Adolescent pregnancy poses many challenges to not only the patient but also to all members of the interdisciplinary health care team. Many factors influence these pregnancies which can result in adverse maternal and neonatal outcomes. The current literature provides conflicting outcomes regarding adolescent pregnancies particularly the antenatal risks associated and mode of delivery. Our objective was to review all pregnancies and deliveries in the province of Nova Scotia Canada between 2000 and 2005 to identify perinatal outcomes of pregnancy in young women less than 19 years of age compared to the adult population. This study was a retrospective cohort study using the Nova Scotia Atlee Perinatal Database (NSAPDB) a provincial population-based clinically oriented database committed to the collection of clinical perinatal information including pregnancy outcomes. This database includes several hundred variables containing maternal and newborn information such as demographic variables procedures interventions maternal and newborn diagnoses and morbidity and mortality information for every pregnancy and birth occurring in Nova Scotia hospitals and to Nova Scotia residents since 1988. Pregnancy complications and outcomes were compared between women less than 19 years of age (N = 918) and all others (N = 50942). Using SAS version 8.2 Chi-square tests were performed to find statistical significance. Fischers Exact test was also used where appropriate. 2.7% of adolescents between the ages of 15 and 19 years became pregnant. Approximately 55% went on to have a live birth and 44% underwent an induced abortion. Overall the obstetrical patients under the age of 18 were statistically more likely to have anemia (p = 0.0024) a spontaneous vaginal delivery (p = less than 0.0001) preterm delivery before 32 weeks gestation (p = 0.0031) or have an infant weighing less than 2500g (p = less than 0.0001). They were less likely to have GDM (p = 0.0027) to breastfeed (p = less than 0.0001) to have an assisted vaginal delivery (p = 0.0024) caesarean section (p = less than 0.0001) or have an infant weighing greater than 4000g (p = less than 0.0001). There was not a statistical difference between groups with respect to mild or severe PIH preterm delivery less than 37 weeks or NICU admission. Overall adolescent patients who are pregnant are at increased risk of certain obstetrical outcomes including anemia preterm birth and giving birth to infants that are small for gestational age. We should be aware of these differences when providing care to this patient population. (authors)