Labor induction in adolescent pregnancies - A scoping review

Abstract

Background: This scoping review explores the need for labor induction in adolescent pregnancies (≤19 years). It aims to identify and synthesize evidence on adolescent motherhood's unique challenges and implications on maternal and neonatal outcomes.

Methods: This review followed the PRISMA-ScR guidelines. To identify relevant studies on labor induction in adolescent pregnancies, a comprehensive search strategy was implemented. Data were extracted from 8 eligible studies with a total population of 119,153 participants. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Both qualitative and quantitative synthesis methods were employed. The quality of the included evidence was assessed using the ROBINS-I tool.

Results: Adolescents were less likely to undergo labor induction than adults (18.1% vs. 24.4%; p = 0.009). Adolescent induction showed higher success rates, with lower failure rates (1.69% vs. 2.52%; p < 0.05). Neonatal outcomes demonstrated a higher risk of low birth weight (<2500 g) (OR = 1.7, 95% CI: 1.2-2.4; p < 0.001) and stillbirth in adolescent pregnancies. Despite these risks, adolescents had higher rates of spontaneous vaginal delivery (85.0% vs. 59.5%; p < 0.001) and lower rates of cesarean sections (13.8% vs. 23.1%; p < 0.001). Maternal anemia was significantly more prevalent in adolescents (19.3% vs. 11.8%; p < 0.001).

Conclusions: Labor induction in adolescent pregnancies is less common but associated with favorable outcomes. However, adolescents face a higher risk of pregnancy and neonatal complications. These findings emphasize the significance of labor induction in this group and highlight the need for further research to establish evidence-based timing and indications for its use.

Keywords: Adolescent pregnancy; high-risk pregnancy; labor induction; labor induction in adolescents; teenage pregnancy.