Kadhim Jasim Shaymaa, Al-Momen Hayder, Abdul Razzak Obaid Ali
Department of Obstetrics and Gynecology, College of Medicine, University of Baghdad, Baghdad, Iraq.
Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
Int J Reprod Biomed. 2021 Dec 13;19(11):1005-1014. doi: 10.18502/ijrm.v19i11.9916. eCollection 2021 Nov.
Repeated teenage pregnancy is a major burden on the healthcare system worldwide.
We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications.
This cross-sectional study was performed on female teenagers (aged 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and third pregnancy groups was 96 and 47, respectively.
There was a significant risk of preeclampsia in the first pregnancy group (p = 0.01). Low birth weight, five-min Apgar score 7, and neonatal intensive care unit admission were the most significant neonatal outcomes in the first pregnancy group. In the third pregnancy group, significant predictors of neonatal complications included very young age in the first pregnancy ( 15 yr), an inter-pregnancy interval 2 yr, current anemia, and history of obstetric and/or neonatal complications in previous pregnancies.
Based on the results, teenagers with their first pregnancy had comparable obstetric outcomes (except for preeclampsia) as teenagers with their third pregnancy, whereas neonatal complications occurred more frequently in the first pregnancy group. Overall, we can predict high-risk neonates in the third pregnancy, based on the abovementioned parameters.
青少年反复怀孕是全球医疗保健系统的一项重大负担。
我们旨在比较青少年首次怀孕和第三次怀孕的情况，并评估新生儿并发症的可能性。
本横断面研究针对单胎妊娠的青少年女性（年龄≤19岁）进行。在12个月内对受试者（n = 298）进行筛查。根据排除标准，96名女性被排除。其余受试者（n = 202）分为两组：首次怀孕的青少年（n = 96）和第三次怀孕的青少年（n = 47）。在整个孕期和分娩过程中对受试者进行观察。首次怀孕组和第三次怀孕组的最终样本量分别为96例和47例。
首次怀孕组发生子痫前期的风险显著（p = 0.01）。低出生体重、5分钟阿氏评分≤7分以及入住新生儿重症监护病房是首次怀孕组最显著的新生儿结局。在第三次怀孕组中，新生儿并发症的显著预测因素包括首次怀孕时年龄非常小（≤15岁）、两次怀孕间隔≤2年、目前贫血以及既往怀孕时有产科和/或新生儿并发症史。
根据研究结果，首次怀孕的青少年与第三次怀孕的青少年具有可比的产科结局（子痫前期除外），而首次怀孕组新生儿并发症的发生频率更高。总体而言，基于上述参数，我们可以预测第三次怀孕时的高危新生儿。
