Abstract
BackgroundThe adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10–50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China.MethodsThere were 238,598 singleton pregnant women aged 10–34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10–19 years) and adult group (aged 20–34 years). The adolescent group was divided into two subgroups (aged 10–17 years, aged 18–19 years), the adult group was divided into two subgroups (aged 20–24 years, aged 25–34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy.ResultsCompared with women aged 20–34 years, women aged 10–19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70–0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41–0.73). Women aged 10–19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54–2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08–1.30), stillbirth (aRR: 2.58, 95%CI: 1.83–3.62), neonatal death (aRR: 2.63, 95%CI: 1.60–4.32). The adolescent women aged 10–17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36–9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74–15.33) compared with the women aged 25–34 years. Younger adults (20–24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20–1.32), stillbirth (aRR: 1.45, 95%CI: 1.23–1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21–1.90) compared with women aged 25–34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy.ConclusionsThe adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.
Highlights
The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact
About 11% of newborns worldwide are delivered by adolescent women, the pregnancy complications of adolescent women account for 23% of women of all ages, and more than 90% of them occur in developing countries [2]
Adolescent pregnancy is a serious problem in the world, pregnancy complications are the major cause of death in adolescent women [2, 8]
Summary
The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10–50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China. Compared with the pregnancy of adult women, the pregnancy of adolescent women usually increases the risk of adverse pregnancy outcomes, including fetal growth restriction, preterm delivery and neonatal death [3]. The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact [6, 7]. Adolescent pregnancy is a serious problem in the world, pregnancy complications are the major cause of death in adolescent women [2, 8]. The rate of adolescent pregnancy has declined, with the increasing of adolescent population, the number of adolescent pregnancy is large, especially in developing countries [9, 10]
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