Outcomes of Teenage Pregnancies on the Avalon Peninsula of Newfoundland and Labrador Between 2001-2008 in Comparsions to Their 20-24 Year Old Counterparts

Abstract

Background: Teenage pregnancies have been shown in several studies to be at higher risk of complications. The extent of that risk has been debated in the literature. An increased risk of pre-term birth, growth restriction, and late fetal demise has been documented in some studies while others have failed to show the same risks. Maternal risks have included anemia, UTI and poor long term social outcomes. The objective of this study was to assess pregnancy outcomes at a tertiary care center within the province of Newfoundland and Labrador on the east coast of Canada. Methods: Using the Newfoundland and Labrador Provincial Perinatal Surveillance Program, a retrospective cohort was performed. Pregnancy in girls 19 years of age and less were compared to their adult counterpart aged 20-24 years old for increased pregnancy complications. Outcomes of interest included low birth weight, preterm delivery, mode of delivery as well hypertension and gestational diabetes. Using Chi-Squared test and logistic regression outcomes were compared for each age group. Ethics approval was obtain through the local Human Investigation Committee. Results: 738 teenage pregnancies were compared to 2716 pregnancies in the 20-24 year olds. No significant difference was seen in rates of gestational hypertension or gestational diabetes. There was no significant difference in birth weight or preterm delivery less than 37 weeks. Teenagers were however more likely to deliver before 34 weeks (6.2 vs 3.9%, p1⁄40.006). Logistic regressionwas performed for preterm birth less than 34 weeks and a significant difference was seen. Within the group of teenagers who delivered less than 34 weeks 60.9% delivered via spontaneous vaginal delivery while c-section rate was 39.1%. Labor was induced in 15.2% of teenagers delivering less than 34 weeks while 60.9% went into spontaneous labour. The remaining 23.9% experienced no labour and were delivered via c-section. An overall lower rate of caesarean section in teenage mothers (14% versus 20%, p1⁄40.04) was observed. Both groups were three times more likely to undergo a LSCS if they delivered preterm and had double the risk of c-section if theywere overweight or obese. Within both groups over 60% of patients gained more than the recommended pregnancy weight gain based on their pre-pregnancy BMI. Conclusion: Our retrospective study we found that teenagers were more likely to deliver before 34 weeks. We did not find an increase in other complications such as low birth weight, gestational hypertension or gestational diabetes. Teenage mothers were more likely to have a vaginal delivery and had a significantly lower rate of c-section. The increased weight gain during pregnancy within both groups was concerning and is a modifiable risk factor for both the present pregnancy and future pregnancies. These findings may require future research to assess for possible preventive measures or increased monitoring in our pregnant teenagers.