Use of a focussed teen prenatal clinic at a military teaching hospital: model for improved outcomes of unmarried mothers.
We evaluated the utility of a focussed, multidisciplinary adolescent clinic in improving perinatal outcomes. The study population included all delivering unmarried teenagers (13-19 years) from January 1, 1993 to December 31, 1995 attending the focussed adolescent obstetrical clinic compared to a similar cohort of married teenagers (13-19 years), married 20-24 year-old patients, and unmarried 20-24 year-old patients. There were no statistical differences in chorioamnionitis, intrauterine growth retardation (IUGR), postpartum haemorrhage, maternal weight gain, mean gestational age at delivery, preterm delivery rates (<37 weeks), low birth-weight (<2,500 g), Caesarean delivery, postterm delivery rates (>41 weeks), macrosomia (>4,000 g), placental abruption, chronic hypertension, alcohol use, Apgar scores or stillbirth rates or neonatal death rates among the 4 groups studied. Statistical differences were noted in mean delivery weights (p<0.05), preeclampsia (p<0.004), gestational diabetes (p<0.01), history of substance abuse (p<0.0001), tobacco use (p<0.0001), and forceps delivery rates (p<0.004). However, in the teen cohort none of these differences appeared to adversely affect perinatal outcomes in our patients. The focussed, adolescent obstetrical clinic appears to provide perinatal morbidities equal to a low-risk, general population generating better than expected outcomes for pregnant teenagers.
Madigan Army Medical Center, Tacoma, Washington 98431, United States of America.
R
R
Perez
T
T
Patience
E
E
Pulous
G
G
Brown
A
A
McEwen
A
A
Asato
R
R
Hume
B C
BC
Calhoun
D000293:Adolescent; D005260:Female; D006772:Hospitals, Military; D006784:Hospitals, Teaching; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012189:Retrospective Studies; D015406:Single Parent; D014861:Washington