Prenatal care and maternal health during adolescent pregnancy: a review and meta-analysis.
OBJECTIVE
A meta-analysis and review of pregnancy complications and behavioral risk factors associated with infant low birth weight and other poor outcomes which occur during adolescent pregnancy was undertaken using the published literature.


METHODS
Studies were eligible for inclusion if they: 1) utilized a clearly defined sample of teenagers 2) provided numeric data on complications of interest or the proportions needed to compute this information 3) included a control or comparison group.


RESULTS
Many behavioral risk factors (smoking, drinking and drug use) appeared to be less prevalent among teenage gravidas, particularly when the young women were ethnic minorities. An increased risk of preterm delivery was associated with young maternal age in both developed and developing countries. In the developed world, risk of cesarean delivery was reduced for teenagers and there was a secular decline in maternal anemia and pregnancy induced hypertension in comparison to the risk sustained by more mature women. Programs of comprehensive prenatal care appeared to have the potential to diminish risk of many complications. In the developing world, teenagers were at increased risk of maternal anemia, preterm birth and cesarean delivery.


CONCLUSIONS
Although future research efforts will need to address the issues of bias inherent in much of the published research, the published literature suggests that prenatal care regimens which provide social and behavioral services along with medical care could improve both the health of the mother and the outcome of her pregnancy.
Scholl
T O
TO
Department of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey-SOM, Camden 08103.
Hediger
M L
ML
Belsky
D H
DH
D000293:Adolescent; D016022:Case-Control Studies; D002585:Cesarean Section; D003191:Comprehensive Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D015438:Health Behavior; D006302:Health Services Research; D006801:Humans; D008423:Maternal Age; D008429:Maternal Welfare; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D015397:Program Evaluation; D012107:Research Design; D012307:Risk Factors