Torres Ramírez A, Coria Soto I L, Zambrana M M, Lara Ricalde R
Ginecol Obstet Mex. 1999 Aug;67:377-84.
Information relative to the frequency of vaginal delivery and cesarean section in adolescent population is limited and contradictory. Some publications refer that cesarean section is practiced more frequently in adolescents than in adults, because teenagers have a biological immaturity and a less medical control during pregnancy; but others show that frequency of cesarean section and vaginal delivery is very similar in adolescents as in adults. The reason of this contradiction is the fact that all studies compare general populations, with or without sistemic pathologies, and with or without obstetric antecedents. Therefore, the authors of this paper consider that if they compare adolescent and adult populations in their first pregnancy and without sistemic pathologies, the frequency of cesarean section and vaginal delivery should be the same in the two groups of women. To confirm their hypothesis, the authors collected original data from 121 adolescent women in their first pregnancy, seventeen years old or younger, without sistemic pathology, attended in the Instituto Nacional de Perinatología, and they compared them with original data collected from 121 adult women also in their first pregnancy, between 20 to 27 years old, without sistemic pathology, attended in the same institution and during the same period. The authors concluded that there were not statistical differences between the two groups in relation to the number of prenatal care visits; the weeks of pregnancy at the time of delivery; the indications of the different obstetric procedures to resolve the delivery; and in the perinatal mortality. Nevertheless, there were differences with high statistical significance between the number of vaginal deliveries and the number of cesarean sections; in fact, the cesarean section was performed more frequently in adult women. The authors considered that in the population of adolescents they studied, the age by itself was not a risk factor; furthermore, it is necessary to perform other studies to confirm and to explain why the cesarean section was performed more frequently in the adult population.
关于青少年人群中阴道分娩和剖宫产频率的信息有限且相互矛盾。一些出版物指出，青少年剖宫产的实施频率高于成年人，因为青少年在孕期存在生理不成熟且医疗管控较少的情况；但另一些研究表明，青少年剖宫产和阴道分娩的频率与成年人非常相似。这种矛盾的原因在于，所有研究都是在比较普通人群，这些人群有或没有系统性疾病，有或没有产科病史。因此，本文作者认为，如果比较首次怀孕且无系统性疾病的青少年和成年人群体，两组女性的剖宫产和阴道分娩频率应该相同。为了证实他们的假设，作者收集了墨西哥国家围产医学研究所收治的121名首次怀孕、年龄在17岁及以下且无系统性疾病的青少年女性的原始数据，并将其与同一时期在该机构收治的121名同样首次怀孕、年龄在20至27岁且无系统性疾病的成年女性的原始数据进行比较。作者得出结论，两组在产前检查次数、分娩时的孕周、解决分娩的不同产科操作指征以及围产儿死亡率方面没有统计学差异。然而，阴道分娩次数和剖宫产次数之间存在高度统计学意义的差异；事实上，成年女性剖宫产的实施频率更高。作者认为，在他们所研究的青少年人群中，年龄本身并不是一个风险因素；此外，有必要开展其他研究来证实并解释为什么成年人群体剖宫产的实施频率更高。
