Abstract
Recent studies have suggested that teenage pregnancies are not as hazardous as thought to be earlier. To compare the sociodemographic data, obstetric complications and attitudes towards family planning in teenagers and older women. A prospective cohort study at the University Obstetrics Unit, Teaching Hospital, Galle. Sociodemographic data, details of antenatal care and family support, antenatal complications, gestation at delivery, mode of delivery, the proportion of unplanned pregnancies, and the possible effects of contraceptive counselling, in two groups of pregnant teenagers (13-16 years, n = 95 and 17-19 years, n = 250) were compared with a control group of pregnant women (20-24 years, n = 275). The teenagers were from lower socioeconomic strata and the younger teenagers were significantly less educated than the controls. Teenagers had a significantly higher risk of anaemia (Odds Ratio (OR) = 2.3, 95%CI = 1.7-3.3, p < 0.001). The younger teenagers had a significantly higher risk of gestational hypertension (OR = 4.8, 95%CI = 1.8-13.0, p < 0.001) and pre-eclampsia (OR = 5.0, 95%CI = 1-27, p = 0.03). The older teenagers had a significantly higher risk of delivery before 34 weeks of gestation (OR = 13.6, 95%CI = 1.8-287, p = 0.001). There were no significant differences in the mode of delivery. The younger teenagers had a much higher proportion (54%) of unplanned pregnancies compared to the controls (16 %). A significantly higher proportion of younger teenagers (48%) and older teenagers (25 %), if counselled, would have delayed their pregnancies compared to the controls (10 %). Teenage pregnancies, especially those below 17 years of age have a significantly higher risk of adverse outcomes. A large proportion of these pregnancies is unplanned and could be prevented by counselling.
Highlights
Teenage pregnancy, especially below 17 years of age, has been considered to have a higher risk than pregnancy in an adult, because of biological immaturity of the teenager
Teenagers had a significantly higher risk of anaemia (Odds Ratio (OR) = 2.3, 95%CI = 1.7–3.3, p < 0.001)
Adverse effects associated with teenage pregnancy include maternal anaemia [1,2], pregnancy induced hypertension [1,2,3], spontaneous miscarriage [4], low birthweight primarily due to preterm delivery and leading to a high perinatal and postneonatal morbidity and mortality [2, 5,6,7], high maternal mortality [8,9], the mother finding it difficult to cope with the pregnancy [10], and behavioural problems and poor cognitive abilities and achievements in the child later on [11]
Summary
Especially below 17 years of age, has been considered to have a higher risk than pregnancy in an adult, because of biological immaturity of the teenager. Teenage pregnancy is linked to poor education, poverty and social exclusion, and is a major worldwide public health problem [2, 5,6,7, 10,11,12] Papers. Several authors have suggested that young age itself does not carry a significantly higher risk of adverse pregnancy outcomes. They concede that the cumulative effects of the associated social and economic deprivation and exclusion on the health of these mothers and babies is a serious public health problem [1, 13]. There is concern that teenage pregnancy rates are increasing in Sri Lanka. The present study was conducted because no data were available from southern Sri Lanka
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