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Universidade Federal do Estado do Rio de Janeiro – UNIRIO - Brazil

Title
Pregnancy among adolescents: a risk factor for childbirth?

Introduction
Pregnant teenagers face many of the same obstetrics issues as women in their 20s and 30s.
However, there are additional medical concerns for younger mothers, particularly those under 15
years old and those living in developing countries.
In many studies, the association of adolescents´ pregnancy with low birth weight, natimortality, small
size for gestational age, preterm birth and low Apgar score shows statistically significant results, but,
several times, the result changes when confounding variables are analyzed, such as poor health care,
low education, poverty, the use of illicit drugs and smoking.
Thus, the association between maternal age and low birth outcomes are still controversial.

Material and methods


This cohort study was conducted between January, 2001 to May, 2007 in the maternity of the
University Hospital Gaffrée and Guinle – Rio de Janeiro.
A total of 3.972 birth records were analyzed and 2.045 files with maternal age between 10 and 24
years have been selected.
The following variables were considered:
- maternal age: 45 (1,13%) early adolescents (10 - 14 yrs.), 759 (19,1%) adolescents (15 - 19 yrs.)
and 1.241 (31,24%) young adults (20 - 24 yrs.);
- gestational age: premature (20 - 36 weeks) and full-term (37 or more weeks) – average 37,62;
median 38;
- birth weight: low birth weight (500g – 2.499g) and optimal weight (≥ 2.500g);
- Apgar 1-min: low (< 7) and normal (≥ 7);
- natimortality: neonatal deaths (fetuses >500g and >20 weeks).

Results
Early adolescents – prematurity 26,31%, birth weight 22,22%, Apgar 1-min 8,33%, 1 stillbirth.
Adolescents – prematurity 17,31%, birth weight 9,90%, Apgar 1-min 13,07%, 6 stillbirths.
Young adults – prematurity 19,64%, birth weight 9,62%, Apgar 1-min 9,67%, 11 stillbirths.

Discussion
The results have showed a significantly higher risk of low birth weight among early adolescents, 35%
higher risk of low Apgar score and a trend toward protection for prematurity among adolescents.
However the P-value and the confidence interval of these associations were not statistically
significant.