Teenage pregnancy in the Texas Panhandle.
OBJECTIVE
This study compares rural and small-city teenage and adult pregnancies, with respect to complication rates and pregnancy outcomes.


METHODS
Chart review of Medicaid patients (513 teenage [under 20 years] and 174 adult controls [ages 25-34]) delivered (excluding multiple gestation) in Amarillo, Texas, from January 1999 to April 2001. Demographic data collected included maternal race, gravidity, parity, smoking status, drug usage, presence of antenatally diagnosed sexually transmitted disease(s), county type (rural vs small city) and number of prenatal visits. Outcomes included mode of delivery, primary cesarean section rates, preterm birth (<34 or <37 weeks), birth weight, birth weight <2500 g, preeclampsia, total maternal weight gain, hemoglobin changes after delivery, Apgar scores, and neonatal intensive care unit admissions. Statistical comparisons between groups were made for a number of factors and outcomes (P < .05).


RESULTS
Teenagers did not have a significantly higher frequency of either illicit drug or tobacco usage, but teenagers <17 years had a greater incidence of sexually transmitted diseases (19.8% vs 10.4%, P < .008) and preeclampsia (7.1% vs 2.3%, P < .025, odds ratio 3.2 [1.1 to 9.9]) when compared with adults. The total weight gain was highest for teens < or =17 years (36.4 pounds vs adults: 28.2, P < .001). The primary cesarean section rate was higher in adults (all teens 18.5% vs adults 38.6%, P < 001). County rurality had no impact on any of the observed findings or variables tested.


CONCLUSIONS
Young teenagers have a higher incidence of sexually transmitted diseases and preeclampsia and also gain significantly more weight with pregnancy than young adults. However, the pregnancy outcomes were no different for rural vs small city teens.
Galvez-Myles
Department of Family Practice, St. Luke's Hospital, Chesterfield, MO, USA.
Myles
Thomas D
TD
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D015430:Weight Gain / Q000502:physiology; D016387:Women's Health