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A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes

Year 2023, Volume: 21 Issue: 3, 361 - 370, 15.12.2023

Fatma Tuba Engindeniz Deniz Simsek Burcu Dinçgez

https://doi.org/10.20518/tjph.1285907

Abstract

Objective: Adolescent pregnancy, associated with increased adverse pregnancy outcomes, is a major public health problem. We aimed to assess adverse perinatal outcomes in adolescent pregnanciesto develop preventive strategies or treatment options.

Methods: A total of 37248 births were registered between 2017 and 2020. Random numbers table was used to choose participants. Patients who had unavailable records,different ethnicity, education level, marital status,insurance type were excluded and3567 pregnant were included in the study. The adolescent pregnant group comprised 1104 women whileadults comprised 2463 pregnan.Fetal anomaly, gestational diabetes, preeclampsiaeclampsia, intrauterine growth restriction, intrahepatic cholestasis, polyhydramnios, placenta previa, inutero mort fetus, uterine rupture, placenta abruption, umbilical cord prolapse, acute fetal distress, preterm birth, cesarean section, labor arrest, birth weight, macrosomia, dystocia, birth trauma, APGAR scores, neonatal intensive care unit admission, postpartum hemorrhage, hysterectomy, blood transfusion, and postpartum infection were recorded.

Results: Rates of acute fetal distress, preterm birth, low birth weight, neonatal intensive care unit admission, postpartum hemorrhage, and blood transfusion were higher while birth weight, APGAR scores, the rates of cesarean section, prolonged and arrested labor, gestational diabetes,and macrosomia were lower in adolescents. Being adolescent increase the risk of acute fetal distress by 1.4 times (aOR=1.44;95%CI=1.03-2.01,p=0.033), preterm birth by 1.7 times(aOR=1.69;95%CI=1.10-2.60,p=0.016) and decrease the risk of gestational diabetes(aOR=0.18;95%CI=0.12-.29,p<0.001),macrosomia(aOR=0.59;95%CI=0.40-0.9,p=0.08),labor arrest(aOR=0.50;95%CI=0.27-0.95,p=0.033) and cesarean section(aOR=0.33;95%CI=0.27-0.39,p<0.001) after adjusting for confounders.

Conclusion: Considering increased acute fetal distress, preterm birth, low birth weight, neonatal intensive care unit admission, postpartum hemorrhageblood transfusion risk for adolescent pregnancies, adolescents and healthcare providers should be informed and follow-ups must be performed in well-equipped centers.

Keywords

adolescent pregnancy cesarean section gestational diabetes labor arrest preterm birth

References

  • Kawakita T, Wilson K, Grantz KL, et al. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol. 2016;29(2):130–6.
  • Ganchimeg T, Ota E, Morisaki N, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. Bjog. 2014;121(Suppl 1):40–8.
  • Karacam Zekiye, Damla Kizilca Cakaloz, and Rukiye Demir. “The impact of adolescent pregnancy on maternal and infant health in Turkey: Systematic review and meta-analysis. Journal of Gynecology Obstetrics and Human Reproduction 50.4 2021:102093.
  • Hacettepe University Institute of Population Studies. Turkey Demographic and Health Survey 2013. Ankara, Turkey: Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, T.R. Prime Ministry Undersecretary of State Planning Organization and TUBİTAK; 2014. www.hips.hacettepe.edu.tr/eng/tdhs08/TDHS-2008_Main_Report.pdf.
  • WHO. Adolescent Pregnancy: World Health Organization; 2014. Available from: http://www.who.int/mediacentre/factsheets/fs364/en/.
  • Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. American journal of obstetrics and gynecology. 2005;192(2):342–9. 10.1016/j.ajog.2004.10.593
  • Amjad S, MacDonald I, Chambers T, et al. Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2019;33(1):88–99.
  • Westenberg L, van der Klis KA, Chan A, et al. Aboriginal teenage pregnancies compared with non-aboriginal in South Australia 1995-1999. Aust NZJ Obstet Gynaecol. 2002;42(2):187–92.
  • Munim S, Islam Z, Zohra N, Yasmin H, Korejo R. Guidelines on prevention of preterm birth. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35(25): 9527-9531.
  • Chen X-K, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. International journal of epidemiology. 2007;36(2):368–73.
  • White SL, Ayman G, Bakhai C, Hillier TA, Magee LA. Screening and diagnosis of gestational diabetes. BMJ. 2023; 2:381:e071920.
  • Gupta S, Petras L, Tufail MU, Rodriguez Salazar JD, Jim B. Hypertension in pregnancy: what we now know. Current opinion in nephrology and hypertension 2023;32(2):153-164.
  • ACOG Practice Bulletin No. 204: fetal growth restriction. et al. Obstet Gynecol 2019;133:0.
  • Smith DD, Rood KM. Intrahepatic Cholestasis of Pregnancy. Clin Obstet Gynecol. 2020 Mar;63(1):134-151.
  • Hwang DS, Mahdy H. Polyhydramnios. 2022 Mar 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 32965811.
  • Jain V, Bos H, Bujold E. Guideline No. 402: diagnosis and management of placenta previa. Journal of Obstetrics and Gynaecology Canada. 2020;42(7): 906-917.
  • Davis DD, Roshan A, Canela CD, Varacallo M. Shoulder Dystocia. 2022 Jun 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29261950).
  • Bienstock JL, Eke AC, Hueppchen NA. Postpartum hemorrhage. New England Journal of Medicine. 2021;384(17):1635-1645.
  • Indarti J, et al. Teenage pregnancy: Obstetric and perinatal outcome in a tertiary centre in Indonesia. Obstet. Gynecol. Int. 2020;2020:2787602. doi: 10.1155/2020/2787602. Engindeniz FT., et al. Turk J Public Health 2023;21(3) 370
  • Zhang T, et al. The adverse maternal and perinatal outcomes of adolescent pregnancy: A cross sectional study in Hebei, China. BMC Pregnancy Childbirth. 2020;20:339. doi: 10.1186/s12884-020-03022-7.
  • Ogawa K, et al. Association between adolescent pregnancy and adverse birth outcomes, a multicenter cross sectional Japanese study. Sci. Rep. 2019;9:2365. doi: 10.1038/s41598-019-38999-5.
  • Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global health. 2014;2(6):e323–33.
  • Moraes AN, Likwa RN, Nzala SH. A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: the case of Luapula Province, Zambia. Maternal Health, Neonatology and Perinatology. 2018;4(1):20.
  • Ayuba II, Gani O. Outcome of teenage pregnancy in the niger delta of Nigeria. Ethiop J Health Sci. 2012;22(1):45–50.
  • Narukhutrpichai P, Khrutmuang D, Chattrapiban T. The Obstetrics and Neonatal Outcomes of Teenage Pregnancy in Naresuan University Hospital. J Med Assoc Thai. 2016;99(4):361–7.
  • Getachew Mullu Kassa, Ayodele O. Arowojolu, Akin Tunde A. Odukogbe, Alemayehu Worku Yalew. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLoS One. 2021; 16(9): e0257485.
  • Kayastha S, Pradhan A. Obstetric Outcome of Teenage Pregnancy. Nepal Journal of Obstetrics and Gynaecology. 2014;7(2):29–32.
  • Leppälahti S, Gissler M, Mentula M, Heikinheimo O et al. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open, 2013;19;3:e003225.
  • Demirgöz M, Canbulat N. Adolescent Pregnancy, Review, Turkiye Klinikleri J Med Sci. 2008; 28: 947-52.
  • Medhi R, Das B, Das A, et al. Adverse obstetrical and perinatal outcome in adolescent mothers associated with first birth: a hospital-based case–control study in a tertiary care hospital in North-East India. Adolesc Health Med Ther. 2016; 7: 37-42.
  • Canbaz S, Sunter AT, Cetinoglu CE, Peksen Y. Obstetric outcomes of adolescent pregnancies in Turkey. Adv Ther 2005; 22:636-41
  • Fleming N, Ng N, Osborne C, Biederman S, Yasseen AS 3rd, Dy J, et al. Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can. 2013;35(3):234–45.
  • Gupta N, Kiran U, Bhal K. Teenage pregnancies: obstetric characteristics and outcome. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):165–71.
  • Paladugu RK, Donipudi PC, Chimata D, Jasti M. Adolescent pregnancy and its outcomes: a crosssectional study. International Journal of Community Medicine and Public Health. 2018;5(10):4408–14.
  • Minjares-Granillo RO, Reza-Lopez SA, CaballeroValdez S, et al. Maternal and perinatal outcomes among adolescents and mature women: a hospital-based study in the North of Mexico. J Pediatr Adolesc Gynecol. 2016; 29: 304-11.
  • Jolly MC, Sebere MN, Harris J, et al. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol. 2000;96:962–6.
  • Torvie AJ, Callegari LS, Schiff MA, et al. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol. 2015;213 d.ed-x.ex.
  • Vivatkusol Y, Thavaramara T, Phaloprakarn C. Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes. International journal of women’s health. 2017;9:347–52.
  • Wang C, Wang XY, Yang HX. Effect of maternal age on pregnancy outcomes in Beijing. Zhonghua Fu Chan Ke Za Zhi. 2017;52(8):514–20
  • Marvin-Dowle K, Kilner K, Burley VJ, et al. Impact of adolescent age on maternal and neonatal outcomes in the born in Bradford cohort. BMJ Open. 2018;8(3):e016258.
  • Getachew Mullu Kassa, Ayodele O. Arowojolu, Akin Tunde A. Odukogbe, Alemayehu Worku Yalew. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia. PLoS One. 2019;14(6): e0218259.
  • Naz U. Comparison of obstetric outcome in terms of the risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Journal of the College of Physicians and Surgeons—Pakistan: JCPSP. 2014;24(2):131–4.
  • Stevens-Simon C, Beach RK, McGregor JA. Does incomplete growth and development predispose teenagers to preterm delivery? A template for research. J. Perinatol. 2002;22:315–323.
  • Thaithae S, Thato R. Obstetric and Perinatal Outcomes of Teenage Pregnancies in Thailand. Journal of pediatric and adolescent gynecology. Longitu

Year 2023, Volume: 21 Issue: 3, 361 - 370, 15.12.2023

Fatma Tuba Engindeniz Deniz Simsek Burcu Dinçgez

https://doi.org/10.20518/tjph.1285907

Abstract

References

  • Kawakita T, Wilson K, Grantz KL, et al. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol. 2016;29(2):130–6.
  • Ganchimeg T, Ota E, Morisaki N, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. Bjog. 2014;121(Suppl 1):40–8.
  • Karacam Zekiye, Damla Kizilca Cakaloz, and Rukiye Demir. “The impact of adolescent pregnancy on maternal and infant health in Turkey: Systematic review and meta-analysis. Journal of Gynecology Obstetrics and Human Reproduction 50.4 2021:102093.
  • Hacettepe University Institute of Population Studies. Turkey Demographic and Health Survey 2013. Ankara, Turkey: Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, T.R. Prime Ministry Undersecretary of State Planning Organization and TUBİTAK; 2014. www.hips.hacettepe.edu.tr/eng/tdhs08/TDHS-2008_Main_Report.pdf.
  • WHO. Adolescent Pregnancy: World Health Organization; 2014. Available from: http://www.who.int/mediacentre/factsheets/fs364/en/.
  • Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. American journal of obstetrics and gynecology. 2005;192(2):342–9. 10.1016/j.ajog.2004.10.593
  • Amjad S, MacDonald I, Chambers T, et al. Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2019;33(1):88–99.
  • Westenberg L, van der Klis KA, Chan A, et al. Aboriginal teenage pregnancies compared with non-aboriginal in South Australia 1995-1999. Aust NZJ Obstet Gynaecol. 2002;42(2):187–92.
  • Munim S, Islam Z, Zohra N, Yasmin H, Korejo R. Guidelines on prevention of preterm birth. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35(25): 9527-9531.
  • Chen X-K, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. International journal of epidemiology. 2007;36(2):368–73.
  • White SL, Ayman G, Bakhai C, Hillier TA, Magee LA. Screening and diagnosis of gestational diabetes. BMJ. 2023; 2:381:e071920.
  • Gupta S, Petras L, Tufail MU, Rodriguez Salazar JD, Jim B. Hypertension in pregnancy: what we now know. Current opinion in nephrology and hypertension 2023;32(2):153-164.
  • ACOG Practice Bulletin No. 204: fetal growth restriction. et al. Obstet Gynecol 2019;133:0.
  • Smith DD, Rood KM. Intrahepatic Cholestasis of Pregnancy. Clin Obstet Gynecol. 2020 Mar;63(1):134-151.
  • Hwang DS, Mahdy H. Polyhydramnios. 2022 Mar 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 32965811.
  • Jain V, Bos H, Bujold E. Guideline No. 402: diagnosis and management of placenta previa. Journal of Obstetrics and Gynaecology Canada. 2020;42(7): 906-917.
  • Davis DD, Roshan A, Canela CD, Varacallo M. Shoulder Dystocia. 2022 Jun 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29261950).
  • Bienstock JL, Eke AC, Hueppchen NA. Postpartum hemorrhage. New England Journal of Medicine. 2021;384(17):1635-1645.
  • Indarti J, et al. Teenage pregnancy: Obstetric and perinatal outcome in a tertiary centre in Indonesia. Obstet. Gynecol. Int. 2020;2020:2787602. doi: 10.1155/2020/2787602. Engindeniz FT., et al. Turk J Public Health 2023;21(3) 370
  • Zhang T, et al. The adverse maternal and perinatal outcomes of adolescent pregnancy: A cross sectional study in Hebei, China. BMC Pregnancy Childbirth. 2020;20:339. doi: 10.1186/s12884-020-03022-7.
  • Ogawa K, et al. Association between adolescent pregnancy and adverse birth outcomes, a multicenter cross sectional Japanese study. Sci. Rep. 2019;9:2365. doi: 10.1038/s41598-019-38999-5.
  • Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global health. 2014;2(6):e323–33.
  • Moraes AN, Likwa RN, Nzala SH. A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: the case of Luapula Province, Zambia. Maternal Health, Neonatology and Perinatology. 2018;4(1):20.
  • Ayuba II, Gani O. Outcome of teenage pregnancy in the niger delta of Nigeria. Ethiop J Health Sci. 2012;22(1):45–50.
  • Narukhutrpichai P, Khrutmuang D, Chattrapiban T. The Obstetrics and Neonatal Outcomes of Teenage Pregnancy in Naresuan University Hospital. J Med Assoc Thai. 2016;99(4):361–7.
  • Getachew Mullu Kassa, Ayodele O. Arowojolu, Akin Tunde A. Odukogbe, Alemayehu Worku Yalew. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLoS One. 2021; 16(9): e0257485.
  • Kayastha S, Pradhan A. Obstetric Outcome of Teenage Pregnancy. Nepal Journal of Obstetrics and Gynaecology. 2014;7(2):29–32.
  • Leppälahti S, Gissler M, Mentula M, Heikinheimo O et al. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open, 2013;19;3:e003225.
  • Demirgöz M, Canbulat N. Adolescent Pregnancy, Review, Turkiye Klinikleri J Med Sci. 2008; 28: 947-52.
  • Medhi R, Das B, Das A, et al. Adverse obstetrical and perinatal outcome in adolescent mothers associated with first birth: a hospital-based case–control study in a tertiary care hospital in North-East India. Adolesc Health Med Ther. 2016; 7: 37-42.
  • Canbaz S, Sunter AT, Cetinoglu CE, Peksen Y. Obstetric outcomes of adolescent pregnancies in Turkey. Adv Ther 2005; 22:636-41
  • Fleming N, Ng N, Osborne C, Biederman S, Yasseen AS 3rd, Dy J, et al. Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can. 2013;35(3):234–45.
  • Gupta N, Kiran U, Bhal K. Teenage pregnancies: obstetric characteristics and outcome. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):165–71.
  • Paladugu RK, Donipudi PC, Chimata D, Jasti M. Adolescent pregnancy and its outcomes: a crosssectional study. International Journal of Community Medicine and Public Health. 2018;5(10):4408–14.
  • Minjares-Granillo RO, Reza-Lopez SA, CaballeroValdez S, et al. Maternal and perinatal outcomes among adolescents and mature women: a hospital-based study in the North of Mexico. J Pediatr Adolesc Gynecol. 2016; 29: 304-11.
  • Jolly MC, Sebere MN, Harris J, et al. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol. 2000;96:962–6.
  • Torvie AJ, Callegari LS, Schiff MA, et al. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol. 2015;213 d.ed-x.ex.
  • Vivatkusol Y, Thavaramara T, Phaloprakarn C. Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes. International journal of women’s health. 2017;9:347–52.
  • Wang C, Wang XY, Yang HX. Effect of maternal age on pregnancy outcomes in Beijing. Zhonghua Fu Chan Ke Za Zhi. 2017;52(8):514–20
  • Marvin-Dowle K, Kilner K, Burley VJ, et al. Impact of adolescent age on maternal and neonatal outcomes in the born in Bradford cohort. BMJ Open. 2018;8(3):e016258.
  • Getachew Mullu Kassa, Ayodele O. Arowojolu, Akin Tunde A. Odukogbe, Alemayehu Worku Yalew. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia. PLoS One. 2019;14(6): e0218259.
  • Naz U. Comparison of obstetric outcome in terms of the risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Journal of the College of Physicians and Surgeons—Pakistan: JCPSP. 2014;24(2):131–4.
  • Stevens-Simon C, Beach RK, McGregor JA. Does incomplete growth and development predispose teenagers to preterm delivery? A template for research. J. Perinatol. 2002;22:315–323.
  • Thaithae S, Thato R. Obstetric and Perinatal Outcomes of Teenage Pregnancies in Thailand. Journal of pediatric and adolescent gynecology. Longitu
There are 44 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Fatma Tuba Engindeniz 0000-0001-9323-6060

Deniz Simsek 0000-0002-0975-9457

Burcu Dinçgez 0000-0002-2697-7501

Early Pub Date December 15, 2023
Publication Date December 15, 2023
Submission Date April 19, 2023
Acceptance Date December 5, 2023
Published in Issue Year 2023 Volume: 21 Issue: 3

Cite

APA Engindeniz, F. T., Simsek, D., & Dinçgez, B. (2023). A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes. Turkish Journal of Public Health, 21(3), 361-370. https://doi.org/10.20518/tjph.1285907
AMA Engindeniz FT, Simsek D, Dinçgez B. A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes. TJPH. December 2023;21(3):361-370. doi:10.20518/tjph.1285907
Chicago Engindeniz, Fatma Tuba, Deniz Simsek, and Burcu Dinçgez. “A Hidden Burden on Public Health: Adolescent Pregnancy and Increased Adverse Perinatal Outcomes”. Turkish Journal of Public Health 21, no. 3 (December 2023): 361-70. https://doi.org/10.20518/tjph.1285907.
EndNote Engindeniz FT, Simsek D, Dinçgez B (December 1, 2023) A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes. Turkish Journal of Public Health 21 3 361–370.
IEEE F. T. Engindeniz, D. Simsek, and B. Dinçgez, “A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes”, TJPH, vol. 21, no. 3, pp. 361–370, 2023, doi: 10.20518/tjph.1285907.
ISNAD Engindeniz, Fatma Tuba et al. “A Hidden Burden on Public Health: Adolescent Pregnancy and Increased Adverse Perinatal Outcomes”. Turkish Journal of Public Health 21/3 (December 2023), 361-370. https://doi.org/10.20518/tjph.1285907.
JAMA Engindeniz FT, Simsek D, Dinçgez B. A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes. TJPH. 2023;21:361–370.
MLA Engindeniz, Fatma Tuba et al. “A Hidden Burden on Public Health: Adolescent Pregnancy and Increased Adverse Perinatal Outcomes”. Turkish Journal of Public Health, vol. 21, no. 3, 2023, pp. 361-70, doi:10.20518/tjph.1285907.
Vancouver Engindeniz FT, Simsek D, Dinçgez B. A hidden burden on public health: adolescent pregnancy and increased adverse perinatal outcomes. TJPH. 2023;21(3):361-70.
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