Younger Age in Adolescent Pregnancies Is Associated with Higher Risk of Adverse Outcomes.

Maria De La Calle,Silvia M Arribas,David Ramiro-Cortijo,Nuria Martinez,Miriam Turiel,Jose L Bartha,Cristina M Lopez

doi:10.3390/ijerph18168514

Abstract

Adolescent pregnancy remains a health issue worldwide also in developed countries, since it has been associated with adverse maternal and neonatal outcomes. Some data suggest that very young adolescents have higher risk, likely due to immaturity. Therefore, we aimed to assess the influence of maternal age on complications during gestation and labor in pregnant women between 13 and 19 years of age. In particular, we evaluated the possible association between maternal age and obstetric, fetal and labor complications. This is a retrospective, observational and exploratory study conducted at Hospital Universitario La Paz (HULP, Madrid, Spain). The clinical history of 279 women who delivered between 2013 and 2018 was analyzed. Maternal age and the presence of maternal, fetal and labor complications, as well as risk of postpartum depression and breastfeeding intention, were recorded. General regression models were used to analyze the contribution of maternal age on each complication. The percentage of adolescent pregnancies at HULP between 2013 and 2018 was 0.9%. The risk of all the maternal complications analyzed decreased significantly with every year of age of the mother (hyperemesis, lower back pain, anemia, gestational diabetes mellitus, and threat of premature labor and premature rupture of membranes). Every year of maternal age decreased 0.8-fold [0.8; 0.9] the prevalence of fetal complications and also reduced the risk of C-section, postpartum hemorrhage and obstetrical hysterectomy. Furthermore, higher maternal age increased 1.1-fold [1.0; 1.2] the breastfeeding intention. In conclusion, young adolescents are at higher risk of complications during pregnancy and labor.

Highlights

Since we focused on maternal age as a risk factor, we excluded women with diagnoses of sexually transmitted infections (n = 5) or toxic habits during pregnancy (n = 13, including smoking, alcohol and/or illegal drug intake) to eliminate possible confounding factors influencing the risk of complications
We demonstrated that in the per year increase of maternal age, there is a reduction in the risk of maternal and fetal complications, but an increase in the risk of labor complications
This study found a relationship between maternal complications and the younger age group, in hyperemesis, lower back pain, anemia, gestational diabetes mellitus, and threat of preterm labor and premature rupture of membranes

Summary

Introduction

Adolescent pregnancy is a global health problem affecting different countries at varying degrees. A global decline in births has been found since the implementation of contraceptive measures and legalization of abortion in many countries, there are still many women who become pregnant between 13 and 19 years old. Approximately 19% of women below 19 years old become pregnant [1]. The highest rates are found in Africa, Central America, and South America [1]. Several sociocultural factors contribute to adolescent pregnancies, including low economic and educational level, growing up in dysfunctional family, family history of adolescent pregnancy, premature onset of sexual activity, early menarche and lack of information on the use of contraceptive

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