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

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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.)

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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

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Cited by (0)

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

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