title: Factors That Affect Perinatal Outcomes of the Second Pregnancy of Adolescents.
abstract: OBJECTIVE
  We assessed factors that might affect perinatal outcomes in second pregnancies in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, MAIN OUTCOME MEASURES: This longitudinal retrospective study was carried out on 66 adolescents who experienced 2 deliveries during their adolescence. Data were collected for the first and second pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) for adverse perinatal outcomes in the second pregnancy were calculated using a logistic regression model and SPSS software (version 17.0 for Windows; SPSS Inc, Chicago, IL). A P value < .05 was considered to indicate statistical significance.
  
  
  RESULTS
  Body mass index, number of antenatal care visits, weight gain during pregnancy, incidence of anemia, smoking status, gestational week at delivery, cesarean section rate, and birth weight were similar between the first and second pregnancies of these adolescents. Neonatal intensive care unit admission rate, preeclampsia rate, low neonatal birth weight rate, and 5-minute Apgar scores <7 were significantly higher in the first than in the second pregnancy (P < .001). Age of 16 years or younger at the time of first pregnancy (OR = 1.5; 95% CI, 0.9-2.1; P < .01), less than an 18-month interval between births (OR = 1.4; 95% CI, 0.2-1.7; P < .04), presence of gestational complications in the first pregnancy (OR = 1.9; 95% CI, 1.0-3.4; P < .01), and the presence of perinatal complications in the first pregnancy (OR = 1.3; 95% CI, 1.0-1.9; P < .01) were found to be significant indicators for adverse neonatal outcomes in second pregnancies of adolescents.
  
  
  CONCLUSIONS
  We found that the second pregnancies of adolescents were associated with fewer adverse perinatal outcomes than were their first pregnancies. However, some factors regarding the presence of perinatal complications in the first pregnancy, such as maternal age of 16 years or younger at the time of the first pregnancy and interval between first and second pregnancy of less than 18 months, were found to increase the risk of adverse perinatal outcomes for the second births.
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Timur
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Mahmut Kuntay
authors.initials: MK
authors.lastname: Kokanalı
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey. Electronic address: dronurtopcu@gmail.com.
authors.forename: Hasan Onur
authors.initials: HO
authors.lastname: Topçu
authors.affiliation: Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Topçu
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Erkılınç
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Uygur
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Halil İbrahim
authors.initials: Hİ
authors.lastname: Yakut
mesh_terms: D000293:Adolescent; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D020073:Gravidity; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012907:Smoking; D013997:Time Factors; D015430:Weight Gain
keywords: Adolescent; Adolescent pregnancy; Multiparous adolescents; Perinatal outcomes; Repeated pregnancy