Mahavarkar S H, Madhu C K, Mule V D
Department of Obstetrics and Gynaecology, Government Medical College, Miraj, Maharashtra, India.
J Obstet Gynaecol. 2008 Aug;28(6):604-7. doi: 10.1080/01443610802281831.
Teenage pregnancy is a global problem and is considered a high-risk group, in spite of conflicting evidence. Our objective was to compare obstetric outcomes of pregnancy in teenagers and older women. This was a retrospective study of case records of pregnancies from August 2000 to July 2001. Girls aged < or =19 years were compared with pregnancy outcomes in older women (19-35 years) in the same hospital. The study took place in the Government General Hospital, Sangli, India, a teaching hospital in rural India, with an annual delivery rate of over 3,500. A total of 386 teenage pregnancies were compared with pregnancies in 3,326 older women. Socioeconomic data, age, number of pregnancies, antenatal care and complications, mode of delivery, and neonatal outcomes were considered. The incidence of teenage pregnancy in the study was 10%. A significant proportion of teenage pregnant mothers were in their first pregnancies. The teenage mothers were nearly three times more at risk of developing anaemia (OR = 2.83, 95% CI = 2.2-3.7, p < 0.0001) and delivering pre-term (OR = 2.97, 95% CI = 2.4-3.7, p < 0.0001). Teenage mothers were twice as likely to develop hypertensive problems in pregnancy (OR = 2.2, 95% CI = 1.5-3.2, p < 0.0001) and were more likely to deliver vaginally with no significant increase in the risk of assisted vaginal delivery or caesarean section. Young mothers were nearly twice at risk of delivering low birth weight babies (OR = 1.8, 95% CI = 1.5-2.2, p < 0.0001) and 50% less likely to have normal birth weight babies (OR = 0.5, 95% CI = 1.2-2.9, p < 0.0001). The outcome of this study showed that teenage pregnancies are still a common occurrence in rural India in spite of various legislations and government programmes and teenage pregnancy is a risk factor for poor obstetric outcome in rural India. Cultural practices, poor socioeconomic conditions, low literacy rate and lack of awareness of the risks are some of the main contributory factors. Early booking, good care during pregnancy and delivery and proper utilisation of contraceptive services can prevent the incidence and complications in this high-risk group.
青少年怀孕是一个全球性问题，尽管存在相互矛盾的证据，但青少年怀孕群体仍被视为高危群体。我们的目的是比较青少年与成年女性的妊娠产科结局。这是一项对2000年8月至2001年7月期间妊娠病例记录的回顾性研究。将年龄≤19岁的女孩与同一家医院的成年女性（19 - 35岁）的妊娠结局进行比较。该研究在印度桑利的政府综合医院进行，这是一家位于印度农村的教学医院，年分娩率超过3500例。共将386例青少年妊娠与3326例成年女性妊娠进行了比较。考虑了社会经济数据、年龄、妊娠次数、产前护理及并发症、分娩方式和新生儿结局。该研究中青少年怀孕的发生率为10%。相当一部分青少年怀孕母亲是首次怀孕。青少年母亲患贫血的风险几乎是成年女性的三倍（比值比=2.83，95%置信区间=2.2 - 3.7，p<0.0001），早产风险也是成年女性的近三倍（比值比=2.97，95%置信区间=2.4 - 3.7，p<0.0001）。青少年母亲孕期患高血压问题的可能性是成年女性的两倍（比值比=2.2，95%置信区间=1.5 - 3.2，p<0.0001），且更有可能经阴道分娩，辅助阴道分娩或剖宫产风险无显著增加。年轻母亲分娩低体重儿的风险几乎是成年女性的两倍（比值比=1.8，95%置信区间=1.5 - 2.2，p<0.0001），分娩正常体重儿的可能性比成年女性低50%（比值比=0.5，95%置信区间=1.2 - 2.9，p<0.0001）。这项研究的结果表明，尽管有各种立法和政府项目，但青少年怀孕在印度农村地区仍然很常见，而且青少年怀孕是印度农村地区不良产科结局的一个危险因素。文化习俗、社会经济条件差、识字率低以及对风险缺乏认识是一些主要的促成因素。早期预约、孕期和分娩期间的良好护理以及正确使用避孕服务可以预防这一高危群体中的发病率和并发症。
