title: Birth outcomes for teenage women in New South Wales, 1998-2003.
abstract: BACKGROUND
  Pregnancy and childbirth in teenage women are associated with obstetric and social risks, and there is evidence that the birth rate among teenagers in rural and remote areas of Australia is not in decline. The combination of non-urban residence and young age at delivery might define a subgroup of women at special risk of adverse birth outcomes.
  
  
  OBJECTIVE
  To compare birth outcomes of New South Wales (NSW) teenagers residing in rural and remote areas with those living in larger centres with greater access to services.
  
  
  METHODS
  Outcomes for all singleton deliveries to teenage women living in NSW during the period 1998-2003 were reviewed. The women's place of residence was assigned an ARIA (Accessibility/Remoteness Index of Australia) classification according to remoteness and access to services. Analysis included obstetric factors (such as parity), and smoking status. Logistic regression analysis was undertaken to examine the impact of maternal factors on obstetric outcomes.
  
  
  RESULTS
  During the study period, 21 880 teenage women had singleton deliveries. Babies of teenage mothers in very remote areas had higher rates of preterm birth, small-for-gestational age and stillbirth. Rates of smoking were higher in more remote areas, and smoking correlated with preterm birth and stillbirth.
  
  
  CONCLUSIONS
  Teenagers living in remote areas of NSW face a higher risk of adverse pregnancy outcomes than their urban cousins.
authors.affiliation: Department of Obstetrics and Gynaecology, The Canberra Hospital, Australian National University Medical School, Australian Capital Territory, Australia. steve.robson@act.gov.au
authors.forename: Stephen
authors.initials: S
authors.lastname: Robson
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Cameron
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008427:Maternal Health Services / Q000600:supply & distribution; D008507:Medically Underserved Area; D009517:New South Wales / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D012307:Risk Factors; D019035:Rural Health Services; D050497:Stillbirth