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泰国青少年怀孕的产科和围产期结局

Obstetric and perinatal outcomes of teenage pregnancies in Thailand.

作者信息

Thaithae Suparp, Thato Ratsiri

机构信息

Department of Obstetrics and Gynecology Nursing, Kuakarun College of Nursing, Dusit, Bangkok, Thailand.

出版信息

J Pediatr Adolesc Gynecol. 2011 Dec;24(6):342-6. doi: 10.1016/j.jpag.2011.02.009.

Abstract

STUDY OBJECTIVE

To determine whether, when controlling for confounding factors, there was still an association of adolescence with adverse outcomes.

DESIGN

Retrospective case control study.

SETTING

Seven Bangkok Metropolitan Administration General Hospitals.

PARTICIPANTS

Charts of all women aged 19 and younger (n = 1,354) having singleton live births in 2004, 2005, and 2006 were retrieved. For the adult group, 1,389 charts of mothers between the ages of 20 and 34 delivering singleton babies were selected using proportionate systematic random sampling. Maternal age was divided into 3 groups: 11-15, 16-19, and 20-34.

MAIN OUTCOME MEASURES

Obstetric and perinatal outcomes.

RESULTS

After statistically controlling for known confounding factors, teenage pregnancy was associated with increased risks of anemia (11-15: AOR = 1.81, P < 0.001; 16-19: AOR = 1.48, P < 0.01), very preterm deliveries (11-15: AOR = 2.18, P < 0.05), very low birth weight babies (11-15: AOR = 6.98, P < 0.05; 16-19: AOR = 9.86, P < 0.01), newborn admission to Intensive Care Unit (11-15: AOR = 1.93, P < 0.01; 16-19: AOR = 2.10, P < 0.01), and postpartum complications (11-15: AOR = 3.33, P < 0.01). The rates of cesarean delivery (11-15: AOR 0.58, P < 0.01; 16-19: AOR = 0.57, P < 0.01), operative delivery (11-15: AOR = 0.49, P < 0.01), and oxytocin augmentation (16-19: AOR = 0.66, P < 0.01) were less frequent in younger mothers.

CONCLUSION

Independent of known confounding factors, teenage pregnancy was associated with increased risks of adverse maternal and neonatal outcomes requiring clinical and outreach interventions from health care providers.

摘要

研究目的

确定在控制混杂因素后,青少年时期与不良结局之间是否仍存在关联。

设计

回顾性病例对照研究。

地点

曼谷市七家大都会管理总医院。

参与者

检索了2004年、2005年和2006年所有19岁及以下单胎活产妇女的病历(n = 1354)。对于成年组,采用按比例系统随机抽样的方法,选取了1389例年龄在20至34岁之间、分娩单胎婴儿的母亲的病历。产妇年龄分为3组:11 - 15岁、16 - 19岁和20 - 34岁。

主要观察指标

产科和围产期结局。

结果

在对已知混杂因素进行统计学控制后,青少年怀孕与贫血风险增加相关(11 - 15岁:调整后比值比[AOR]=1.81,P < 0.001;16 - 19岁:AOR = 1.48,P < 0.01)、极早产风险增加(11 - 15岁:AOR = 2.18,P < 0.05)、极低出生体重儿风险增加(11 - 15岁:AOR = 6.98,P < 0.05;16 - 19岁:AOR = 9.86,P < 0.01)、新生儿入住重症监护病房风险增加(11 - 15岁:AOR = 1.93,P < 0.01;16 - 19岁:AOR = 2.10,P < 0.01)以及产后并发症风险增加(11 - 15岁:AOR = 3.33,P < 0.01)。年轻母亲的剖宫产率(11 - 15岁:AOR 0.58,P < 0.01;16 - 19岁:AOR = 0.57,P < 0.01)、手术分娩率(11 - 15岁:AOR = 0.49,P < 0.01)和缩宫素引产率(16 - 19岁:AOR = 0.66,P < 0.01)较低。

结论

独立于已知混杂因素,青少年怀孕与孕产妇和新生儿不良结局风险增加相关,需要医疗保健提供者进行临床和外展干预。

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