Adolescent pregnancy in Portugal: effectiveness of continuity of care by an obstetrician.
OBJECTIVE
To improve health among newborn infants of pregnant adolescents in Portugal, we developed and evaluated a prenatal care intervention.


METHODS
The study group consisted of 80 adolescents recruited as they registered for prenatal care at Hospital Santa Maria in Lisbon. The intervention consisted of three components: initiation of prenatal care at registration, continuity of care by the same obstetrician, and emphasis on the specific nutritional and other health needs of pregnant adolescents. Controls were recruited after delivery on the maternity ward of the same hospital and were matched for age at conception, race, socioeconomic status, years of education, planned versus unplanned pregnancy, and previous body mass index. Controls received the routine care provided to pregnant adult women, including initiation of prenatal care at some point after registration and care by different general practitioners at each visit.


RESULTS
Twenty mothers in the control group did not receive prenatal care and were excluded from further analysis. Mothers in the intervention group had their first prenatal visit 2 weeks sooner (P = .02) and had on average almost twice the number of prenatal visits (P = .0001) as controls. They gained 2.0 kg more on average compared with controls (P = .05). Infants of the mothers in the intervention group weighed an average of 181 g more than those in the control group. Fewer infants in the intervention group needed care in the high-risk pediatric unit (P = .005). When potentially confounding variables were controlled in a multivariate analysis, infants in the intervention group weighed on average 174 g more than those in the routine-care group (P = .02).


CONCLUSIONS
This intervention, based on traditional tenets of good medical care, is effective in improving the outcomes of infants born to adolescent mothers in Portugal.
Silva
M O
MO
Department of Obstetrics and Gynecology, Hospital Santa Maria/Faculdade de Medicina de Lisboa, Lisbon, Portugal.
Cabral
H
H
Zuckerman
B
B
D000293:Adolescent; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011174:Portugal; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D011295:Prenatal Care; D012959:Socioeconomic Factors