| Abstract: | In India, there has been a declining trend in teenage pregnancy between 1977-79 and 1981-84. Teenage pregnancy tends to occur within marriages, often arranged by parents, and few pregnancies occur among unmarried teenagers. There are nevertheless concerns about the higher rates of nutritional and obstetric problems associated with adolescent pregnancy and the ignorance and immaturity which can result in higher morbidity and mortality among mothers and babies. The change to a minimum age of 18 years for marriage has been suggested as a means of reducing the number of adolescent pregnancies. The study sample included 5994 deliveries in the rural health district area of Sirur, Maharashtra state, India, between 1981 and 1984. Adolescent pregnancies (to women under 20 years old) amounted to 598 deliveries, or 10% of deliveries. The perinatal mortality rate among teenage first births to high-risk mothers (238) under 18 years old was 67.2 per 100 births; the neonatal mortality rate was 61.4. Risk factors such as prolonged labor, short stature, and anemia were associated more with women under 18 years old. Statistically significant differences were found in the rate of low birth weight infants, stillbirths, and late neonatal deaths among women aged under 18 years compared to other women. The perinatal mortality rate was 7-16 times greater when associated risk factors, except anemia, were present. The neonatal mortality rate was 2.5-18 times greater when associated risk factors, except anemia and edema, were present. Late neonatal mortality was 2.2 times higher among infants with mothers under 18 years old. Recommendations were to provide general health education about risks of teenage pregnancy, strictly enforce the minimum age at marriage law, screen all pregnant mothers for risk factors, and provide at-risk mothers with education about child bearing and rearing and referral to a hospital for safe delivery. Referrals are particularly important among first pregnancies among women under 18 years old with multiple risk factors. |
