Teenage antenatal clinics may reduce the rate of preterm birth: a prospective study.
OBJECTIVE
To examine whether teenage antenatal clinics reduce the incidence of preterm birth.


METHODS
A multicentre prospective study was performed.


METHODS
Three Australian hospitals with maternity services.


METHODS
Consecutive teenage patients (N= 731) were approached at their first or second antenatal visit.


METHODS
Cases were women attending multidisciplinary teenage antenatal clinics and controls attended general hospital-based antenatal clinics. Teenage antenatal clinics involved multidisciplinary care and included guidelines to screen and treat all patients for infectious and social pathology. General antenatal clinic care was in accordance with Australian standards.


METHODS
Preterm birth, newborn biometry adjusted for gestational age, breastfeeding and contraception plans at discharge.


RESULTS
Consent was obtained from 651 (89%) patients. Teenage pregnancy clinic patients were significantly less likely to present with threatened preterm labour (OR 0.45; 95% CI 0.29-0.68), preterm, prelabour, prolonged rupture of membranes (OR 0.34; 95% CI 0.18-0.63) or deliver preterm (OR 0.40; 95% CI 0.25-0.62) compared with those from general clinics. However, there was no independent effect of clinic care upon newborn biometry outcomes. Clinic care did not significantly alter rates of initiation of breastfeeding in hospital. However, significantly more of the teenage antenatal clinic mothers were discharged on contraception (OR 1.58; 95% CI 1.07-2.25).


CONCLUSIONS
Teenage-specific antenatal clinics may reduce the rate of preterm birth.
Quinlivan
Julie A
JA
Department of Obstetrics and Gynaecology, University of Melbourne, Australia.
Evans
Sharon F
SF
D000293:Adolescent; D000554:Ambulatory Care Facilities; D001315:Australia; D003267:Contraception; D005260:Female; D005865:Gestational Age; D006771:Hospitals, Maternity; D006801:Humans; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D010348:Patient Care Team; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000458:organization & administration*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014626:Vaginal Smears