Lastinger Julia, Enengl Sabine, Neururer Sabrina, Leitner Hermann, Oppelt Peter, Stelzl Patrick
Universitätsklinik für Gynäkologie, Geburtshilfe und Gynäkologische Endokrinologie, Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Linz, Austria.
Institut für klinische Epidemiologie der Tirol-Kliniken (IET), Landesinstitut für Integrierte Versorgung Tirol (LIV), Innsbruck, Austria.
Geburtshilfe Frauenheilkd. 2022 Oct 25;83(2):212-219. doi: 10.1055/a-1911-1996. eCollection 2023 Feb.
Even though teenage pregnancy rates have been declining in the last decades, their global prevalence is still high and shows country-specific discrepancies. Insufficient sexual education, poor availability of contraceptives and early marriage are some of the multifactorial causes for adolescent pregnancies. Very often teenage pregnancies are classified as high-risk pregnancies. Studies have found higher rates of peripartal complications, such as preterm birth, low birth weight or low fetal Apgar-Scores. The aim of this retrospective cohort study is to evaluate the prevalence of teenage pregnancies in Austria and to identify principal differences in maternal and neonatal outcome. Data were collected from the Austrian Birth Registry between 01/2012 and 12/2020. A total of 751661 deliveries in Austria were documented. Obstetric, maternal and neonatal parameters were descriptively analyzed. Mothers were subclassified into two age groups: teenage mothers of 19 years and younger and adult mothers of 20 to 39 years of age. Newborns of teenage mothers were significantly smaller (49.98 ± 3.11 vs. 50.31 ± 3.16 cm, p < 0.001) and had a lower birth weight (3216 ± 564 vs. 3247 ± 576 g, p < 0.001) than newborns of adult mothers. The percentage of caesarean deliveries in the teenage group was significantly lower than in adult mothers (21.1 vs. 31.8%, p < 0.001). Newborns of teenage mothers had significantly higher rates of very low (< 4) and low (< 7) 5-minute Apgar scores (5-minute Apgar < 4: 0.75 vs. 0.54%, p = 0.004) (5-minute Apgar < 7: 1.77 vs. 1.37%, p = 0.001) and significantly lower arterial umbilical-cord pH (7.25 ± 0.08 vs. 7.26 ± 0.08, p < 0.001). Perinatal mortality was higher in the age group below 20 years (0.7 vs. 0.6%, p = 0.043). The data of this study show significantly poorer outcomes in pregnancies of teenagers compared to adult women, even though the healthcare system in Austria is considered excellent. Future guideline recommendations should focus on important aspects of obstetric care in teenage mothers.
尽管在过去几十年里青少年怀孕率一直在下降，但其全球患病率仍然很高，并且存在国家间的差异。性教育不足、避孕药具供应匮乏以及早婚是青少年怀孕的一些多因素成因。青少年怀孕常常被归类为高危妊娠。研究发现围产期并发症的发生率更高，如早产、低出生体重或低胎儿阿氏评分。这项回顾性队列研究的目的是评估奥地利青少年怀孕的患病率，并确定母婴结局的主要差异。数据收集自奥地利出生登记处2012年1月至2020年12月期间的记录。奥地利总共记录了751661例分娩。对产科、母亲和新生儿参数进行了描述性分析。母亲被分为两个年龄组：19岁及以下的青少年母亲和20至39岁的成年母亲。青少年母亲所生新生儿明显更小（49.98±3.11 vs. 50.31±3.16厘米，p<0.001），出生体重更低（3216±564 vs. 3247±576克，p<0.001）。青少年组剖宫产的比例明显低于成年母亲（21.1%对31.8%，p<0.001）。青少年母亲所生新生儿出生后5分钟阿氏评分极低（<4分）和低（<7分）的比例明显更高（出生后5分钟阿氏评分<4分：0.75%对0.54%，p = 0.004）（出生后5分钟阿氏评分<7分：1.77%对1.37%，p = 0.001），动脉脐血pH值明显更低（7.25±0.08对7.26±0.08，p<0.001）。20岁以下年龄组的围产期死亡率更高（0.7%对0.6%，p = 0.043）。本研究的数据显示，与成年女性相比，青少年怀孕的结局明显更差，尽管奥地利的医疗保健系统被认为是出色的。未来的指南建议应关注青少年母亲产科护理的重要方面。
