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Kadhim Jasim, S., Al-Momen, H., & Abdul Razzak Obaid, A. (2021). Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study. International Journal of Reproductive BioMedicine (IJRM), 19(11), 1005–1014. https://doi.org/10.18502/ijrm.v19i11.9916
https://doi.org/10.18502/ijrm.v19i11.9916
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- Cited by 3 articles
authors
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Shaymaa Kadhim Jasim
Shaymaa Kadhim Jasim
Department of Obstetrics and Gynecology, College of Medicine, University of Baghdad, Baghdad, Iraq.
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Hayder Al-Momen
Hayder Al-Momen
Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
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Ali Abdul Razzak Obaid
Ali Abdul Razzak Obaid
Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
Published Date
- Dec 13, 2021
Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study
Abstract
Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide.
Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications.
Materials and Methods: 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.
Results: 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.
Conclusion: 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.
Key words: Teenage pregnancy, Complications, Neonate.
References
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[3] Santelli JS, Lindberg LD, Grilo SA, Kantor LM. Ideology or evidence? Examining the population-level impact of US Government funding to prevent adolescent pregnancy. Am J Public Health 2019; 109: 356–357.
[4] Aparicio EM, Kachingwe ON, Phillips DR, Fleishman J, Novick J, Okimoto T, et al. Holistic, trauma-informed adolescent pregnancy prevention and sexual health promotion for female youth experiencing homelessness: Initial outcomes of Wahine Talk. Children Youth Serv Rev 2019; 107: 104509.
[5] Caffe S, Plesons M, Camacho AV, Brumana L, Abdool ShN, Huaynoca S, et al. Looking back and moving forward: Can we accelerate progress on adolescent pregnancy in the Americas? Reprod Health 2017; 14: 83.
[6] Qasim A, Bahaaldeen E. Effect of maternal age on the mother and neonatal health in Baghdad maternity hospitals. Iraq Natl J Nurs Special 2014; 2: 23–30.
[7] Ogawa K, Matsushima S, Urayama KY, Kikuchi N, Nakamura N, Tanigaki S, et al. Association between adolescent pregnancy and adverse birth outcomes: A multicenter cross sectional Japanese study. Sci Report 2019; 9: 2365.
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[11] Jasim SK, Al-Momen H, Majeed BA, Hussein MJ. Rate of fetal macrosomia with maternal and early neonatal complications in internally moved people affected by violence. Int J Med Res Health Sci 2018; 7: 141–146.
[12] Turkay Ü, Aydin Ü, Çalişkan E, Salici M, Terzi H, Astepe B. Comparison of the pregnancy results between adolescent Syrian refugees and local adolescent Turkish citizens who gave birth in our clinic. J Maternal-Fetal Neonatal Med 2020; 33: 1353–1358.
[13] Hubel GS, Moreland AD. What do adolescent parents need to prevent repeat pregnancy? A qualitative investigation. Vulnerable Child Youth Stud 2019; 15: 1–11.
[14] Jasim K, Al-Momen H, Al-Asadi F. Maternal anemia prevalence and subsequent neonatal complications in Iraq. Open Access Maced J Med Sci 2020; 8: 71–75.
[15] Malabarey OT, Balayla J, Klam SL, Shrim A, Abenhaim HA. Pregnancies in young adolescent mothers: A population-based study on 37 million births. J Pediatr Adolesc Gynecol 2012; 25: 98–102.
[16] Abu-Heija A, Al Haddabi R, Al Bash M, Al Mabaihsi N, Al-Maqbali NS. Early teenage pregnancy: Is it safe? J Obstet Gynecol India 2016; 66: 88–92.
[17] Torvie AJ, Callegari LS, Schiff MA, Debiec KE. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol 2015; 213: 95–101.
[18] Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: A World Health Organization multicountry study. BJOG 2014; 121: 40–48.
[19] Jasim SK. Post cesarean section surgical site infection: Incidence and risk factors. Int J Sci Res 2017; 6: 1864–1868.
[20] Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang CC, Gomez-Lobo V. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol 2016; 29: 130–136.
[21] Macedo TCC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, et al. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol 2020; 248: 177–186.
[22] Shrim A, Ates S, Mallozzi A, Brown R, Ponette V, Levin I, et al. Is young maternal age really a risk factor for adverse pregnancy outcome in a Canadian tertiary referral hospital? J Pediatr Adolesc Gynecol 2011; 24: 218–222.
[23] Permana I, Kadi FA, Yuniati T, Primadi A, Hidajat S. Difference of mortality and morbidity between neonates in adolescent pregnancy and young adult pregnancy. Int J Clin Pediatr Child Health 2019; 1: 1–8.
[24] Khader YS, Batieha A, Al Fursan RK, Al-Hader R, Hijazi SS. Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes. Int J Adolesc Med Health 2017; 31: 75–79.
[25] Maki AH. Teenage pregnancy risk factors and complications in Karbala province. Karbala J Pharm Sci 2020; 17: 31–42.
[26] Karai A, Gyurkovits Z, Nyári TA, Sári T, Németh G, Orvos H. Adverse perinatal outcome in teenage pregnancies: An analysis of a 5-year period in Southeastern Hungary. J Maternal-Fetal Neonatal Med 2019; 32: 2376–2379.
[27] Suciu LM, Pasc AL, Cucerea M, Bell EF. Teenage pregnancies: Risk factors and associated neonatal outcomes in an Eastern-European academic perinatal care center. Am J Perinatol 2016; 33: 409–414.
[28] Korenčan S, Pinter B, Grebenc M, Verdenik I. The outcomes of pregnancy and childbirth in adolescents in Slovenia. Zdr Varst 2017; 56: 268–275.
[29] Rexhepi M, Besimi F, Rufati N, Alili A, Bajrami S, Ismaili H. Hospital-based study of maternal, perinatal and neonatal outcomes in adolescent pregnancy compared to adult women pregnancy. Open Access Maced J Med Sci 2019; 7: 760–764.
[30] Moraes AN, Likwa RN, Nzala SH. A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: The case of Luapula Province, Zambia. Matern Health Neonatal Perinatol 2018; 4: 20–24.
[31] Timur H, Kokanali MK, Topçu HO, Topçu S, Erkilinç S, Uygur D, et al. Factors that affect perinatal outcomes of the second pregnancy of adolescents. J Pediatr Adolesc Gynecol 2016; 29: 18–21.
[32] Harding JF, Knab J, Zief S, Kelly K, McCallum D. A systematic review of programs to promote aspects of teen parents’ self-sufficiency: Supporting educational outcomes and healthy birth spacing. Matern Child Health J 2020; 24 (Suppl.): 84–104.
[33] Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. J Nutr 2013; 143: 486–492.
[34] Chirayus S, Chandeying V. Outcome of adolescent pregnancy in different periods: Vachira Phuket Hospital. J Med Assoc Thai 2012; 95: 1384–1388.
[35] Norton M, Chandra-Mouli V, Lane C. Interventions for preventing unintended, rapid repeat pregnancy among adolescents: A review of the evidence and lessons from high-quality evaluations. Glob Health Sci Pract 2017; 5: 547–570.
[2] Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. J Adolesc Health 2015; 56: 223–230.
[3] Santelli JS, Lindberg LD, Grilo SA, Kantor LM. Ideology or evidence? Examining the population-level impact of US Government funding to prevent adolescent pregnancy. Am J Public Health 2019; 109: 356–357.
[4] Aparicio EM, Kachingwe ON, Phillips DR, Fleishman J, Novick J, Okimoto T, et al. Holistic, trauma-informed adolescent pregnancy prevention and sexual health promotion for female youth experiencing homelessness: Initial outcomes of Wahine Talk. Children Youth Serv Rev 2019; 107: 104509.
[5] Caffe S, Plesons M, Camacho AV, Brumana L, Abdool ShN, Huaynoca S, et al. Looking back and moving forward: Can we accelerate progress on adolescent pregnancy in the Americas? Reprod Health 2017; 14: 83.
[6] Qasim A, Bahaaldeen E. Effect of maternal age on the mother and neonatal health in Baghdad maternity hospitals. Iraq Natl J Nurs Special 2014; 2: 23–30.
[7] Ogawa K, Matsushima S, Urayama KY, Kikuchi N, Nakamura N, Tanigaki S, et al. Association between adolescent pregnancy and adverse birth outcomes: A multicenter cross sectional Japanese study. Sci Report 2019; 9: 2365.
[8] Karataşli V, Kanmaz AG, Inan AH, Budak A, Beyan E. Maternal and neonatal outcomes of adolescent pregnancy. J Gynecol Obstet Hum Reprod 2019; 48: 347–350. [9] Workicho A, Belachew T, Argaw A, Ghosh S, Kershaw M, Lachat C, et al. Adolescent pregnancy and linear growth of infants: A birth cohort study in rural Ethiopia. Nutr J 2019; 18: 22–23.
[10] Kassa GM, Arowojolu AO, Odukogbe AA, Yalew AW. Adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia. PloS One 2019; 14: e0218259.
[11] Jasim SK, Al-Momen H, Majeed BA, Hussein MJ. Rate of fetal macrosomia with maternal and early neonatal complications in internally moved people affected by violence. Int J Med Res Health Sci 2018; 7: 141–146.
[12] Turkay Ü, Aydin Ü, Çalişkan E, Salici M, Terzi H, Astepe B. Comparison of the pregnancy results between adolescent Syrian refugees and local adolescent Turkish citizens who gave birth in our clinic. J Maternal-Fetal Neonatal Med 2020; 33: 1353–1358.
[13] Hubel GS, Moreland AD. What do adolescent parents need to prevent repeat pregnancy? A qualitative investigation. Vulnerable Child Youth Stud 2019; 15: 1–11.
[14] Jasim K, Al-Momen H, Al-Asadi F. Maternal anemia prevalence and subsequent neonatal complications in Iraq. Open Access Maced J Med Sci 2020; 8: 71–75.
[15] Malabarey OT, Balayla J, Klam SL, Shrim A, Abenhaim HA. Pregnancies in young adolescent mothers: A population-based study on 37 million births. J Pediatr Adolesc Gynecol 2012; 25: 98–102.
[16] Abu-Heija A, Al Haddabi R, Al Bash M, Al Mabaihsi N, Al-Maqbali NS. Early teenage pregnancy: Is it safe? J Obstet Gynecol India 2016; 66: 88–92.
[17] Torvie AJ, Callegari LS, Schiff MA, Debiec KE. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol 2015; 213: 95–101.
[18] Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: A World Health Organization multicountry study. BJOG 2014; 121: 40–48.
[19] Jasim SK. Post cesarean section surgical site infection: Incidence and risk factors. Int J Sci Res 2017; 6: 1864–1868.
[20] Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang CC, Gomez-Lobo V. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol 2016; 29: 130–136.
[21] Macedo TCC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, et al. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol 2020; 248: 177–186.
[22] Shrim A, Ates S, Mallozzi A, Brown R, Ponette V, Levin I, et al. Is young maternal age really a risk factor for adverse pregnancy outcome in a Canadian tertiary referral hospital? J Pediatr Adolesc Gynecol 2011; 24: 218–222.
[23] Permana I, Kadi FA, Yuniati T, Primadi A, Hidajat S. Difference of mortality and morbidity between neonates in adolescent pregnancy and young adult pregnancy. Int J Clin Pediatr Child Health 2019; 1: 1–8.
[24] Khader YS, Batieha A, Al Fursan RK, Al-Hader R, Hijazi SS. Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes. Int J Adolesc Med Health 2017; 31: 75–79.
[25] Maki AH. Teenage pregnancy risk factors and complications in Karbala province. Karbala J Pharm Sci 2020; 17: 31–42.
[26] Karai A, Gyurkovits Z, Nyári TA, Sári T, Németh G, Orvos H. Adverse perinatal outcome in teenage pregnancies: An analysis of a 5-year period in Southeastern Hungary. J Maternal-Fetal Neonatal Med 2019; 32: 2376–2379.
[27] Suciu LM, Pasc AL, Cucerea M, Bell EF. Teenage pregnancies: Risk factors and associated neonatal outcomes in an Eastern-European academic perinatal care center. Am J Perinatol 2016; 33: 409–414.
[28] Korenčan S, Pinter B, Grebenc M, Verdenik I. The outcomes of pregnancy and childbirth in adolescents in Slovenia. Zdr Varst 2017; 56: 268–275.
[29] Rexhepi M, Besimi F, Rufati N, Alili A, Bajrami S, Ismaili H. Hospital-based study of maternal, perinatal and neonatal outcomes in adolescent pregnancy compared to adult women pregnancy. Open Access Maced J Med Sci 2019; 7: 760–764.
[30] Moraes AN, Likwa RN, Nzala SH. A retrospective analysis of adverse obstetric and perinatal outcomes in adolescent pregnancy: The case of Luapula Province, Zambia. Matern Health Neonatal Perinatol 2018; 4: 20–24.
[31] Timur H, Kokanali MK, Topçu HO, Topçu S, Erkilinç S, Uygur D, et al. Factors that affect perinatal outcomes of the second pregnancy of adolescents. J Pediatr Adolesc Gynecol 2016; 29: 18–21.
[32] Harding JF, Knab J, Zief S, Kelly K, McCallum D. A systematic review of programs to promote aspects of teen parents’ self-sufficiency: Supporting educational outcomes and healthy birth spacing. Matern Child Health J 2020; 24 (Suppl.): 84–104.
[33] Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. J Nutr 2013; 143: 486–492.
[34] Chirayus S, Chandeying V. Outcome of adolescent pregnancy in different periods: Vachira Phuket Hospital. J Med Assoc Thai 2012; 95: 1384–1388.
[35] Norton M, Chandra-Mouli V, Lane C. Interventions for preventing unintended, rapid repeat pregnancy among adolescents: A review of the evidence and lessons from high-quality evaluations. Glob Health Sci Pract 2017; 5: 547–570.