TEENAGE PREGNANCY: MATERNAL & FETAL OUTCOMES
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Mohd Pazudin I, Najihah AZ, NM Zaki, Mohd Shukri O, Noraliza AG
Department of Obstetrics & Gynaecology, School of Medical Sciences, Health Campus USM, 16150 Kubang Kerian,
Kelantan, Malaysia.
Methods
Objectives
INTRODUCTION
Teenage pregnancy nowadays is reducing but still remains
relatively high and the rates vary worldwide. Some important
factors like socioeconomic deprivation, disrupted family
structure and limited education appear to be most
consistently related to teenage pregnancy. Many adverse
outcomes of the fetal as well as the maternal, have been
associated with teenage pregnancy including premature
delivery, small for gestational age, low birth weight and
increased neonatal mortality, anaemia and gestational
hypertension.
Teenage Pregnancy is defined as a teenage or underage
girl (19years old and less), usually refers to women who have
not reached legal adulthood that become pregnant
OBJECTIVES
To study the maternal and fetal outcomes of teenage
pregnancy and to compare the outcomes with the normal
population.
SPECIFIC OBJECTIVES
STUDY DESIGN
This is a comparative cross sectional study carried out in
Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian,
Kota Bharu Kelantan.
Results
Conclusions
A total of 488 pregnant nulliparous successfully participated and
completed in this study. They were divided into two groups, which
were the teenage group (study group, n=244 patients) and the
non teenage group (control group, n=244 patients).
Table 1: Characteristics of Patients in Teenage and Non Teenage Group
Study Participants
During the study period, all nulliparous women aged ≤19
years old and at gestation of more than 24 weeeks, seen in
clinics, antenatal ward or labour room were included as
teenage group (study group). When each of the teenage
group delivered in labour room HUSM, the first nulliparous
women aged 20-34years delivered following each teenage
case was selected as the non teenage group (control
group). Data regarding the maternal demographic , various
fetal and maternal outcome were compiled by reviewing
their antenatal and delivery records, and also interview was
conducted.
Characteristic
Teenage
Maternal age
(year, mean ± SD)
17.49 ± 1.35
Height
( meter, mean ± SD)
1.54 ± 0.49
1.55±0.52
0.056a
Marital status
(married-nonmarried)
85.7% ( n=209)
100% ( n=244)
<0.001b
Gestation at booking
(week, mean ± SD)
18.48 ± 7.45
14.92 ± 5.28
<0.001a
Gestation at delivery
(week, mean ± SD)
38.59 ± 2.18
38.86 ± 1.64
0.123a
Rape case, n (%)
8 (3.3)
1 (0.4)
0.037c
Inclusion criteria
Singleton pregnancy
Gestation>24weeks
Premarital conception,
n (%)
74 (30.3)
3 (1.2)
<0.001b
Non Teenage
Exclusion criteria
Multiple pregnancy
No consent from patient.
Table 2: Univariate Analysis of Maternal-Fetal Outcomes In Teenage and Non
teenage Group
27.±3.02
p value
<0.001a
aIndependent
t test, significant at p<0.05
b Pearson Chi-square tes; tsignificant at p < 0.05
Outcome
Teenage
Non Teenage
Wald
Crude Or
p Value
N (%)
1. To compare the maternal demographic, major antenatal
complications, outcome of labour, mode of delivery and
perinatal outcome between the study group and the control
group.
2. To identify the fetomaternal outcomes and complications
among the study groups.
Content goes here…
N (%)
OUTCOME MEASURES
Antenatal Outcome:
Anaemia, Antepartum haemorrhage, Hypertension or PE,
GDM and PROM
Labour outcome:
Premature or term labour, IOL, mode of delivery, duration of
labour, Postpartum Haemorrhage and Third and fourth
degree perineal tear.
Perinatal outcome:
Apgar score
Birthweight
congenital abnormalities
NICU Admission
Perinatal mortality
(95% CI)
Hypertension or PE
16 (6.6)
17 (7.0)
0.126
0.881 (0.438,1.771)
0.595
APH
2 (0.8)
3 (1.2)
0.199
0.664 (0.110,4.009)
1.000
Anaemia
44 (18.0)
35 (14.3)
1.219
1.314 (0.809,2.132)
0.269
GDM
3 (1.2)
22 (9.0)
11.108
0.126 (0.037,0.429)
<0.001
Premature Delivery
31 (12.7)
15(6.1)
4.969
2.254 (1.103,4.604)
0.016
PROM
52 (21.3)
38 (15.6)
2.652
0.681 (0.429,1.081)
0.102
IOL
27 (11.1)
53 (21.7)
9.785
0.448 (0.279,0.741)
<0.001
SVD
213 (87.3)
191 (78.3)
8.829
2.107 (1.289,3.445)
0.003
LSCS
28 (11.5)
51 ( 20.9)
7.788
0.491 (0.297,0.809)
0.005
Instrumental delivery
3 (1.2)
2 (0.8)
0.199
1.506 (0.249,9.094)
0.653
PPH
3 (1.2)
6 (2.5)
2.652
0.494 (0.122,1.997)
0.362
3rd or 4th degree tear
1 (0.4)
14 ( 5.7)
6.721
0.068 (0.009,0.518)
0.001
Poor Apgar Score
10 (4.1)
5 ( 2.0)
1.654
2.043 (0.688,6.067)
0.190
Congenital Anomaly
7 (2.9)
0 (0)
0.000
4.711 (1.008,)
0.015
NICU Admission
24 (9.8)
13 (5.3)
0.3.437
1.938 (0.963,3.903)
0.064
Perinatal Mortality
2 01.8)
2 (0.8)
0.199
0.664 (0.110,4.009)
1.000
significant at p<0.05
Table 3 : Birth weight of Newborn In Teenage and Non Teenage Group
≤ 2.50
2.51-3.99
≥ 4.00
48 (19.7)
194 (79.5)
2 (0.8)
Teenage
25 (10.2)
217 (88.9)
2 (0.8)
1. The youngest age in the teenage group was 13 years-old. The
mean age of teenage group was 17.49 (±SD 1.35) while the
non teenage group was 27.29 (±SD 3.05), statistically
significant p value of 0.001. All non-teenage mothers were
married whereas only 85.7% of the teenage mothers were
married (14.3% single mother). About 30% of the teenage
group conceived before they got married while in the non
teenage group only 1% (p value <0.001). There were 8 cases
of rape in teenage group but only one case in non-teenage
group. There were significant delay booking in teenage group,
mean gestational 18.48 weeks vs 14.92 weeks.
2. There were higher incidence of premature delivery in teenage
group as compare to non-teenage group (p value, 0.016).
However there were no significant difference incidence of preeclampsia, prelabour rupture of membrane, antepartum
haemorrhage, anaemia and instrumental delivery between the
groups.
3. The incidence of postpartum haemorrhage was about the same
between both groups. For the incidence of third and fourth
degree perineal tear, surprisingly 14 cases happened in the non
teenage group as compared to only one case from the teenage
group (p value 0.001).
4. There were higher incidence of baby weighing less then 2.5kg
in teenage group about 19% vs 10% in the non teenage group.
This would be explained by the higher incidence of premature
delivery in the teenage group. The incidence of poor Apgar
score and admission to NICU were doubled in the teenage
group as compared to the non teenage group however the p
value were not significant.
5. The incidence of congenital abnormality was 7 (2.9%) in
teenage group , while nil from the non teenage group, a
significant p value of 0.015. The congenital abnormality found
were congenital talipes equinavarus, cleft lips and
hydrocephalus.
References
1.
2.
3.
4.
Birth weight (kg)
n(%)
GROUP
X2 value (df)
p valueb
8.543 (2)
0.014
5.
6.
Non Teenage
b Pearson
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.
Chi-square test; significant at p < 0.05
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