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2015年至2021年罗马尼亚青少年孕妇队列中的围产期结局反映情况

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021.

作者信息

Matasariu Daniela Roxana, Dumitrascu Irina, Bujor Iuliana Elena, Cristofor Alexandra Elena, Boiculese Lucian Vasile, Mandici Cristina Elena, Grigore Mihaela, Socolov Demetra, Nechifor Florin, Ursache Alexandra

机构信息

Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.

Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania.

出版信息

Diagnostics (Basel). 2023 Jun 27;13(13):2186. doi: 10.3390/diagnostics13132186.

DOI:10.3390/diagnostics13132186
PMID:37443580
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10341149/
Abstract

Although the rates of adolescent pregnancies appear to have dropped according to the World Health Organization (WHO), the decrease in the age of the first menarche and better nutrition seems to contribute to the otherwise high rate of adolescent pregnancy worldwide, despite the efforts of different organizations to improve upon this trend. We conducted a population-based retrospective cohort study from January 2015 to December 2021 using our hospitals' database. We totaled 2.954 adolescent and 6.802 adult pregnancies. First, we compared younger adolescents' outcomes with those of older adolescents, as well as with adolescents aged between 18 and 19 years old; secondly, we compared adolescent pregnancies with adult ones. We detected higher percentages of cephalo-pelvic disproportion (43.2%), cervical dystocia (20.7%), and twin pregnancy (2.7%) in underage adolescents compared with 32%, 14.1%, and 1% in older underage adolescents, respectively, and 15.3%, 3.1%, and 0.6% in older ones. As teens became older, the likelihood of malpresentations and previous C-sections rose, whereas the likelihood of vaginal lacerations declined. When comparing adolescents with adult women, we found more cases that required episiotomy (48.1% compared with 34.6%), instrumental delivery (2.1% compared with 1%), and cervical laceration (10.7% compared with 8.4%) in the adolescent group, but the rates of malpresentation (11.4% compared with 13.5%), previous C-section (13.9% compared with 17.7%), and placenta and vasa praevia (4.5.6% compared with 14%) were higher in the adult women group. Adolescent pregnancy is prone to being associated with higher risks and complications and continues to represent a challenge for our medical system.

摘要

尽管根据世界卫生组织(WHO)的数据,青少年怀孕率似乎有所下降,但初潮年龄的降低和营养状况的改善似乎导致了全球青少年怀孕率居高不下,尽管不同组织都在努力改善这一趋势。我们使用医院数据库进行了一项基于人群的回顾性队列研究,研究时间为2015年1月至2021年12月。我们共统计了2954例青少年怀孕和6802例成人怀孕。首先,我们比较了年龄较小的青少年与年龄较大的青少年以及18至19岁青少年的妊娠结局;其次,我们比较了青少年怀孕与成人怀孕的情况。我们发现,与年龄较大的未成年青少年(分别为32%、14.1%和1%)以及年龄较大的青少年(分别为15.3%、3.1%和0.6%)相比,未成年青少年中头盆不称(43.2%)、宫颈难产(20.7%)和双胎妊娠(2.7%)的比例更高。随着青少年年龄的增长,胎位异常和既往剖宫产的可能性增加,而阴道撕裂伤的可能性下降。在将青少年与成年女性进行比较时,我们发现青少年组中需要会阴切开术(48.1%,而成年女性组为34.6%)、器械助产(2.1%,而成年女性组为1%)和宫颈撕裂伤(10.7%,而成年女性组为8.4%)的病例更多,但成年女性组中胎位异常(11.4%,而青少年组为13.5%)、既往剖宫产(13.9%,而青少年组为17.7%)以及前置胎盘和前置血管(4.5.6%,而成年女性组为14%)的发生率更高。青少年怀孕容易伴有更高的风险和并发症,并且仍然是我们医疗系统面临的一项挑战。

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