title: Tertiary care availability and adolescent pregnancy characteristics in Saudi Arabia.
abstract: BACKGROUND
  In this study, we aimed to assess the rate of adolescent delivery in a Saudi tertiary health care center and to investigate the association between maternal age and fetal, neonatal, and maternal complications where a professional tertiary medical care service is provided.
  
  
  METHODS
  A cross-sectional study was performed between 2005 and 2010 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. All primigravid Saudi women ≥24 weeks gestation, carrying a singleton pregnancy, aged <35 years, and with no chronic medical problems were eligible. Women were divided into three groups based on their age, ie, group 1 (G1) <16 years, group 2 (G2) ≥16 up to 19 years, and group 3 (G3) ≥19 up to 35 years. Data were collected from maternal and neonatal medical records. We calculated the association between the different age groups and maternal characteristics, as well as events and complications during the antenatal period, labor, and delivery.
  
  
  RESULTS
  The rates of adolescent delivery were 20.0 and 16.3 per 1,000 births in 2009 and 2010, respectively. Compared with G1 and G2 women, G3 women tended to have a higher body mass index, a longer first and second stage of labor, more blood loss at delivery, and a longer hospital stay. Compared with G1 and G2 women, respectively, G3 women had a 42% and a 67% increased risk of cesarean section, and had a 52% increased risk of instrumental delivery. G3 women were more likely to develop gestational diabetes or anemia, G2 women had a three-fold increased risk of premature delivery (odds ratio 2.81), and G3 neonates had a 50% increased overall risk of neonatal complications (odds ratio 0.51).
  
  
  CONCLUSIONS
  The adolescent birth rate appears to be low in central Saudi Arabia compared with other parts of the world. Excluding preterm delivery, adolescent delivery cared for in a tertiary health care center is not associated with a significantly increased medical risk to the mother, fetus, or neonate. The psychosocial effect of adolescent pregnancy and delivery needs to be assessed.
authors.affiliation: Department of Obstetrics and Gynecology, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hanan M
authors.initials: HM
authors.lastname: Al-Kadri
authors.affiliation: Department of Obstetrics and Gynecology, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Azza
authors.initials: A
authors.lastname: Madkhali
authors.affiliation: King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Mohammed T
authors.initials: MT
authors.lastname: Al-Kadi
authors.affiliation: Department of Obstetrics and Gynecology, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hanadi
authors.initials: H
authors.lastname: Bakhsh
authors.affiliation: King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Nourah N
authors.initials: NN
authors.lastname: Alruwaili
authors.affiliation: King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hani M
authors.initials: HM
authors.lastname: Tamim
keywords: adolescent pregnancy; maternal morbidity; maternal mortality; neonatal morbidity; neonatal mortality
references.citation: Circulation. 2009 Apr 7;119(13):1720-7
references.pmid: 19307476
references.citation: Am J Obstet Gynecol. 2005 Feb;192(2):342-9
references.pmid: 15695970
references.citation: Arch Gynecol Obstet. 2001 Jan;264(4):169-70
references.pmid: 11205700
references.citation: Obstet Gynecol. 1975 Jul;46(1):49-52
references.pmid: 1153137
references.citation: Pop Sahel. 1990 Aug;(13):14-6
references.pmid: 12346448
references.citation: PLoS One. 2013 Apr 16;8(4):e59864
references.pmid: 23613716
references.citation: Fam Pract. 2011 Oct;28(5):482-8
references.pmid: 21525140
references.citation: N Y Times Web. 1999 Nov 24;:A18
references.pmid: 11647738
references.citation: Int Angiol. 2006 Sep;25(3):261-7
references.pmid: 16878074
references.citation: JAMA. 2010 Aug 4;304(5):509-10
references.pmid: 20682925
references.citation: Acta Paediatr. 2007 Feb;96(2):166-71
references.pmid: 17429898
references.citation: J Obstet Gynaecol Can. 2013 Mar;35(3):234-245
references.pmid: 23470111
references.citation: Am J Prev Med. 1991 Jan-Feb;7(1):47-52
references.pmid: 1867899
references.citation: Rev Med Inst Mex Seguro Soc. 2010 Jul-Aug;48(4):439-42
references.pmid: 21194515
references.citation: Harefuah. 2000 Jun 1;138(11):919-23, 1008, 1007
references.pmid: 10979399
references.citation: Ann Epidemiol. 1997 Aug;7(6):400-6
references.pmid: 9279449
references.citation: J Obstet Gynaecol Can. 2011 Dec;33(12):1223-1233
references.pmid: 22166276
references.citation: Int J Obes Relat Metab Disord. 2001 Aug;25(8):1175-82
references.pmid: 11477502
references.citation: Am J Obstet Gynecol. 2007 May;196(5):422-3
references.pmid: 17466692
references.citation: Fertil Steril. 2008 Nov;90(5 Suppl):S21-9
references.pmid: 19007633
references.citation: Adv Pediatr. 1981;28:75-98
references.pmid: 7041565
references.citation: Health Care Women Int. 2009 Aug;30(8):670-89
references.pmid: 19575320
references.citation: Arch Womens Ment Health. 2014 Apr;17(2):155-8
references.pmid: 24221407
references.citation: QJM. 2001 Jul;94(7):347-56
references.pmid: 11435630
references.citation: Public Health. 2012 Dec;126(12):1038-43
references.pmid: 23158057
references.citation: J Matern Fetal Neonatal Med. 2010 Jun;23(6):501-5
references.pmid: 19724969
references.citation: Rev Med Chil. 2000 Jun;128(6):571-3
references.pmid: 11016054
references.citation: Obstet Gynecol. 2004 Oct;104(4):671-7
references.pmid: 15458884
references.citation: Clin Exp Obstet Gynecol. 2007;34(3):146-8
references.pmid: 17937087
references.citation: J Crit Care. 2012 Feb;27(1):104.e1-7
references.pmid: 21715135
references.citation: J Obstet Gynaecol Can. 2011 May;33(5):443-448
references.pmid: 21639963
references.citation: Pan Afr Med J. 2012;13:27
references.pmid: 23308332