Obstetrical and perinatal outcome in adolescent pregnancy: a retrospective study at a tertiary care center in rural India

Authors

  • Arpitha Shruthi Department of Obstetrics and Gynecology, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
  • Sheela S. R. Department of Obstetrics and Gynecology, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
  • Vishnu Priya Kesani Department of Obstetrics and Gynecology, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191506

Keywords:

Adolescent pregnancy, Obstetric complications, Neonatal outcomes

Abstract

Background: Adolescent pregnancy is a serious health and social problem worldwide. The aim of this study was to determine the obstetrical and perinatal outcomes of nulliparous adolescent pregnancies in a tertiary care centre in rural India.

Methods: This is a retrospective study conducted between April 2017 and March 2018.Adolescent primigravidae completing 28 weeks of gestation with singleton pregnancy were included in the study group. Primigravidae aged between 20 and 25 years were taken as a control group. The factors under study included obstetric complications and neonatal outcomes. The association was considered significant at P-value <0.05.

Results: 450 women were included in the study group and 460 to the control group. The incidence of adolescent pregnancy was 18.3% during the study period. The adolescent mothers had a significantly higher incidence of preeclampsia (12.8 % vs 8.4 %; p = 0.03), eclampsia (3.5% vs 1.5%; p = 0.01), preterm delivery (18.6% vs 10.8%; p = 0.0009), low birth weight (39.1 % vs 24.2 %; p = 0.00001),very low birth weight babies (13.7 % vs 8.7 %; p = 0.01) compared to control group. There was higher proportion of NICU admissions in adolescent group (20.8% vs 12.3 %; p = 0.0005) compared to control group. No significant difference was found regarding postpartum complications and still birth.

Conclusions: Adolescent pregnancy is associated with poorer feto-maternal outcomes. Regular antenatal visits, adequate nutritional supplementation and early detection of high-risk factors may contribute in decreasing the obstetric risk of childbirth in adolescent mothers.

References

World Health Organization. Adolescent Pregnancy: Issues in Adolescent Health and Development. Geneva: World Health Organization; 2004. (WHO discussion papers on adolescence). Accessed at: https://apps.who.int/iris/bitstream/handle/10665/42903/9241591455_eng.pdf;jsessionid=06CA46C7496F6E57BA7F6EF08DD3E2CE?sequence=1.

World Health Organization. Early marriages, adolescent and young pregnancies 2011. Geneva: World Health Organization. Accessed at: http://apps.who.int/gb/ebwha/pdf_files/EB130/B130_12-en.pdf. Accessed on: February 19, 2019.

The World Bank. Adolescent Fertility Rate (births per 1000 women aged 15-19 years). United Nations Population Prospects. Accessed at: http://data.worldbank.org/indicator/SP.ADO.TFRT. Accessed from: February 19, 2019.

Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. European J Public Health. 2005;16(2):157-61.

Blomberg M, Tyrberg RB, Kjølhede P. Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ Open. 2014;4(11):e005840.

Leppälahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open. 2013;3(8):e003225.

Briggs MM, Hopman WM, Jamieson MA. Comparing pregnancy in adolescents and adults: obstetric outcomes and prevalence of anemia. J Obstet Gynaecol Canada. 2007;29(7):546-55.

Kumar A, Singh T, Basu S, Pandey S, Bhargava V. Outcome of teenage pregnancy. Indian J Pediat. 2007;74(10):927-31.

Tufail AM, Hashmi HA. Maternal and perinatal outcome in teenage pregnancy in a community-based hospital. Pak J surg. 2008;24(2):130-4.

Ganchimeg T, Mori R, Ota E, Koyanagi A, Gilmour S, Shibuya K, et al. Maternal and perinatal outcomes among nulliparous adolescents in low‐and middle‐income countries: a multi‐country study. BJOG: An Int J Obstet Gynaecol. 2013;120(13):1622-30.

Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG: An Int J Obstet Gynaecol. 2014;121:40-8.

UNFPA. State of World Population 2013. Motherhood in Childhood. Facing the Challenge of Adolescent Pregnancy; 2013. Accessed at: http://www.unfpa.org/sites/default/files/pub-pdf/EN-SWOP2013-final.pdf. Accessed from: February 19, 2019.

Ago BU, Abeshi S, Njoku C, Agban TU, Ekabua J. Obstetric outcomes of booked teenage pregnancies at University of Calabar teaching hospital, Nigeria. Adolesc Health Med Ther. 2012;3:105-9.

Sulaiman S, Othman S, Razali N, Hassan J. Obstetric and perinatal outcome in teenage pregnancies. South African J Obstet Gynaecol. 2013;19(3):77-80.

WHO. Expert Committee Report. Physical Status: The Use and Interpretation of Anthropometry. Technical report Series 854, Geneva: World Health Organisation; 1995. Lao TT, Ho LF. Obstetrics outcomes of teenage pregnancy. Hum Reprod. 1998;13(11):3228-32.

Iqbal F, Azad S, Tayyab R. Obstetrical and fetal outcome in teen age primigravida. Annals of King Edward Medical University. 2004;10(4).

Hidalgo LA, Chedraui PA, Chávez MJ. Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study. Archiv Gynecol Obstet. 2005;271(3):207-11.

Mukhopadhyay P, Chaudhuri RN, Paul B. Hospital-based perinatal outcomes and complications in teenage pregnancy in India. J Health Population Nutrit. 2010;28(5):494.

Brosens I, Benagiano G. Menstrual preconditioning for the prevention of major obstetrical syndromes in polycystic ovary syndrome. Am J Obstet Gynecol. 2015;213(4):488-93.

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Published

2019-04-29

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Original Research Articles