Adverse effects of teenage pregnancy.
BACKGROUND
Recent studies have suggested that teenage pregnancies are not as hazardous as thought to be earlier.


OBJECTIVE
To compare the sociodemographic data, obstetric complications and attitudes towards family planning in teenagers and older women.


METHODS
A prospective cohort study at the University Obstetrics Unit, Teaching Hospital, Galle.


METHODS
Sociodemographic data, details of antenatal care and family support, antenatal complications, gestation at delivery, mode of delivery, the proportion of unplanned pregnancies, and the possible effects of contraceptive counselling, in two groups of pregnant teenagers (13-16 years, n = 95 and 17-19 years, n = 250) were compared with a control group of pregnant women (20-24 years, n = 275).


RESULTS
The teenagers were from lower socioeconomic strata and the younger teenagers were significantly less educated than the controls. Teenagers had a significantly higher risk of anaemia (Odds Ratio (OR) = 2.3, 95%CI = 1.7-3.3, p < 0.001). The younger teenagers had a significantly higher risk of gestational hypertension (OR = 4.8, 95%CI = 1.8-13.0, p < 0.001) and pre-eclampsia (OR = 5.0, 95%CI = 1-27, p = 0.03). The older teenagers had a significantly higher risk of delivery before 34 weeks of gestation (OR = 13.6, 95%CI = 1.8-287, p = 0.001). There were no significant differences in the mode of delivery. The younger teenagers had a much higher proportion (54%) of unplanned pregnancies compared to the controls (16 %). A significantly higher proportion of younger teenagers (48%) and older teenagers (25 %), if counselled, would have delayed their pregnancies compared to the controls (10 %).


CONCLUSIONS
Teenage pregnancies, especially those below 17 years of age have a significantly higher risk of adverse outcomes. A large proportion of these pregnancies is unplanned and could be prevented by counselling.
Goonewardene
I M R
IM
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Ruhuna, Sri Lanka. malikg@eureka.lk
Deeyagaha Waduge
R P K
RP
D000293:Adolescent; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D049168:Pregnancy, Unplanned; D011295:Prenatal Care; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013188:Sri Lanka / Q000453:epidemiology