BACKGROUND
Although substantial efforts have been made to reduce the rates of adolescent pregnancy,
the United States continues to have higher rates than other industrialized countries.
Research and reporting usually focus on adolescents aged 15 to 19 years. Although
less common, there are pregnant young adolescents that are ≤15 years of age, with
developmental and social differences from older, high school–aged adolescents.
OBJECTIVE
Because adolescent pregnancies are of particular concern because of long-term socioeconomic
consequences to parent and child, we sought to determine whether young adolescents
(≤15 years old) had worse perinatal outcomes than older adolescents (16–19 years old)
and older parents (≥20 to 34 years old) among those living in an urban inner city.
STUDY DESIGN
This was a study of pregnant individuals who delivered a singleton pregnancy without
evidence of chronic hypertension or pregestational diabetes mellitus at a safety net
hospital from January 2010 to May 2021. Parents were grouped by age at the time of
delivery into young adolescents (≤15 years old) and older adolescents (16–19 years
old). For a comparison group, nulliparous older parents aged 20 to 34 years with singleton
pregnancies were analyzed for perinatal outcomes and compared with the adolescent
cohorts. When analyzing baseline parental characteristics, a preponderance of obesity
was noted in the young adolescent cohort. An analysis of parental characteristics
and perinatal outcomes among young adolescents with obesity vs young adolescents without
obesity ≤15 years old was performed. Statistical analysis included χ2 and Student t test with P values of <.05 considered significant. Logistic regression analysis was performed
to control for potentially confounding demographic variables.
RESULTS
Overall, 10,894 adolescent women delivered, with 868 young adolescents and 10,026
older adolescents. Pairwise comparisons showed young adolescents had a different race
distribution than older adolescents (P=.006) and older parents (P<.001). Young adolescents were more likely to be Hispanic or non-Hispanic Black (P<.001) and accessed prenatal care at a later gestational age (19.7±8.9 weeks) compared
with older adolescents (16.7±8.6 weeks) and the comparison older cohort of parents
(15.7±8.7 weeks) (P<.001) and less frequently in pregnancy (P<.001) compared with older parents. Young adolescents were more likely to have preterm
birth at <37 weeks of gestation (P<.001) and eclampsia (0.5% vs 0.1%) (P=.01) than older adolescents. Therefore, low birthweights of ≤2500 g (P=.02) and neonatal intensive care unit admission (P=.048) were also increased in adolescents. When adjusted for race, ethnicity, and
body mass index, preeclampsia with severe features (P<.001) and preterm birth at <37 weeks of gestation (P=.048) remained significant. Young adolescents with obesity were more likely to have
preeclampsia with severe features (odds ratio, 1.81; 95% confidence interval, 1.22–2.68)
and be delivered via cesarean delivery (odds ratio, 2.71; 95% confidence interval,
1.85–3.99) than adolescents without obesity.
CONCLUSION
In an urban inner city, young adolescent parents were more likely to be women of color,
have later presentations to prenatal care, and have increased rates of preterm birth.
Young adolescents had high rates of obesity, which was associated with increased rates
of hypertensive disorders of pregnancy and cesarean delivery, than adolescents without
obesity.
Key words
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Article info
Publication history
Published online: December 23, 2022
Accepted:
December 19,
2022
Received in revised form:
December 13,
2022
Received:
May 24,
2022
Footnotes
Portions of this manuscript were presented at the Society for Maternal-Fetal Medicine 42nd Annual Pregnancy Meeting Poster Session III on February 4, 2022 scheduled to be in Orlando, Florida (abstract number 860).
The authors report no conflict of interest.
Cite this article as: Ambia AM, Pruszynski JE, Fairchild E, et al. Perinatal outcomes of young adolescent pregnancies in an urban inner city. Am J Obstet Gynecol MFM 2022;XX:x.ex–x.ex.
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