A retrospective investigation of the maternal risks and neonatal outcomesof the adolescent pregnancies

A retrospective investigation of the maternal risks and neonatal outcomesof the adolescent pregnancies Objective: Adolescent pregnancy is defined as the pregnancyseen at the ages of 19years and below. Today, adolescent pregnancy is one of the public health problemsin both developed and developing countries, negatively affecting the health of both the mother and thebaby. Besides, adolescent pregnancies are considered as high-risk with in pregnancies, and hence they may lead to significant social and health problems for the mother and the baby. The aim of this study involves a retrospective investigation of the maternal risks and neonatal outcomesof the adolescent pregnancies admitted to our hospital. Materials and Methods: This study includes 100 mothers get pregnant at the ages of 10-19 years and 88 babies delivered by these mothers admitted to our hospital between 01.01.2010-31.10.2014. The necessary information required for the cases are retrospectively collected. They involves demographic characteristics (age at marriage, birthage, number of children they give birth in adolescence, kinship status with their husbands, socioeconomic status, place of residence), obstetric complications and outcomes (abortus, smoking during pregnancy, preeclampsia, eclampsia, type of delivery, gestational diabetes, anaemia, preterm labour, polyhydramnios, oligohidroamnios) and neonatal outcomes (prematurity, sepsis, fatal distress, congenital malformations, neonatal mortality, breast feeding and newborn jaundice). The results were statistically evaluated and for the comparison of parameters they were considered as significant where p-value<0.05. Results: The mean age of adolescent girls when they get married was found as 17.12±0.99 while the mean age when they become pregnantwas found as 17.63± 0.95. It was found that all the adolescent mothers got the pregnant at their first year of the marriage and 88% of them gave birth and 13% of them delivered more than one baby in the adolescent period. 19% of the mothers were illiterate. 46% of adolescent pregnancies were relatives of their husbands where this ratio was 100% at the earlier ages (10-15 years) while it was 41% at the later ages (15-19 years) with a significant statistical difference (p= 0.018). In addition, socioeconomic level of 37% was reported as poor, 62% of them were from rural areas. It was found that 19% of adolescent pregnant had smoking habit. This habit was 20%in the firstage group (10-15) while it was 18% in the last age group (15-19). The difference was not significant (p =0.660). 25% of the mothers gave birth viacaesarean section was carried while 75% of them via normal spontaneous vaginal delivery. The difference in the rate of abortus in these two groups was not significant (40% vs 25.3%, p=0.389). The rate of abortus in the whole cases was 26%. The following pregnancy complications were found in the mothers; preeclampsia (10%), gestational diabetes (1%), preterm labour (23%), EMR (23%), polyhydramnios (4%) and oligohidroamnios (22%). Anaemia was observed in 58% of adolescent pregnancies. Prevalence of anaemia in pregnant women was 60% in the first age group while 57.9% in the last (p = 0.650). A delivery rate of 26.1% was premature and 2.3 % of these infants received treatment due to sepsis. Fatal distress (12.5%), congenital anomalies (19.3%), jaundice with a required level of treatment (6.8%) and neonatal mortality (17%) were recorded in the babies delivered by adolescent mothers. It was found that 62.5 % of them breastfed their babies within the first 6 months. A higher rate of kinship with their husbands, living in rural areas, smoking during pregnancy, anaemia and abortus incidence in adolescent mothers was found compared to available studies. It was also found that the incidence of anaemia and abortus was increased with decreasing the age of pregnancy. Although there are no much record of studies on the incidence of polyhydramnios and oligohidroamniyos in pregnant adolescents, these were higher compared with pregnant adults. Contrary to popular belief, the incidence of caesarean section was lower in these pregnancies. Although available studies showed an increased incidence of eclampsia in adolescent cases compared to the adults, this was not high in our study. Evaluation of the neonatal outcomes indicated that an increased incidence of congenital anomalies, neonatal mortality and premature birth compared with the avaliable current date in the literature. The incidence of jaundice in the babies delivered by adolescent mothers was found lower compared with those delivered by adult mothers. Conclusion: As a result, adolescent pregnancy bears high risks and hence a right antenatal care should be provided to prevent the complications. The education and socioeconomic status of adolescent girls must be improved so that they can be provented to get pregnant and concequently to become adolescent mothers. Keywords: adolescent pregnancy, maternal outcomes, neonatal outcomes