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青少年怀孕风险高吗?发展中国家的一项对比研究。

Are teenage pregnancies at high risk? A comparison study in a developing country.

机构信息

Department of Obstetrics and Gynaecology, JIPMER, Pondicherry 605005, India.

出版信息

Arch Gynecol Obstet. 2012 Mar;285(3):573-7. doi: 10.1007/s00404-011-1987-6. Epub 2011 Jul 26.

Abstract

OBJECTIVE

The aim of this study was to compare obstetric and perinatal outcome in teenage and non-teenage pregnancies.

METHODS

We analyzed retrospective data of 15,498 pregnant patients who delivered from March 2008 to April 2009 in Jawaharlal Institute of Postgraduate Medical Education and Research, a referral tertiary care and teaching hospital in Pondicherry, South India. Girls aged ≤ 19 years were compared with pregnancy outcomes in women aged > 19 years who delivered in the same hospital during the study period. A total of 620 teenage pregnancies were compared with 14,878 non-teenage women. The obstetric and perinatal outcome was compared in the study and control groups using t test with Yates correction. We calculated Odds ratio (OR), 95% confidence intervals(CI) and p values; p < 0.005 was considered significant.

RESULTS

The incidence of teenage pregnancy in the study was 4%. A signicant proportion of teenage mothers were in their first pregnancies and their mean age was 18.04 years. Our study showed a significantly higher incidence of anaemia, past dates, premature rupture of membranes (PROM), normal vaginal delivery, episiotomy, low birth weight, and a significantly lower incidence of caesarean sections/perineal tears in teenage mothers compared to other mothers. In contrast, the incidence of hypertension, intrauterine growth restriction of fetus, pre-term labour and postpartum haemorrhage were similar in both the groups.

CONCLUSION

The data in our study should throw more light on the current thinking of the obstetrical problems facing teenage mothers, in which some of our results support and others refute several long held beliefs about the risks in teenage pregnancy. Early booking, adequate antenatal care and delivery by trained people should improve the obstetric and perinatal outcome in teenage pregnancies, which is still an unresolved problem inspite of various government programmes in developing countries.

摘要

目的

本研究旨在比较青少年和非青少年妊娠的产科和围产结局。

方法

我们分析了 2008 年 3 月至 2009 年 4 月在印度南部本地治里贾瓦哈拉尔尼赫鲁医学研究所(Jawaharlal Institute of Postgraduate Medical Education and Research)分娩的 15498 例孕妇的回顾性数据。将年龄≤19 岁的女孩与同期在同一家医院分娩的年龄>19 岁的妊娠结局进行比较。共比较了 620 例青少年妊娠和 14878 例非青少年妇女。采用 t 检验(Yates 校正)比较研究组和对照组的产科和围产结局。我们计算了优势比(OR)、95%置信区间(CI)和 p 值;p<0.005 为差异有统计学意义。

结果

研究中青少年妊娠的发生率为 4%。相当一部分青少年母亲处于初次妊娠,平均年龄为 18.04 岁。与其他母亲相比,我们的研究表明,青少年母亲的贫血、过期妊娠、胎膜早破(PROM)、正常阴道分娩、会阴切开术、低出生体重的发生率显著较高,而剖宫产/会阴撕裂的发生率显著较低。相比之下,两组的高血压、胎儿宫内生长受限、早产和产后出血的发生率相似。

结论

本研究的数据应该更清楚地阐明目前青少年母亲所面临的产科问题的思考,其中一些结果支持,而另一些则反驳了关于青少年妊娠风险的一些长期观点。早期预约、充分的产前保健和由训练有素的人员进行分娩,应该可以改善青少年妊娠的产科和围产结局,尽管发展中国家有各种政府方案,但这仍然是一个未解决的问题。

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