Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy - 18/02/16
, Kathy Wilson, MD 2, Katherine L. Grantz, MD, MS 1, Helain J. Landy, MD 3, Chun-Chih Huang, PhD 4, Veronica Gomez-Lobo, MD 1Abstract |
Study Objective |
To investigate the outcomes of adolescent pregnancy.
Design |
Retrospective cohort study from the Consortium on Safe Labor between 2002 and 2008.
Setting |
Twelve clinical centers with 19 hospitals in the United States.
Participants |
Nulliparous women (n = 43,537) younger than 25 years of age, including 1189 younger adolescents (age ≤ 15.9 years), 14,703 older adolescents (age 16-19.9 years), and 27,645 young adults (age 20-24.9 years).
Interventions |
Adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated, controlling for maternal characteristics and pregnancy complications (young adults as a reference group).
Main Outcome Measures |
Maternal, neonatal outcomes, cesarean indications, and length of labor.
Results |
Younger adolescents had an increased risk of maternal anemia (aOR = 1.25; 95% CI, 1.07-1.45), preterm delivery at less than 37 weeks of gestation (aOR = 1.36; 95% CI, 1.14-1.62), postpartum hemorrhage (aOR = 1.46; 95% CI, 1.10-1.95), preeclampsia or hemolysis, increased liver enzyme levels, and low platelet syndrome (aOR = 1.44; 95% CI, 1.17-1.77) but had a decreased risk of cesarean delivery (aOR = 0.49; 95% CI, 0.42-0.59), chorioamnionitis (aOR = 0.63; 95% CI, 0.47-0.84), and neonatal intensive care unit admission (aOR = 0.80; 95% CI, 0.65-0.98). Older adolescents had an increased risk of maternal anemia (aOR = 1.15; 95% CI, 1.09-1.22), preterm delivery at less than 37 weeks of gestation (aOR = 1.16; 95% CI, 1.08-1.25), and blood transfusion (aOR = 1.21; 95% CI, 1.02-1.43), but had a decreased risk of cesarean delivery (aOR = 0.75; 95% CI, 0.71-0.79), chorioamnionitis (aOR = 0.83; 95% CI, 0.75-0.91), major perineal laceration (aOR = 0.82; 95% CI, 0.71-0.95), and neonatal intensive care unit admission (aOR = 0.89; 95% CI, 0.83-0.96). Older adolescents were less likely to have a cesarean delivery for failure to progress or cephalopelvic disproportion (aOR = 0.89; 95% CI, 0.81-0.98). For adolescents who entered spontaneous labor, the second stage of labor was shorter (P < .01).
Conclusion |
Adolescents were less likely to have a cesarean delivery. Failure to progress or cephalopelvic disproportion occurred less frequently in older adolescents. Adolescents who entered spontaneous labor had a shorter second stage of labor.
Le texte complet de cet article est disponible en PDF.Key Words : Cesarean delivery, Length of labor, Pregnancy in adolescence, Pregnancy outcomes
Plan
| The authors indicate no conflicts of interest. |
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| This research was presented, in part, at the North American Society for Pediatric and Adolescent Gynecology (NASPAG), Miami, Florida (April 2012) as “Are Adolescent Pregnancies Associated with Adverse Outcomes?” |
Vol 29 - N° 2
P. 130-136 - avril 2016 Retour au numéro
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