Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study.
Maria de Lourdes de Souza, Fiona Ann Lynn, Linda Johnston and 3 others
PMID 28403340WHAT IT FOUND
In Santa Catarina, adolescent mothers were more likely to have inadequate prenatal care, preterm birth, low birth weight and low 5-minute Apgar scores, especially mothers aged 10-14.
Early antenatal contact and closer monitoring are warranted.
Key findings
01Adolescent mothers were more likely to have fewer than seven prenatal appointments than mothers aged 20 or over, especially mothers aged 10-14 (OR: 2.40; 95% CI: 2.26-2.54; p<0.001).
02Mothers aged 10-14 had higher odds of preterm birth (13.6%; OR: 1.71; 95% CI: 1.57-1.86; p<0.001), low birth weight (OR: 1.53; 95% CI: 1.40-1.68; p<0.001) and a 5-minute Apgar score of 7 or less (OR: 1.82; 95% CI: 1.56-2.13; p<0.001) compared with mothers aged 20 or over.
03Adolescent mothers were less likely to have a caesarean section than mothers aged 20 or over: 43.2% among mothers aged 10-14, 42.1% among mothers aged 15-19, and 59.7% among mothers aged 20 or over (p<0.001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study analysed anonymised birth records, not individual patients, and did not directly recruit or consent participants. It included only live births, so miscarriages, terminations and stillbirths were not counted, which may understate the adolescent pregnancy burden. Fertility rates for mothers aged 10-14 are likely underestimated because the denominator used all females aged 10-14 rather than an estimate of exposure to childbearing. Regional fertility trends could be calculated only for 2006-2012 because regional denominator data were unavailable for 2013. The analysis reports associations by maternal age and does not show that inadequate prenatal care caused the worse outcomes.
Declared interests
The study was supported by Fundação de Amparo a Pesquisa e Inovação do Estado de Santa Catarina (FAPESC), Brazil, process #1436/2012, Termo de Outorga 13075/2012 -PPSUS 03/2012.
The easy way to misread this
Do not read the higher odds of preterm birth, low birth weight and low Apgar scores as proof that adolescent mothers are inherently at high individual risk or that inadequate prenatal care caused the differences. This study compares population-level birth records by maternal age and does not test whether any component of care changed outcomes.