Labor and delivery complications among teenage mothers

Comparison of Maternal and Neonatal Outcomes in Teenage and Reproductive Age Pregnancy at Tertiary Hospital in West Java, Indonesia

Aim: This study was aimed to compare the maternal and neonatal outcomes among teenage and reproductive-age pregnancies. Patients and methods: This was a cross-sectional study of pregnant mothers in Hasan Sadikin General Hospital, the tertiary referral hospital in West Java, Indonesia. Patients who gave birth during January 2015-December 2018 were included and divided into two groups (teenage and reproductive-age pregnancy). Their medical record data then were evaluated to compare both maternal and neonatal outcomes. Results: The incidence of teenage pregnancy was 10.05%. A total of 3810 patients were recruited. The teenage mothers were 522 subjects and reproductive-age mothers were 3288 subjects. The incidence of eclampsia (5.2% vs 1.9%, p<0.001), anaemia (18.4% vs 14.9%, p=0.040), and preterm delivery (27.2% vs 18.6%, p<0.001) were more frequent in teenage pregnancies. Teenage mothers also had a higher percentage of low-birth-weight babies (42.3% vs 36.2%, p=0.007). Conclusion: Teenage pregnancies also had a higher risk of eclampsia, anaemia, preterm delivery, and having low-birth-weight babies. More efforts to prevent teenage and high-risk pregnancy are needed, especially in rural areas.

Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies

The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.

Complications in adolescent pregnancy: systematic review of the literature

Sexual activity during adolescence can lead to unwanted pregnancy, which in turn can result in serious maternal and fetal complications. The present study aimed to evaluate the complications related to adolescent pregnancy, through a systematic review using the Medical Subject Headings: “pregnancy complication” AND “adolescent” OR “pregnancy in adolescence”. Only full original articles in English or Portuguese with a clearly described methodology, were included. No qualitative studies, reviews or meta-analyses, editorials, case series, or case reports were included. The sample consisted of 15 articles; in that 10 were cross-sectional and 5 were cohort studies. The overall prevalence of adolescent pregnancy was 10%, and among the Brazilian studies, the adolescent pregnancy rate was 26%. The cesarean delivery rate was lower than that reported in the general population. The main maternal and neonatal complications were hypertensive disorders of pregnancy, prematurity and low birth weight, respectively. Adolescent pregnancy is related to increased frequency of neonatal and maternal complications and lower prevalence of cesarean delivery.