Outcome of teenage pregnancy

Objective The objective of the study was to evaluate the obstetric, fetal and neonatal outcomes of teenage pregnancy in a tertiary care teaching hospital. Methods A retrospective case control study was performed over a period of 5 years. Data were retrieved from hospital records. All teenage mothers (aged 13–19 completed years at delivery) delivering in the University Hospital were taken as cases. Next 3 consecutive deliveries in the age group of 20–30 year were selected as controls for each case. For statistical analysis the cases were further subdivided into 2 groups, ≤17 years (Group A) and 18–19 years (Group B). Groups were compared for obstetric complications and neonatal outcome. Statistical analysis was done by software package SPSS 10. Results The incidence of teenage deliveries in hospital over last 5 years was 4.1%. Majority of the teenagers were primigravida (83.2% vs. 41.4%, p<0.01). Complications like pregnancy induced hypertension (PIH) (11.4% vs 2.2%, p<0.01), pre-eclamptic toxemia (PET) (4.3% vs 0.6%, p<0.01) eclampsia (4.9% vs 0.6%, p<0.01) and premature onset of labor (26.1% vs 14.6%, p<0.01) occurred more commonly in teenagers compared to controls. Teenage mothers also had increased incidence of low birth weight (LBW) (50.4% vs 32.3%, p<0.01), premature delivery (51.8% vs 17.5%, p<0.01) and neonatal morbidities like perinatal asphyxia (11.7% vs 1.9%, p<0.01), jaundice (5.7% vs 1.2%, p<0.01) and respiratory distress syndrome (1.9% vs 0.3%, p<0.05). Teenage pregnancy was also associated with higher fetal (1.9% vs 0.3%, p<0.05) and neonatal mortality (3.8% vs 0.5%, p<0.05). Conclusion Teenage pregnancy was associated with a significantly higher risk of PIH, PET, eclampsia, premature onset of labor, fetal deaths and premature delivery. Increased neonatal morbidity and mortality were also seen in babies delivered to teenage mothers. Younger teenager group (≤17 years) was most vulnerable to adverse obstetric and neonatal outcomes.     

Characteristics of the mother and child in teenage pregnancy

As shown in 11,464 black and white pregnant teenagers and 28,477 older pregnant women, teenage mothers tend to be of small stature and weight, consistent with age and early maturation. The small size of their infants is in proportion to their smaller size and not to their early age at conception. Although the progeny of teenage mothers show a higher incidence of prematurity and diminished birth size, in the extent of fetal loss, low Apgar and Bayley scores, and in the frequency of medical abnormalities, they are not at a disadvantage compared with infants of third-decade mothers of comparable size.     

The long term benefits of a comprehensive teenage pregnancy program

A comprehensive program was founded in 1982 to provide adolescents with prenatal and family planning care. The program's impact through its first five years of operation on medical aspects of pregnancy course and fetal outcome will be the subject of a separate report. This study examines subsequent maternal and infant health of the patients attending the program compared to a control group. Four hundred ninety-eight adolescents and their newborns attending the program's mother-baby family planning clinic from 1982 to 1989 (subject group) were compared to ninety-one adolescents and their newborns receiving postpartum family planning and pediatrics clinics from 1980 through 1989 (control group). Seventy-five percent of the subject group regularly attended mother-baby clinic, compared to 18% of the control group attending family planning and pediatric clinics (P less than or equal to .0001). The subject group experienced less maternal and infant morbidity, greater school attendance, graduation, employment, and contraceptive use than the control group (P less than or equal to .0001). Many parameters improved with each program year indicating continued wide acceptance of our program by area adolescents.     

Delay in obstetrical care in newly diagnosed teenage pregnancy.

A retrospective study of 42 adolescent patients diagnosed as being pregnant between June 1987 and February 1990 at the Downtown Health Center (DHC), an inner city pediatric primary care clinic, was conducted to determine whether patients referred to a hospital-based Teen Pregnancy Clinic (TPC) were seen within a reasonable period of time. The frequency of sexually transmitted diseases (STDs) was also determined when these women were initially seen at TPC. Only 5 of the 42 patients seen at DHC had a pelvic exam prior to referral. Of the 40 patients seen at TPC, 20% were not seen until four weeks or more after initial diagnosis. Fifty percent had a STD. Pediatricians should recognize that pregnant teenagers may have a significant delay between diagnosis of pregnancy and entry into obstetrical care. Pelvic exam including cultures for STDs is recommended prior to referral.     

Trends in teenage smoking during pregnancy. Washington State: 1984 through 1988

Smoking rates in the United States have decreased since 1963, but this trend is less apparent in adolescents, especially girls. Using data on birth certificates from 1984 through 1988, we analyzed smoking trends during pregnancy in teenagers in Washington State. There was a small but significant increase in the overall smoking prevalence during pregnancy between 1984 (32%) and 1988 (37%). Smoking rates varied by mother's age, race and ethnicity, marital status, and prenatal care. Whites had the highest smoking prevalence, and native Americans showed the largest increase in smoking prevalence over time. In the 5 years studied, unmarried pregnant teenagers had a smoking prevalence of 42.8%, compared with a rate of 31.7% in married teenagers. Compared with other studies of smoking rates in nonpregnant teenagers, pregnant teenagers in Washington State had a much higher smoking prevalence than their nonpregnant peers, and the differences between these two groups did not appear to diminish over time. This study suggests that there is little movement toward meeting the 1990 Health Objectives for the Nation regarding smoking in Washington State teenagers who become pregnant.     

Breast fibroadenoma in teenage females

Over a period of 30 years, the author received surgical specimens of fibroadenoma from doctors who had operated on 530 teenage females of the Igbo ethnic group, who inhabit southeastern Nigeria, West Africa. The peak age was 18 years. The right breast (51.3%) was involved more often than the left (48.7%). There were 58 bilateral cases, i.e., 10.9% of the entire series. Seven teenagers had undergone previous operations for fibroadenoma and five growths were infarcted. The teenagers showed awareness of breast disease as manifested by (a) rising incidence trend during the 1970s, 1980s, and 1990s, (b) little delay in presenting for treatment and (c) smallness of the excised tumors.     

A teenage girl with extreme tachypnea

Dyspnea and tachypnea are common presenting complaints in an emergency department. Respiratory and cardiac causes are the most common etiology. Functional respiratory disorders should be considered in patients with atypical presentation to avoid extensive investigations. We describe an adolescent who presented to our emergency department with extreme tachypnea.     

Cross-cultural perspectives on teenage alcohol use

Alcohol use by teenagers is a widespread and well-documented behavior in many Western nations. In contrast, very little is known about the drinking habits and attitudes toward alcohol of teenagers in the world's developing countries. In this paper we propose that adolescents learn about alcohol as part of the socialization process, just as they learn other social behaviors. Central to this learning is the development of a set of expectancies within one's culture about the effects of alcohol upon the user. These expectancies are important determinants of subsequent drinking behavior. An understanding of the sociocultural environment in which these expectancies develop, and in which teenage drinking occurs, is essential for developing intervention strategies aimed at promoting responsible alcohol use and avoiding alcohol-related problems among young people.