Obstetric and neonatal outcomes of adolescent primiparous singleton pregnancies: a cohort study in the South of Reunion Island, Indian Ocean.
OBJECTIVE
To describe the maternal and neonatal outcomes of a large cohort of adolescent pregnancies in a tertiary care hospital at Reunion Island.


METHODS
Retrospective study of all primiparous singleton pregnancies over 10.5 years. Adolescent (<18 years) were compared to 18-29 years pregnancies. The maternal outcomes were obstetric illness, labor complications, and way of delivery. Neonatal outcomes were preterm birth, low birth weight (LBW), small for gestational age, birth asphyxia, need for mechanical ventilation, and mortality.


RESULTS
We analyzed 1839 adolescent pregnancies and 11,445 controls. Adolescents had worse prenatal care than older mothers, (4.4 vs. 1.4%; p < 0.0001), higher rates of smoking and alcohol assumption (13 vs. 11% and 0.7 vs. 0.4%, both p < 0.05). They showed less pregnancy-related illness and labor complications and higher rates of normal vaginal delivery (80 vs. 69%; p < 0.0001), without increased risk of episiotomy or postpartum hemorrhage. Offspring mortality, preterm birth, and LBW were higher in adolescent pregnancies (3.3 vs. 2.2%; p = 0.001, 14 vs. 12%; p = 0.0008; 17 vs. 14%; p = 0.002).


CONCLUSIONS
In this population, adolescents had an obstetrical outcome better than controls, but their offspring short-term outcomes were unfavorable. Furthers studies are needed to better elucidate the link between adolescent pregnancy and impaired neonatal outcome.
Neonatology and NICU, Pôle Femme-Mère-Enfant, CHU La Réunion, Saint Pierre, France. silvia.iacobelli@chu-reunion.fr
Silvia
S
Iacobelli
Pierre-Yves
PY
Robillard
Jean-Bernard
JB
Gouyon
Thomas C
TC
Hulsey
Georges
G
Barau
Francesco
F
Bonsante
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007195:Indian Ocean Islands / Q000453:epidemiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010298:Parity / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D055815:Young Adult