Abstract
Although most studies show that adolescent pregnant women are at a higher risk for adverse birth outcomes, there has been limited research examining this relationship in Canada. This systematic review and meta-analysis investigated the prevalence of low birthweight (LBW), preterm birth (PTB), and stillbirth in Canadian adolescent women compared to adult women. Studies were included if they were primary research and included a sample of adolescent mothers (≤19 years) and adult mothers (≥20 years) who gave birth to singleton infants in Canada. Birth outcomes must have been measured consistently in at least 3 studies for inclusion. Comprehensive electronic literature searches were conducted from database inception until August 2020 in 5 databases. Random effects meta-analysis models were used to estimate pooled odds ratios (pOR) for LBW, PTB, and stillbirth between adolescent and adult pregnant women. Outcomes reported included PTB (8 studies), LBW (6 studies), and stillbirth (3 studies). Compared to adult mothers, adolescent mothers had a 56% increase in the prevalence of LBW (pOR 1.56, 95% confidence interval [CI] 1.24, 1.97), a 23% increase in PTB (pOR 1.23, 95% CI 1.06, 1.42), a 20% increase in stillbirth (pOR 1.20, 95% CI 1.05, 1.37). Heterogeneity, as assessed by I2, was high for LBW and PTB and was low for stillbirth. A subgroup analysis did not remove the high heterogeneity, and some studies did not adjust for confounding variables and were missing information on sociodemographic and behavioral factors. Future research is needed to investigate the mechanisms surrounding these differences by maternal age.
Highlights
We were unable to use this ninth study[32] in the final synthesis due to missing data, but it provided information regarding the direction of the relationship between adolescent pregnancy, low birthweight (LBW), and preterm birth (PTB)
A recent meta-analysis examining the relationship between adolescent pregnancies and adverse birth outcomes worldwide found that adolescent mothers have a higher risk of LBW and PTB infants.[20]
The findings suggest that, irrespective of the degree or type of welfare support, infants born to adolescent mothers in all countries were at greater risk for PTB, infant mortality, unplanned hospital admissions, and emergency department visits within the first 12 months of postnatal discharge compared to births among women aged 30-34 years
Summary
Adolescent pregnancy in Canada refers to pregnancy in female individuals under the age of 20 years[1,2] and is calculated as the number of recorded live births, induced abortions, and miscarriages per 1000 women aged 15-19 years.[1,3] Despite a 47% decline in adolescent pregnancies in Canada between 1990 and 2010, these pregnancies continue to draw attention to policy development and intervention strategies to mitigate their occurrence.[1,4,5] From 1998 to 2000, stillbirth occurrence averaged 929 events among adolescent mothers in Canada.[6]Although adolescent pregnancies are more socially acceptable than in the past,[4,7,8] socioeconomic and psychological obstacles remain.[2,9] For example, adolescent motherhood is associated with financial hardship and social exclusion, and young mothers find it challenging toThe authors have no conflicts of interest to disclose. ∗ Address correspondence to: Dr Jamie A. Seabrook, School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, Ontario N6G 1H2, Canada.
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