Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy.
OBJECTIVE
To investigate the outcomes of adolescent pregnancy.


METHODS
Retrospective cohort study from the Consortium on Safe Labor between 2002 and 2008.


METHODS
Twelve clinical centers with 19 hospitals in the United States.


METHODS
Nulliparous women (n = 43,537) younger than 25 years of age, including 1189 younger adolescents (age ≤ 15.9 years), 14,703 older adolescents (age 16-19.9 years), and 27,645 young adults (age 20-24.9 years).


METHODS
Adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated, controlling for maternal characteristics and pregnancy complications (young adults as a reference group).


METHODS
Maternal, neonatal outcomes, cesarean indications, and length of labor.


RESULTS
Younger adolescents had an increased risk of maternal anemia (aOR = 1.25; 95% CI, 1.07-1.45), preterm delivery at less than 37 weeks of gestation (aOR = 1.36; 95% CI, 1.14-1.62), postpartum hemorrhage (aOR = 1.46; 95% CI, 1.10-1.95), preeclampsia or hemolysis, increased liver enzyme levels, and low platelet syndrome (aOR = 1.44; 95% CI, 1.17-1.77) but had a decreased risk of cesarean delivery (aOR = 0.49; 95% CI, 0.42-0.59), chorioamnionitis (aOR = 0.63; 95% CI, 0.47-0.84), and neonatal intensive care unit admission (aOR = 0.80; 95% CI, 0.65-0.98). Older adolescents had an increased risk of maternal anemia (aOR = 1.15; 95% CI, 1.09-1.22), preterm delivery at less than 37 weeks of gestation (aOR = 1.16; 95% CI, 1.08-1.25), and blood transfusion (aOR = 1.21; 95% CI, 1.02-1.43), but had a decreased risk of cesarean delivery (aOR = 0.75; 95% CI, 0.71-0.79), chorioamnionitis (aOR = 0.83; 95% CI, 0.75-0.91), major perineal laceration (aOR = 0.82; 95% CI, 0.71-0.95), and neonatal intensive care unit admission (aOR = 0.89; 95% CI, 0.83-0.96). Older adolescents were less likely to have a cesarean delivery for failure to progress or cephalopelvic disproportion (aOR = 0.89; 95% CI, 0.81-0.98). For adolescents who entered spontaneous labor, the second stage of labor was shorter (P < .01).


CONCLUSIONS
Adolescents were less likely to have a cesarean delivery. Failure to progress or cephalopelvic disproportion occurred less frequently in older adolescents. Adolescents who entered spontaneous labor had a shorter second stage of labor.
Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC. Electronic address: tetsuya.x.kawakita@gunet.georgetown.edu.
Tetsuya
T
Kawakita
Obstetrics and Gynecology, Long Bearch Memorial Medical Group, Long Beach, California.
Kathy
K
Wilson
Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC.
Katherine L
KL
Grantz
Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, DC.
Helain J
HJ
Landy
Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland.
Chun-Chih
CC
Huang
Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC.
Veronica
V
Gomez-Lobo
D000293:Adolescent; D052178:Cephalopelvic Disproportion / Q000453:epidemiology / Q000209:etiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D010298:Parity; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Cesarean delivery; Length of labor; Pregnancy in adolescence; Pregnancy outcomes