title: Deliveries among teenage women - with emphasis on incidence and mode of delivery: a Swedish national survey from 1973 to 2010.
abstract: BACKGROUND
  Since the 1970-ies Sweden has actively developed strategies in social care, education and health care in order to counteract the negative consequences of adolescent parenthood. The aims of this study are to determine the annual incidence of singleton delivery among adolescents 1973-2010 and analyse obstetric and neonatal outcomes.
  
  
  METHODS
  A retrospective cohort study, using data from the Swedish Medical Birth Register was conducted. All singleton deliveries in Sweden between 1973 and 2010 were included. Totally 1,941,940 women had 3,761,576 deliveries during the period. Analyses of obstetric and neonatal outcome were restricted to 1992-2010. Adolescents were subdivided into three groups: <16 years (n = 472), 16-17 years (n = 5376), 18-19 years (n = 23560). The reference group consisted of women age 20-30 years (n = 893505). Data were analysed using multivariate logistic regression models adjusted for confounding factors and presented as crude and adjusted odds ratios with 95% confidence interval.
  
  
  RESULTS
  The annual incidence of teenage births decreased significantly from 7.7 to 1.6%. Teenagers were more likely to deliver normally vaginally (aOR 1.70 (95%CI 1.64-1.75), less likely to have Caesarean section (aOR 0.61 (95%CI 0.58-0.64), and had a greater risk of delivering prematurely (< 28 weeks)(aOR 1.61 (95%CI 1.31-2.00), but did not have more small-for-gestational-age babies (aOR 1.07 (95%CI 0.99-1.14). Risks of placenta previa, postpartum haemorrhage > 1000 ml and perineal rupture were significantly lower among teenagers. Although the rate with Apgar score <7 at 5 minutes was similar the teenager's neonates showed less fetal distress and meconium aspiration.
  
  
  CONCLUSIONS
  Adolescent births have steadily decreased in Sweden. Adolescents were more likely to be delivered vaginally than the adult women. The risks for obstetric maternal complications for adolescents were lower than for adult women except for the risk of prematurity.
authors.forename: Rasmus Birch
authors.initials: RB
authors.lastname: Tyrberg
authors.forename: Marie
authors.initials: M
authors.lastname: Blomberg
authors.affiliation: Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, S - 581 85 Linköping, Sweden. Preben.Kjolhede@liu.se.
authors.forename: Preben
authors.initials: P
authors.lastname: Kjølhede
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D006801:Humans; D007236:Infant, Small for Gestational Age; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010502:Perineum / Q000293:injuries; D010923:Placenta Previa / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult