Trends in adolescent pregnancies

Teenage pregnancy and fertility in New South Wales: an examination of fertility trends, abortion and birth outcomes

This paper reviews the data available in New South Wales on teenage fertility rates and pregnancy outcomes. Teenage births comprise six per cent of all births in New South Wales, but they constitute a significant public health problem because they are associated with elevated rates of adverse pregnancy outcomes, which include low birthweight, perinatal death and pre-eclampsia. Risk is concentrated in females under 18 years of age. Pregnancy outcomes for females aged 18 to 19 years are similar to those of women aged 20 to 24 years. Teenage fertility rates have remained stable since the mid-1980s, following a decline which began in the early 1970s. There are large geographic variations in teenage fertility within the state, with the highest rates in the far west of New South Wales and in western Sydney. Teenage pregnancy in New South Wales (as distinct from fertility which reflects births) cannot be assessed accurately because of the lack of information on terminations of pregnancy. However, available data suggest that teenage pregnancy rates have not increased during the 1980s.

Neonatal outcome and its relationship with maternal age

The relationship between maternal age and neonatal outcome was examined in 22,689 pregnancies using various determinants of neonatal well-being which included evidence of fetal distress, birth-weight, Apgar scores, the necessity for admission to the neonatal unit and other indicators of neonatal morbidity. Differences in the incidence of congenital malformations and perinatal mortality were also studied. There was a trend towards more frequent fetal heart monitoring, lower birth-weight and a higher rate of neonatal unit admission for infants delivered by younger women. There was also a significant increase in the Caesarean section rate with advancing maternal age. Maternal age had no effect, however, on the incidence of fetal distress, Apgar score, the development of respiratory disease, the need for intubation and ventilation nor on subsequent neonatal central nervous system complications. There was also no association between maternal age and either perinatal mortality or the incidence of congenital malformations. The favourable outcome in teenagers in this study may have been influenced by the extremely low pregnancy rate amongst young adolescents in Hong Kong, but a similar outcome in the mature age women was likely to have reflected the recognition of risk and its appropriate management.

Teenage pregnancy in western Sydney

The obstetric performance of 121 young teenagers (less than 17 years of age) confining as public patients at Blacktown District Hospital was retrospectively compared with a randomly-selected control group of older gravidas. These adolescents were less likely to be married, to be certain of their last menstrual period, to book into the hospital early or to attend the antenatal clinic regularly than their older counterparts. However, there was no difference in the rates of anaemia, spontaneous or operative delivery, gestational age at confinement, birth-weight, perinatal mortality or neonatal morbidity rates. When the teenagers were compared with primigravidas from the control group, labour length was significantly shorter and the rates of preeclampsia were similar. These results are more optimistic than previous overseas reports regarding the obstetric performance of young adolescents.

Trends in teenage pregnancy in Australia, 1971-1981

Between 1971 and 1981 the age-specific birth rate among Australian teenagers declined by 49%, faster than in any other age group. This is a reflection of several trends--a decline in the total number of pregnancies indicating better use of contraception, a marked decline in marital births as both the planned births and the ex-nuptially conceived births fell, and a rise in the rates of abortion among teenagers. Since nuptial births declined faster than ex-nuptial births the proportion of ex-nuptial births among teenagers rose from 32% to 57%. However, unmarried teenagers have consistently shown lower rates of ex-nuptial births than other age groups. The options available to young women faced with unplanned pregnancy appear to be changing in emphasis--abortion or single parenthood rather than adoption or forced marriage. The decline may have halted since 1980 and several social factors which may be contributing to the various trends are discussed.