Abstract

PIP: This article reviews the literature of the medical risks associated with teenage pregnancy. Data from South Australia indicate that in 1979 approximately 1/3 of abortions were performed on teenagers. Consideration of the risks of teenage pregnancy must include the risks of abortion. The physical risks of the options of unwanted pregnancy are as important as the psychosocial and the teenager's knowledge of these will help her make the best decision. West Australia data have shown that since 1973 the birthrate for older teenagers (16-19) declined but for younger teenagers has remained steady. The decline in birthrate among older teenagers is likely to be due to increased use of contraception and abortion rather than a decline in sexual activity. The main risk to the teenage mother's health is an increased likelihood of preeclampsia. At highest risk are those under age 16. Other studies have shown that if teenagers have adequate antenatal care they are not at high risk of obstetric complications than older women of similar race and socioeconomic background. The greatest medical risks to teenage childbearing are to the child. West Australian data have confirmed the findings of other studies that the infants of young teenagers in particular are at higher risk of a low birthweight or perinatal death than those of women in their 20s. The higher perinatal mortality in the infants of young teenagers is due in part to the higher percentage of infants of low birth weight. Early medical complications of abortion are those at the time of the procedure or within a few weeks and include a reaction to anesthesia, injury to the cervix or uterus, hemorrhage, pelvic infection, and secondary hemorrhage. When abortions are performed by skilled operators under proper conditions, complications are relatively uncommon. The risk of death from abortion depends on the technique and the stage of pregnancy. Longterm complications include infertility or ectopic pregnancy because of pelvic infection, cervical incompetence leading to spontaneous abortion, and increased risk of premature and low birth weight infants. Currently, there is no agreement in the literature about the magnitude of the longterm risks.