-

Öz

Aim: Recently, number of adolescent and advanced age pregnancies increased and became an important social issue. There are conflicting results on maternal and perinatal outcomes of those pregnancies. The objective of this study is to compare the short-term outcomes of ≤18 (adolescent) years old and ≥35 years old (advanced age) mothers’ infants with 19-34 years old (control group) mothers’ infants.Methods: Medical records of infants hospitalised in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Research and Training Hospital between January 2011- January 2013 were evaluated retrospectively.Results: Overall, 20242 pregnancies in different age groups: 511 (2.5%) adolescent, 16840 (83%) control group, 2891 (14.5%) advanced age were included in the study. Sixteen percent (n=84), 17% (n=2262), and 14% (n=502) of infants of adolescent mothers, advanced age mothers, and control group mothers were hospitalised, respectively (p1, p2, p3=NS). Assisted reproductive technology, multiple pregnancy, gestational diabetes, and preeclampsia were more common in advanced age group (p<0.001). Rates of antenatal care, neonatal mortality and morbidity were similar in all groups.Conclusion: Adolescent or advanced maternal age do not have an adverse effect on short term neonatal outcome in presence of adequate antenatal and neonatal care.

Anahtar Kelimeler

• Adolescent, advanced maternal age, newborn, neonatal intensive care unitCİLT: 45 YIL: 2014 SAYI: 3

Adölesan veya İleri Anne Yaşı: Yenidoğan İçin Risk midir?: Tek Bir Merkezin Retrospektif Sonuçları (Is Adolescent or Advanced Maternal Age Risky for Newborn?: Retrospective Results of a Single Center)

Öz

Amaç: Son yıllarda adölesan ve ileri yaş gebelikler artmış ve önemli bir sosyal konu halini almıştır. Bu gebeliklerin maternal ve perinatal sonuçları konusunda tartışmalı sonuçlar mevcuttur. Bu çalışmanın amacı hastanemizde gerçekleşen doğumlarda ≤18 yaş (adölesan) ve ≥35 yaş (ileri yaş) annelerin bebekleriyle, 19-34 yaşlarında (kontrol) olan anne bebeklerinin erken dönem sonuçlarının karşılaştırılmasıdır

Yöntem: Ocak 2011-Ocak 2013 arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi’nde doğan ve yenidoğan yoğun bakım ünitesinde yatarak izlenen hastaların antenatal ve yenidoğan dönemi verileri retrospektif olarak incelendi.

Bulgular: Çalışma süresince hastanemizde doğum yapan 511 (%2.5) adölesan (≤18 yaş),  16840 (%83) kontrol grubu (19-34 yaş), 2891 (%14.5) ileri yaş (≥35 yaş) gebe olmak üzere toplam 20242 olgu çalışmaya dahil edildi. Adölesan anne bebeklerinin %16’sı (n= 84),19-34 yaş arası anne bebeklerinin %14’ü (n=2262), ≥35 yaş anne bebeklerinin %17’sinin (n=502) YYBÜ’ne yatışı yapılmıştı (p₁, p₂, p₃=NS). İleri yaş annelerde yardımcı üreme tekniği kullanımı, çoğul gebelik, gestasyonel diyabet ve preeklampsi sıklığı diğer gruplara göre daha fazlaydı (p<0.001). Antenatal bakım sıklığı ile neonatal mortalite ve morbidite her üç grupta da benzer oranlardaydı. 

Sonuç: Adölesan veya ileri anne yaşının yeterli antenatal ve neonatal bakım varlığında yenidoğanın erken dönem sonuçları üzerinde olumsuz etkisi olmadığı görülmüştür.

Anahtar kelime: Adölesan, ileri maternal yaş, yenidoğan, yenidoğan yoğun bakım

 

Abstract

Aim: Recently, number of adolescent and advanced age pregnancies increased and became an important social issue. There are conflicting results on maternal and perinatal outcomes of those pregnancies. The objective of this study is to compare the short-term outcomes of  ≤18 (adolescent) years old and  ≥35 years old (advanced age) mothers’ infants with 19-34 years old (control group) mothers’ infants. 

Methods: Medical records of infants hospitalised in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Research and Training Hospital between January 2011- January 2013 were evaluated retrospectively.

Results: Overall, 20242 pregnancies in different age groups: 511 (2.5%) adolescent, 16840 (83%) control group, 2891 (14.5%) advanced age were included in the study. Sixteen percent (n=84), 17% (n=2262), and 14% (n=502) of infants of adolescent mothers, advanced age mothers, and control group mothers were hospitalised, respectively (p₁, p₂, p₃=NS). Assisted reproductive technology, multiple pregnancy, gestational diabetes, and preeclampsia were more common in advanced age group (p<0.001). Rates of antenatal care, neonatal mortality and morbidity were similar in all groups.

Conclusion: Adolescent or advanced maternal age do not have an adverse effect on short term neonatal outcome in presence of adequate antenatal and neonatal care.

Keywords: Adolescent, advanced maternal age, newborn, neonatal intensive care unit

Anahtar Kelimeler

• Adölesan, ileri maternalyaş, yenidoğan, yenidoğan yoğun bakım

Kaynakça

1. Chedraui P, Van Ardenne R, et al. Knowledge and practice of family planning and HIV-prevention behaviour among just delivered adolescents in Ecuador: the problem of adolescent pregnancies. Arch Gynecol Obstet 2007; 276: 139-44
2. Births: Final data for 2010. Natl Vital Stat Rep 2012; 61: 1
3. Ulusal Anne Ölümleri Çalışması, 2005. www.hips.hacettepe.edu.tr/uaop_ankara/UAOC2005-OzetRapor.pdf (Son erişim tarihi 15.04.2014)
4. Chandra PC, Schiavello HJ, Ravi B, et al. Pregnancy outcomes in urban teenagers. Int J Gynaecol Obstet. 2002; 79: 117-22.
5. Karabulut A, Ozkan S, Bozkurt AI,et al. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J Obstet Gynaecol. 2013; 33: 346-50.
6. Laopaiboon M, Lumbiganon P, Intarut N, et al. WHO Multicountry Survey on Maternal Newborn Health Research Network. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG. 2014; 121: 49-56.
7. Nilsen AB, Waldenström U, Hjelmstedt A, et al. Characteristics of women who are pregnant with their first baby at an advanced age. Acta Obstet Gynecol Scand. 2012; 91: 353-362.
8. Kanungo J, James A et al. Advanced maternal age and the outcomes of preterm neonates: a social paradox? Obstet Gynecol 2011; 118: 872-877.

9. Ovali F. Intrauterine growth curves for Turkish infants born between 25 and 42 weeks of gestation. J Trop Pediatr. 2003; 49: 381-3
10. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163: 1723.
11. International committee for the classification of retinopathy of prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol 2005; 123: 991-999.
12. Papile LA, Burstein J, Burstein R. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 g. J Pediatr 1978; 92: 529-534.
13. Walsh MC, Kliegman RM. Neonatal necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986: 33; 179.
14. Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. Am J Obstet Gynecol. 2005; 192: 342-349.
15. Kurth F, Bélard S, Mombo-Ngoma G, et al. Adolescence as risk factor for adverse pregnancy outcome in Central Africa--a cross-sectional study. PLoS One. 2010; 5: e14367.
16. Treffers PE. Teenage pregnancy, a worldwide problem. Ned Tijdschr Geneeskd. 2003; 147: 2320-5.
17. Türkiye Nüfus ve Sağlık Araştırması, 2008. www.hips.hacettepe.edu.tr/tnsa2008/ (Son erişim tarihi 14.04.2014)
18. Canbaz S, Sunter AT, Cetinoglu CE, et al. Obstetric outcomes of adolescent pregnancies in Turkey. Adv Ther. 2005; 22: 636-41
19. Demir B, Guzel AI, Celik Y, et al. Evaluation of adolescent pregnancies: 10-year experience of a hospital in rural Turkey. Clin Exp Obstet Gynecol. 2011; 38: 399-400.
20. Arkan DC, Kaplanoğlu M, Kran H, et al. Adolescent pregnancies and obstetric outcomes in southeast Turkey: data from two regional centers. Clin Exp Obstet Gynecol. 2010; 37: 144-7.
21. Edirne T, Can M, Kolusari A, et al. Trends, characteristics, and outcomes of adolescent pregnancy in eastern Turkey. Int J Gynaecol Obstet. 2010; 110: 105-8.
22. Yildirim Y, Inal MM, Tinar S. Reproductive and obstetric characteristics of adolescent pregnancies in Turkish women. J Pediatr Adolesc Gynecol. 2005; 18: 249-53.
23. Jolly MC, Sebire N, Harris J, et al. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol. 2000; 96: 962-6.
24. Keskinoglu P, Bilgic N, Picakciefe M, et al. Perinatal outcomes and risk factors of Turkish adolescent mothers. J Pediatr Adolesc Gynecol. 2007; 20: 19-24.
25. İmir AG, Çetin M, Balta Ö, et al. Perinatal Outcomes of Adolescent Pregnancies at a University Hospital in Turkey. J Turkish-German Gynecol Assoc 2008;9:71-74.
26. Mills TA, Lavender T. Advanced maternal age. Obstet Gynaecol Reprod Med 2011; 21: 107–11.
27. Salem YS, Levy A, Wiznitzer A, et al. A significant linear association exists between advanced maternal age and adverse perinatal outcome. Arch Gynecol Obstet 2011; 283: 755–9.
28. Ludford I, Scheil W, Tucker G, et al. Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998-2008. Aust N Z J Obstet Gynaecol 2012; 52: 235-41.
29. Ganchimeg T, Ota E, Morisaki N,et al. 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: 1:40-8.