Large Database Links Adolescent Pregnancy to More Adverse Events

MIAMI BEACH – A study of more than 150,000 pregnancies indicates adolescents and their newborns run an increased risk for complications.

Dr. Kathy Wilson and her colleagues at Washington Hospital Center and Georgetown University Hospital, in Washington, compared peripartum outcomes among 1,312 teens aged 15 years and younger; 19,403 teens aged 16 to 19 years; and 130,453 adults aged 20-34 years. Each had a singleton pregnancy of at least 24 weeks’ gestation between 2002 and 2008.

Adolescent mothers had higher rates of complications, including anemia, preterm premature rupture of membranes (PPROM), chorioamnionitis, and eclampsia, compared with adults.

Anemia affected 9.4% of the teens under age 16 years and 10.2% of the older teenagers. These rates were significantly higher than was the 8.2% rate in adults.

PPROM was noted in the records of 2.1% of younger teens, 2.5% of older teens, and 1.9% of adults. Chorioamnionitis occurred in 8.8% of young adolescents, 8.0% of older adolescents, and 4.8% of adults. Rates of both complications were significantly different between adolescents and adults.

Other researchers have researched risks in adolescent pregnancy, but most of these studies have been small, Dr. Wilson said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology. Clinical and demographic data for the 151,476 women in this study come from the Consortium on Safe Labor, which includes electronic medical records from 19 hospitals in the United States. The consortium is sponsored by the National Institute of Child Health and Human Development.

The researchers found a nonsignificant trend for higher prevalence of eclampsia in the adolescent mothers as well – 0.25% of the younger teenagers and 0.12% of the older teenagers vs. 0.008% among adult mothers.

Neonates born to adolescent mothers were more likely to be delivered preterm, to be low birth weight or very low birth weight, to have lower APGAR scores, and to have higher rates of admission to a neonatal intensive care unit.

Preterm births occurred in 21.1% of the teens under age 16 years, 18.3% of teens aged 16-19 years, and 16% of adults.

Low birth weight infants were born to 13.1% of the younger teen mothers, 12% of the older teen mothers, and 7.8% of adult mothers. Very low birth weight infants were born to 2.7% of the young teens, 2.5% of the older teens, and 1.7% of the adults. All differences between infants born to adolescents and adults were statistically significant.

Other findings include a higher percentage of 5-minute APGAR scores below 7 for neonates of younger teen mothers, 2.8%, compared with 2.3% for older teens and 2% for adult mothers. Neonatal ICU admission rates were 14.8% for the newborns of young teens, 14% for those born to older teens, and 11.8% for those born to adults.

Cesarean section rate was one factor that was significantly lower among the younger adolescent mothers. Their c-section rate was 15.9%, compared with 21.1% for the older teenagers and 24.8% for the adults.

Young adolescents were more likely to have public health insurance, 70.3%, compared with 66.6% of older adolescents and 39.1% of adult mothers.

Dr. Wilson had no relevant financial disclosures.

MIAMI BEACH – A study of more than 150,000 pregnancies indicates adolescents and their newborns run an increased risk for complications.

Dr. Kathy Wilson and her colleagues at Washington Hospital Center and Georgetown University Hospital, in Washington, compared peripartum outcomes among 1,312 teens aged 15 years and younger; 19,403 teens aged 16 to 19 years; and 130,453 adults aged 20-34 years. Each had a singleton pregnancy of at least 24 weeks’ gestation between 2002 and 2008.

Adolescent mothers had higher rates of complications, including anemia, preterm premature rupture of membranes (PPROM), chorioamnionitis, and eclampsia, compared with adults.

Anemia affected 9.4% of the teens under age 16 years and 10.2% of the older teenagers. These rates were significantly higher than was the 8.2% rate in adults.

PPROM was noted in the records of 2.1% of younger teens, 2.5% of older teens, and 1.9% of adults. Chorioamnionitis occurred in 8.8% of young adolescents, 8.0% of older adolescents, and 4.8% of adults. Rates of both complications were significantly different between adolescents and adults.

Other researchers have researched risks in adolescent pregnancy, but most of these studies have been small, Dr. Wilson said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology. Clinical and demographic data for the 151,476 women in this study come from the Consortium on Safe Labor, which includes electronic medical records from 19 hospitals in the United States. The consortium is sponsored by the National Institute of Child Health and Human Development.

The researchers found a nonsignificant trend for higher prevalence of eclampsia in the adolescent mothers as well – 0.25% of the younger teenagers and 0.12% of the older teenagers vs. 0.008% among adult mothers.

Neonates born to adolescent mothers were more likely to be delivered preterm, to be low birth weight or very low birth weight, to have lower APGAR scores, and to have higher rates of admission to a neonatal intensive care unit.

Preterm births occurred in 21.1% of the teens under age 16 years, 18.3% of teens aged 16-19 years, and 16% of adults.

Low birth weight infants were born to 13.1% of the younger teen mothers, 12% of the older teen mothers, and 7.8% of adult mothers. Very low birth weight infants were born to 2.7% of the young teens, 2.5% of the older teens, and 1.7% of the adults. All differences between infants born to adolescents and adults were statistically significant.

Other findings include a higher percentage of 5-minute APGAR scores below 7 for neonates of younger teen mothers, 2.8%, compared with 2.3% for older teens and 2% for adult mothers. Neonatal ICU admission rates were 14.8% for the newborns of young teens, 14% for those born to older teens, and 11.8% for those born to adults.

Cesarean section rate was one factor that was significantly lower among the younger adolescent mothers. Their c-section rate was 15.9%, compared with 21.1% for the older teenagers and 24.8% for the adults.

Young adolescents were more likely to have public health insurance, 70.3%, compared with 66.6% of older adolescents and 39.1% of adult mothers.

Dr. Wilson had no relevant financial disclosures.

MIAMI BEACH – A study of more than 150,000 pregnancies indicates adolescents and their newborns run an increased risk for complications.

Dr. Kathy Wilson and her colleagues at Washington Hospital Center and Georgetown University Hospital, in Washington, compared peripartum outcomes among 1,312 teens aged 15 years and younger; 19,403 teens aged 16 to 19 years; and 130,453 adults aged 20-34 years. Each had a singleton pregnancy of at least 24 weeks’ gestation between 2002 and 2008.

Adolescent mothers had higher rates of complications, including anemia, preterm premature rupture of membranes (PPROM), chorioamnionitis, and eclampsia, compared with adults.

Anemia affected 9.4% of the teens under age 16 years and 10.2% of the older teenagers. These rates were significantly higher than was the 8.2% rate in adults.

PPROM was noted in the records of 2.1% of younger teens, 2.5% of older teens, and 1.9% of adults. Chorioamnionitis occurred in 8.8% of young adolescents, 8.0% of older adolescents, and 4.8% of adults. Rates of both complications were significantly different between adolescents and adults.

Other researchers have researched risks in adolescent pregnancy, but most of these studies have been small, Dr. Wilson said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology. Clinical and demographic data for the 151,476 women in this study come from the Consortium on Safe Labor, which includes electronic medical records from 19 hospitals in the United States. The consortium is sponsored by the National Institute of Child Health and Human Development.

The researchers found a nonsignificant trend for higher prevalence of eclampsia in the adolescent mothers as well – 0.25% of the younger teenagers and 0.12% of the older teenagers vs. 0.008% among adult mothers.

Neonates born to adolescent mothers were more likely to be delivered preterm, to be low birth weight or very low birth weight, to have lower APGAR scores, and to have higher rates of admission to a neonatal intensive care unit.

Preterm births occurred in 21.1% of the teens under age 16 years, 18.3% of teens aged 16-19 years, and 16% of adults.

Low birth weight infants were born to 13.1% of the younger teen mothers, 12% of the older teen mothers, and 7.8% of adult mothers. Very low birth weight infants were born to 2.7% of the young teens, 2.5% of the older teens, and 1.7% of the adults. All differences between infants born to adolescents and adults were statistically significant.

Other findings include a higher percentage of 5-minute APGAR scores below 7 for neonates of younger teen mothers, 2.8%, compared with 2.3% for older teens and 2% for adult mothers. Neonatal ICU admission rates were 14.8% for the newborns of young teens, 14% for those born to older teens, and 11.8% for those born to adults.

Cesarean section rate was one factor that was significantly lower among the younger adolescent mothers. Their c-section rate was 15.9%, compared with 21.1% for the older teenagers and 24.8% for the adults.

Young adolescents were more likely to have public health insurance, 70.3%, compared with 66.6% of older adolescents and 39.1% of adult mothers.

Dr. Wilson had no relevant financial disclosures.