kapsayan 5 yıllık periyotta Hitit Üniversitesi Çorum Eğitim ve Araştırma Hastanesinde gerçekleşmiş doğumların verilerini kapsamaktadır. Dahil edilme kriterlerini karşılayan 19.912 gebe, yaş gruplarına göre 3’e ayrıldı: i Adölesan yaş grubu 12-19 yaş arası, n=1774 , ii Yetişkin yaş grubu 20-35 yaş arası, n=16542 ve iii İleri yetişkin yaş grubu >35 yaş, n=1596 . Çalışmaya dahil olan tüm gebelerin anne yaşı, bebek doğum ağırlıkları, gebelik başı ve sonu hemoglobin düzeyleri, doğum tipleri, yenidoğan yoğun bakım gereksinimi ve major perineal laserasyon varlığı gibi parametrelerinin istatistiksel karşılaştırmaları ve analizleri yapıldı.Bulgular: Adölesan gebeliklerin yaş ortalaması 18.3 yıl iken yetişkin gebeler 26.6 yıl ve ileri yetişkin gebeler ise 38.2 yıl yaş ortalamasına sahip idiler p

Anahtar Kelimeler

• Adölesan, gebelik, sezaryen, laserasyon, yenidoğan

Is adolescent pregnancy really a risk factor?

Abstract

Objective: It was investigated the relationship between adverse maternal and neonatal outcomes and the pregnant women cathegorized into three age groups adolescent, adult and advanced adult groups on the base of obstetric data of a university hospital.Methods: Our study included the obstetric data of the Hitit University Hospital between January 1, 2010 and December 31, 2014. Total of 19912 pregnant women who provide the inclusion criteria were grouped into three according to their ages: i Adolescent age group 12-19 years of age, n=1774 , ii Adult age group 2035 years of age, n=16542 , and iii Advanced adult age group >35 years of age, n=1596 . The comparisons and statistical analyses of parameters including maternal age, birth weight,hemoglobin levels at early and late pregnancy, delivery type, necessity for newborn intensive care unit and presence of major perineal laceration.Results: While the mean age of adolescent pregnants was 18.3 years, the mean age of adults and advanced adults were 26.6 years and 38.2 years respectively p

Keywords

• Adolescent, pregnancy, cesarean, laceration, newborn

Kaynakça

1. 1. World Health Organization (WHO): WHO guidelines on preventing early pregnancy and poor reproductive outcome among adolescents in developing countries. Geneva: WHO; 2011.
2. 2. World Health Organization (WHO). WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Outcome Among Adolescents in Developing Countries. Geneva: WHO; 2011.
3. 3. United Nations Population Fund, The State of World Population, 2014.
4. 4. 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(5): e1228-37.
5. 5. Nord CW, Moore KA, Morrison DR, Brown B, Myers DE. Consequences of teen-age parenting. J Sch Health, 1992; 62(7): 310-8.
6. 6. Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al; WHO Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and child birth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG, 2014 ; 121 Suppl 1: 40-8.
7. 7. Jolly MC, Sebire N, Harris J, Robinson S, Regan L. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol, 2000; 96(6): 962-6.
8. 8. Malabarey OT, Balayla J, Klam SL, Shrim A, Abenhaim HA. Pregnancies in young adolescent mothers: a population-based study on 37 million births. J Pediatr Adolesc Gynecol, 2012; 25(2): 98- 102.

9. 9. Torvie AJ, Callegari LS, Schiff MA, Debiec KE. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol, 2015; 213(1): 95.e1-8.
10. 10. Koniak-Griffin D, Turner-Pluta C. Health risks and psychosocial outcomes of early childbearing: a review of the literature. J Perinat Neonatal Nurs, 2001;15(2): 1-17.
11. 11. Siegel RS, Brandon AR. Adolescents, pregnancy, and mental health. J Pediatr Adolesc Gynecol, 2014; 27(3): 138-50.
12. 12. Moerman ML: Growth of the birth canal in adolescent girls. Am J Obstet Gynecol, 1982; 143(5): 528-32.
13. 13. 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.
14. 14. Ganchimeg T, Mori R, Ota E, Koyanagi A, Gilmour S, Shibuya K, et al. Maternal and perinatal outcomes among nulliparous adolescents in low- and middleincome countries: a multi-country study. BJOG, 2013; 120(13): 1622–33.
15. 15. Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang CC, Gomez-Lobo V. Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy. J Pediatr Adolesc Gynecol, 2016; 29(2): 130-6.
16. 16. Timofeev J, Reddy UM, Huang CC, Driggers RW, Landy HJ, Laughon SK. Obstetric complications, neonatal morbidity, and indications for cesarean delivery by maternal age. Obstet Gynecol, 2013; 122(6): 1184-95.
17. 17. Conde-Agudelo A, Beliza´n JM, Lammers C. Maternal–perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study. Am J Obstetr Gynecol, 2005; 192(2): 342–9.
18. 18. Alouini S, Randriambololona D, Randriamboavonjy R. [Risk factors of teenage pregnancies, deliveries and post-partum in the department of Loiret]. J Gynecol Obstet Biol Reprod (Paris), 2015; 44(5): 443–50.
19. 19. Belachew J, Cnattingius S, Mulic-Lutvica A, Eurenius K, Axelsson O, Wikstrom A. Risk of retained placenta in women previously delivered by caesarean section: a population-based cohort study. BJOG, 2014; 121(2): 224–9.
20. 20. Tsikouras P, Dafopoulos A, Trypsianis G, Vrachnis N, Bouchlariotou S, Liatsikos SA, et al. Pregnancies and their obstetric outcome in two selected age groups of teenage women in Greece. J Matern Fetal Neonatal Med, 2012; 25(9): 1606–11.
21. 21. Lowder JL, Burrows LJ, Krohn MA, Weber AM. Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery. Am J Obstet Gynecol, 2007; 196(4): 344.e1.
22. 22. Landy HJ, Laughon SK, Bailit JL, Kominiarek MA, Gonzalez-Quintero VH, Ramirez M, et al; Consortium on Safe Labor. Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. Obstet Gynecol, 2011; 117(3): 627-35.
23. 23. Aviram A, Raban O, Melamed N, Hadar E, Wiznitzer A, Yogev Y. The association between young maternal age and pregnancy outcome. J Matern Fetal Neonatal Med, 2013; 26(15): 1554-8.
24. 24. 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(2): 151–6.
25. 25. 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.
26. 26. 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.
27. 27. Beard JL. Iron requirements in adolescent females. J Nutr, 2000; 130 (Suppl 2S): 440S–2S.
28. 28. Connolly G, Kennelly S, Conroy R, Byrne P. Teenage pregnancy in the Rotunda Hospital. Ir Med J, 1998; 91(6): 209–12.
29. 29. Fleming N, Ng N, Osborne C, Biederman S, Yasseen AS 3rd, Dy J, et al. Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can, 2013; 35(3): 234–45.
30. 30. Reichman NE, Pagnini DL. Maternal age and birth outcomes: data from New Jersey. Fam Plann Perspect, 1997; 29(6): 268–72, 295.
31. 31. Althabe F, Moore JL, Gibbons L, Berrueta M, Goudar SS, Chomba E, et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global network’s Maternal Newborn Health Registry study. Reprod Health, 2015; 12 Suppl 2: S8.
32. 32. Weng YH, Yang CY, Chiu YW. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age. PLoS One, 2014, 9(12): e114843.
33. 33. 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(2): 232-40.
34. 34. Partridge S, Balayla J, Holcroft CA, Abenhaim HA. Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 U.S. deliveries over 8 years. Am J Perinatol, 2012; 29(10): 787–93.
35. 35. LeGrand TK, Mbacke CS. Teenage pregnancy and child health in urban Sahel. Stud Fam Plann, 1993; 24(3): 137-49.
36. 36. Scholl T, Hediger ML, Belsky DH. Prenatal care and maternal health during adolescent pregnancy: a review and meta-analysis. J Adolesc Health, 1994;15(6): 444-56.