Raatikainen Kaisa, Heiskanen Nonna, Verkasalo Pia K, Heinonen Seppo
Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.
Eur J Public Health. 2006 Apr;16(2):157-61. doi: 10.1093/eurpub/cki158. Epub 2005 Sep 1.
Teenage pregnancies have been associated with fetal growth restriction, low birth weight, preterm birth and neonatal mortality. These could be due to biological immaturity, lifestyle factors or inadequate attendance to maternity care. The objective of this study was to assess the relationship between young age of the mother and pregnancy risk factors and adverse pregnancy outcome in conditions of high-quality maternity care used by almost the entire pregnant population.
We analysed a population-based database of 26,967 singleton pregnancies during 1989-2001. Only 185 of these mothers were under 18 years old. Data were collected using a self-administered questionnaire at 20 weeks of pregnancy and clinical records of pregnancy, delivery and newborn child. The information covered maternal risk factors, pregnancy characteristics and obstetric outcomes. Odds ratios (ORs) for adverse pregnancy outcomes in teenage compared with older mothers were obtained from multiple logistic regression models.
Teenage mothers smoked, were unemployed and had anaemia or chorioamnionitis more often than older mothers. On the other hand, they were overweight and had maternal diabetes less often than adults. Teenage mothers had as many instrumented deliveries (OR 0.70; 95% confidence interval 0.39-1.27) but fewer Caesarean sections (0.62; 0.39-0.97) than adults. We found no evidence for increased risk of preterm delivery, fetal growth restriction, low birth weight, or fetal or perinatal death in teenage mothers.
These results suggest that increased risks for adverse pregnancy outcomes in teenage pregnancies can most probably be overcome by means of high-quality maternity care with complete coverage.
青少年怀孕与胎儿生长受限、低出生体重、早产及新生儿死亡有关。这些情况可能是由于生理不成熟、生活方式因素或孕期保健不足所致。本研究的目的是在几乎所有孕妇都能获得高质量孕期保健的情况下，评估母亲年龄较小与妊娠风险因素及不良妊娠结局之间的关系。
我们分析了1989年至2001年间基于人群的26,967例单胎妊娠数据库。这些母亲中只有185例年龄在18岁以下。在妊娠20周时通过自填问卷收集数据，并收集妊娠、分娩及新生儿的临床记录。信息涵盖母亲风险因素、妊娠特征及产科结局。通过多因素逻辑回归模型得出青少年母亲与年龄较大母亲相比不良妊娠结局的比值比（OR）。
青少年母亲吸烟、失业、患贫血或绒毛膜羊膜炎的情况比年龄较大的母亲更为常见。另一方面，她们超重及患妊娠糖尿病的情况比成年人少。青少年母亲的器械助产分娩次数与成年人相同（OR 0.70；95%置信区间0.39 - 1.27），但剖宫产次数比成年人少（0.62；0.39 - 0.97）。我们没有发现证据表明青少年母亲发生早产、胎儿生长受限、低出生体重或胎儿或围产期死亡的风险增加。
这些结果表明，通过全面覆盖的高质量孕期保健，青少年妊娠中不良妊娠结局增加的风险很可能可以得到克服。
