Obstetric outcome of teenage pregnancies compared with adult pregnancies

Abstract

Background: To compare the obstetric outcome of teenage pregnancies with that of older women.

Methods: Retrospective chart review of singleton births > or =24 weeks' gestational age at the American University of Beirut from 1994 to 2003. Adolescents (<20 years) were compared to subsequently delivered women aged 25-30 years (controls), n=486 each.

Results: Only 131 (27.0%) adolescents were <18 years. More adolescents were nulliparous (79.8 versus 17.9%; p<0.0001). Preterm delivery <37 but not <34 weeks occurred more frequently in cases (11.1 versus 5.8%, p=0.004). Pre-eclampsia was more commonly encountered (2.9 versus 0.6%; p=0.012) and mean predelivery haematocrit was lower in cases (30.6+/-3.3 versus 33.8+/-4.3%, p<0.001), but the incidence of gestational diabetes, placenta previa, abruptio placentae, breech presentation, or meconium-stained amniotic fluid were similar. Caesarean delivery was performed less frequently in cases (9.2 versus 14.0%; p=0.028), but primary caesarean and operative vaginal delivery rates were similar though vacuum was used more frequently in multiparous controls (0.2 versus 2.7%, p=0.011). Nulliparous cases had shorter first and second stages of labour (384+/-304 versus 524+/-339 min, p<0.0001 and 47+/-36 versus 63+/-50 min, p=0.002), respectively. Mean birth weight was higher in controls (3177+/-567 versus 3284+/-511 g, p<0.001), but intrauterine growth restriction, birth weight <2500 g, low Apgar scores, intrauterine fetal death, and stillbirths were similar in both groups.

Conclusions: Adolescents are more likely to deliver preterm than older women, and are more likely to suffer from anaemia and pre-eclampsia. Nulliparous adolescents have a quicker progress of labour while multiparous adolescents require vacuum less frequently compared to their older counterparts. In most other respects, they have comparable maternal and perinatal morbidity.