The health consequences of teenage fertility.

A review of the literature on the health consequences of teenage pregnancy and childbirth shows remarkable similarity in findings from studies conducted in the United States, Canada, Britain, France and Sweden. In particular, results of studies conducted since 1970 have tended to indicate that the increased risk of maternal complications from pregnancy and delivery among teenagers--especially those older than 15--is associated more with socioeconomic factors than with the biological effects of age. Smaller differences in maternal mortality between teenagers and older women exist in England and Wales than in the United States and France; this finding suggests that England and Wales may have minimized the age or socioeconomic factors contributing to a difference in rates. Inadequate prenatal care may be a major cause of pregnancy-related complications for mothers, since teenagers in all countries are more likely than older mothers to seek care late in the pregnancy or not all. There is a very marked association between young age of mother and low birth weight in all countries. Sweden has the lowest rate of low birth weight at all maternal ages, and the United States generally has the highest. Some of the apparent effect of young maternal age on birth weight may be because the birth is likely to be the mother's first, and first births have a higher incidence of prematurity. As in the case of maternal health, inadequate prenatal care has been singled out as an important determinant of both prematurity and low birth weight. Late fetal death rates in the United States, England and Wales, and France are slightly higher among teenagers than among women in their 20s. In Canada and Sweden, however, no substantially increased risk for young women is found. Perinatal death rates, which one might expect to be influenced more by environmental factors than are late fetal deaths, show a more marked increase among infants of teenagers than do rates of late fetal deaths. Again, Sweden does not fit the pattern. Studies that separate data for young teens and older teenage mothers also indicate that increased perinatal and late fetal mortality rates may occur only among very young teenage mothers. There is no evidence of an overall increase in congenital malformations among babies born to teenagers. When individual birth defects are examined, some studies have shown increased rates of cardiovascular and central nervous system malformations among the children of teenage mothers.(ABSTRACT TRUNCATED AT 400 WORDS)