Resident's Papers: Obstetrics
Risk of adverse pregnancy outcomes in young adolescent parturients in an inner-city hospital

https://doi.org/10.1067/mob.2002.123986Get rights and content

Abstract

Objective: Our purpose was to determine the relationship between adolescence and pregnancy-related outcomes. Study Design: A retrospective cohort study was conducted in a population of adolescents delivered in a large inner-city hospital. The study population consisted of 14,718 adolescents and 11,830 nonadolescent controls. Pregnancy outcomes were compared in young adolescents (n = 2930) and mature adolescents (n = 11,788) versus controls. Results: Adolescents were significantly more likely than controls to be African American, single, diagnosed with a sexually transmitted disease during pregnancy, and reside with others (P <.001). Adolescents were significantly more likely than controls to have eclampsia (relative risk [RR] 2.23, 95% CI 1.37-3.66) and preterm delivery (RR 1.12, 95% CI 1.04-1.21). Young adolescents were significantly more likely than controls to have preeclampsia (RR 1.33, 95% CI 1.15-1.54), eclampsia (RR 3.24, 95% CI 1.70-6.14), preterm delivery (RR 1.47, 95% CI 1.31-1.64), low-birth-weight delivery (RR 1.47, 95% CI 1.31-1.64), and very-low-birth-weight delivery (RR 1.25, 95% CI 1.01-1.56). Finally, mature adolescents were significantly more likely than controls to have eclampsia (RR 1.99, 95% CI 1.19-3.34). Conclusion: Young adolescents are at increased risk for adverse pregnancy outcomes. (Am J Obstet Gynecol 2002;186:918-20.)

Section snippets

Material and methods

This study was approved by the Human Investigations Committee of Emory University in Atlanta, Ga. The study was conducted at Grady Memorial Hospital (GMH), an inner-city hospital that serves an indigent patient population. This hospital is the primary teaching hospital for the Emory University Obstetrics and Gynecology Residency Program.

Subjects for this retrospective cohort study were identified from a computerized obstetric database. At delivery, a Master Obstetric Discharge Summary form was

Results

During the 15-year study period, 14,718 adolescents aged 11 to 19 years and 11,830 control subjects were delivered at GMH. Of the 14,718 adolescents, 2930 (20%) were young (aged 11-15 years) and 11,788 (80%) were mature (aged 16-19 years). Demographic characteristics of the patient population are listed in Table I.

. Selected characteristics of study population, 1985-2000

Characteristics*Ages 11-15 y (n = 2930)Ages 16-19 y (n = 11,788)Age 20+ y (n = 11,830)P value
Race
African American2,656 (90.6%)

Comment

In this observational study, we found that adolescents were at increased risk for adverse pregnancy outcomes compared with an older control population. Our findings of an increased risk of adverse pregnancy outcomes in young adolescents is similar to results from a large observational study in Texas.9 The authors of that study divided the adolescents into young and mature subgroups and compared them with adult controls. In addition, they controlled for confounders by logistic regression

References (9)

  • SJ. Ventura

    Vital and health statistics: births to unmarried mothers: United States 1980-1992

    (1995)
  • FC Battaglia et al.

    Obstetric and pediatric complications of juvenile pregnancy

    Pediatrics

    (1963)
  • J Duenhoelter et al.

    Pregnancy performance of patients under 15 years of age

    Obstet Gynecol

    (1975)
  • ER McArney et al.

    Adolescent pregnancy and its consequences

    JAMA

    (1989)
There are more references available in the full text version of this article.

Cited by (52)

  • The impact of uterine immaturity on obstetrical syndromes during adolescence

    2017, American Journal of Obstetrics and Gynecology
  • Which Pregnant Adolescents Would be Interested in Group-Based Care, and Why?

    2015, Journal of Pediatric and Adolescent Gynecology
    Citation Excerpt :

    Age at conception was calculated using the estimated first day of the last menstrual period and date of birth. Age was dichotomized as 16 years or younger as studies consistently demonstrate that adolescents who conceive when they are 16 years or younger are at a risk for adverse pregnancy, parenting, and personal outcomes.20–24 Race/ethnicity was self-reported by participants and categorized as black, Hispanic, white, or other.

  • Labor and delivery outcomes among young adolescents

    2015, American Journal of Obstetrics and Gynecology
    Citation Excerpt :

    In the absence of increased peripartum morbidity, possible explanations include prolonged inpatient stay for social work evaluation or for maternal or neonatal observation given the increased psychosocial vulnerability19,20 of these young patients. Our data regarding the increased risk of preterm delivery, low and very low birthweight, and SGA infants born to 11- to 14-year-olds are consistent with multiple other studies,2-6,8,9 and contribute information regarding a large sample of adolescents aged 11-14 years to the existing literature. Inadequate prenatal care has been hypothesized as a risk factor for these findings, supported by data of Debiec et al21 that preterm delivery is increased in teens with inadequate visits.

View all citing articles on Scopus

Reprint requests: Chineta Eure, MD, MPH, Department of Gynecology and Obstetrics, 69 Jesse Hill Junior Dr, SE, Atlanta, GA 30303.

View full text