A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes

Year 2023, Volume: 21 Issue: 3, 361 - 370, 15.12.2023

Fatma Tuba Engindeniz , Deniz Simsek , Burcu Dinçgez

https://doi.org/10.20518/tjph.1285907

Abstract

Objective: Adolescent pregnancy, associated with increased adverse pregnancy outcomes, is a major public health problem. We aimed to assess adverse perinatal outcomes in adolescent pregnanciesto develop preventive strategies or treatment options.

Methods: A total of 37248 births were registered between 2017 and 2020. Random numbers table was used to choose participants. Patients who had unavailable records,different ethnicity, education level, marital status,insurance type were excluded and3567 pregnant were included in the study. The adolescent pregnant group comprised 1104 women whileadults comprised 2463 pregnan.Fetal anomaly, gestational diabetes, preeclampsiaeclampsia, intrauterine growth restriction, intrahepatic cholestasis, polyhydramnios, placenta previa, inutero mort fetus, uterine rupture, placenta abruption, umbilical cord prolapse, acute fetal distress, preterm birth, cesarean section, labor arrest, birth weight, macrosomia, dystocia, birth trauma, APGAR scores, neonatal intensive care unit admission, postpartum hemorrhage, hysterectomy, blood transfusion, and postpartum infection were recorded.

Results: Rates of acute fetal distress, preterm birth, low birth weight, neonatal intensive care unit admission, postpartum hemorrhage, and blood transfusion were higher while birth weight, APGAR scores, the rates of cesarean section, prolonged and arrested labor, gestational diabetes,and macrosomia were lower in adolescents. Being adolescent increase the risk of acute fetal distress by 1.4 times (aOR=1.44;95%CI=1.03-2.01,p=0.033), preterm birth by 1.7 times(aOR=1.69;95%CI=1.10-2.60,p=0.016) and decrease the risk of gestational diabetes(aOR=0.18;95%CI=0.12-.29,p<0.001),macrosomia(aOR=0.59;95%CI=0.40-0.9,p=0.08),labor arrest(aOR=0.50;95%CI=0.27-0.95,p=0.033) and cesarean section(aOR=0.33;95%CI=0.27-0.39,p<0.001) after adjusting for confounders.

Conclusion: Considering increased acute fetal distress, preterm birth, low birth weight, neonatal intensive care unit admission, postpartum hemorrhageblood transfusion risk for adolescent pregnancies, adolescents and healthcare providers should be informed and follow-ups must be performed in well-equipped centers.

Keywords

adolescent pregnancy, cesarean section, gestational diabetes, labor arrest, preterm birth

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