Briggs M Martha, Hopman Wilma M, Jamieson Mary Anne
Department of Obstetrics and Gynaecology, Kingston General Hospital Queen's University, Kingston ON.
Clinical Research Centre, Kingston General Hospital and Department of Community Health and Epidemiology, Queen's University, Kingston ON.
J Obstet Gynaecol Can. 2007 Jul;29(7):546-555. doi: 10.1016/S1701-2163(16)32506-3.
To characterize the obstetric outcome and prevalence of anemia in primiparous adolescents and compare them with those in older primiparas.
We conducted a retrospective chart review of 207 adolescents (<or19 years old) and 415 adults (>or20 years old) whose prenatal care was provided by a single obstetrician in Kingston, Ontario, and who had a live singleton birth at >or24 weeks gestation between 1996 and 2004.
The mean age of the adolescents (T) was 17.5 years and of the adults (A) 27.3 years. More than 95% of the women were Caucasian. Mean gestational age at delivery was similar in the two groups (T 39.4 weeks, A 39.6 weeks, P = 0.25). Adolescents were more likely to have a preterm delivery (T 12.6%, A 7.5%, P = 0.038), although smoking rather than young maternal age was an independent risk factor for preterm delivery (odds ratio [OR] 3.2; 95% confidence intervals [CI] 1.47.5). A significantly lower proportion of adolescents delivered by Caesarean section (CS) (T 12.1%, A 27.7%, P < 0.001). Older maternal age, higher pre-pregnancy BMI, increased weight gain during pregnancy, and pre-delivery anemia were all independent risk factors for CS. Smoking was the most influential factor in predicting infant birth weight. Adolescents had significantly more low birth weight infants (< 2500 g) than adults (T 10.1% vs. A 4.3%, P = 0.008). Gestational age rather than young maternal age was the most significant risk factor for low birth weight (OR 3.3; 95% CI 1.95.7). After controlling for smoking status, adolescents were 2.5 times more likely than adults to be anemic at 26 to 35 weeks gestation and pre-delivery.
Our results suggest that primiparous adolescents have significantly different obstetric outcomes from primiparous adults. Smoking and anemia are significant risk factors for poor obstetric outcomes and are potentially modifiable.
描述初产青少年的产科结局及贫血患病率，并与年龄较大的初产妇进行比较。
我们对207名青少年（≤19岁）和415名成年人（≥20岁）的病历进行了回顾性分析，这些人在安大略省金斯敦由同一位产科医生提供产前护理，且在1996年至2004年期间单胎妊娠活产，孕周≥24周。
青少年组（T）的平均年龄为17.5岁，成年组（A）为27.3岁。超过95%的女性为白种人。两组的平均分娩孕周相似（T组39.4周，A组39.6周，P = 0.25）。青少年更易发生早产（T组12.6%，A组7.5%，P = 0.038），不过吸烟而非年轻产妇年龄是早产的独立危险因素（比值比[OR] 3.2；95%置信区间[CI] 1.47.5）。青少年剖宫产（CS）分娩的比例显著更低（T组12.1%，A组27.7%，P < 0.001）。产妇年龄较大、孕前体重指数较高、孕期体重增加较多以及产前贫血均为CS的独立危险因素。吸烟是预测婴儿出生体重的最具影响力因素。青少年低出生体重儿（<2500 g）的比例显著高于成年人（T组10.1% vs. A组4.3%，P = 0.008）。孕周而非年轻产妇年龄是低出生体重的最显著危险因素（OR 3.3；95% CI 1.95.7）。在控制吸烟状态后，青少年在妊娠26至35周及产前贫血的可能性是成年人的2.5倍。
我们的结果表明，初产青少年的产科结局与初产成年人有显著差异。吸烟和贫血是不良产科结局的重要危险因素，且可能是可改变的。
