Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil.
Front Public Health. 2021 Apr 9;9:536342. doi: 10.3389/fpubh.2021.536342. eCollection 2021.
Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care. To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services. This retrospective cohort study followed pregnant adolescents (aged 10-17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10-13 years were compared to those of adolescents aged 14-15 years and 16-17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences. Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7-11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10-13 age group, 8.7% for the 14-15 age group and 12.1% for the 16-17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10-13, 14-15, and 16-17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups ( > 0.05). The infants born to mothers aged 10-13 years presented significantly ( < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range. Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.
青少年妊娠是一个公共卫生问题，许多研究都评估了新生儿结局，但很少有研究使用充足的产前保健来比较年轻和年长的青少年。本研究旨在比较通过专门的公共服务提供的小组产前保健（GPC）对接受治疗的青少年进行适当随访后，年轻妊娠青少年不良新生儿结局的风险。这项回顾性队列研究跟踪了 2009 年至 2014 年期间在巴西接受专门公共服务的 GPC 的青少年（10-17 岁）。数据来自病历，并通过与治疗患者的多学科团队进行访谈获得。将 10-13 岁青少年新生儿的新生儿结局（低出生体重、早产、1 分钟和 5 分钟时的 Apgar 评分以及新生儿死亡）与 14-15 岁和 16-17 岁青少年新生儿的结局进行比较。使用 95%置信区间（CI）计算发生率，并使用卡方检验随时间进行比较，以观察趋势。使用泊松多变量逻辑回归调整混杂变量。结果以调整后的相对风险或调整后的平均差异表示。在接受监测的 1112 名青少年中，有 758 名纳入本研究。不良新生儿结局（低出生体重和早产）的总体发生率为 10.2%（95%CI：9.7-11.5）。收集的 1 分钟和 5 分钟 Apgar 评分正常，未发生胎儿死亡。10-13 岁年龄组低出生体重发生率为 16.1%，14-15 岁年龄组为 8.7%，16-17 岁年龄组为 12.1%。10-13 岁、14-15 岁和 16-17 岁的青少年早产发生率分别为 12%、8.5%和 12.6%。10-13 岁母亲出生的婴儿 Apgar 评分明显（<0.05）低于其他年龄组，但评分仍在正常范围内。我们的研究结果显示，青少年妊娠的新生儿不良结局发生率较低，且新生儿结局无风险差异。这可能表明，对妊娠青少年进行小组产前保健的模式比青少年妊娠的年龄更为重要，但仍需要进一步研究。
