Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study
Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study
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DOI：
10.1186/1742-4755-12-s2-s8
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发表时间：
2015-01-01
影响因子：
3.4
通讯作者：
McClure, Elizabeth M.
中科院分区：
文献类型：
--
作者：
Althabe, Fernando;Moore, Janet L.;McClure, Elizabeth M.
背景：15至19岁的少女每年生育约1600万婴儿，约占全球出生人数的11%。在一项关于低资源环境下新生儿结局的前瞻性、基于人群的观察性研究中，我们试图确定与20-24岁的母亲相比，青少年母亲是否有更高的孕产妇和围产期不良结局风险。方法：我们在6个中低收入国家的7个研究中心对指定地理区域的所有孕妇进行了一项前瞻性、基于人群的多国研究（肯尼亚、赞比亚、印度、巴基斯坦、危地马拉和阿根廷）。本分析的研究人群仅限于24岁或以下的女性，其分娩的婴儿至少妊娠20周，体重500 g或以上。我们比较了15-19岁、< 15岁和20-24岁怀孕青少年的不良妊娠母体和围产期结局。结果：从2010年1月至2013年12月，共有269，273名妇女入选。在所有怀孕者中，11.9%（32 097/269 273）是15-19岁的少女，0.14%（370/269 273）是15岁以下的女孩。15-19岁少女怀孕的比例从巴基斯坦的2%到阿根廷的26%不等，15岁以下少女怀孕仅见于撒哈拉以南非洲和拉丁美洲。与成人相比，青少年并未表现出孕产妇不良后果的风险增加。早产和LBW的风险在早期和年龄较大的青少年中显着较高，< 15岁组的风险最高。撒哈拉以南非洲和拉丁美洲的新生儿和围产期死亡率也遵循类似的趋势，青少年早期的风险最高，尽管该年龄组的差异并不显着。然而，在南亚的新生儿和围产期死亡的风险是没有不同的青少年15-19岁相比adults.Conclusions：这项研究表明，青少年怀孕是不相关的更糟糕的孕产妇结局，但与更糟糕的围产期结局，特别是在年轻的青少年。然而，在南亚等地区，情况可能并非如此，在这些地区，少女怀孕率正在下降，主要集中在年龄较大的少女中。在青少年中观察到的风险增加似乎更可能与生物不成熟有关，而不是与社会经济因素、产前或分娩护理不足有关。
Background: Adolescent girls between 15 and 19 years give birth to around 16 million babies each year, around 11% of births worldwide. We sought to determine whether adolescent mothers are at higher risk of maternal and perinatal adverse outcomes compared with mothers aged 20-24 years in a prospective, population-based observational study of newborn outcomes in low resource settings.Methods: We undertook a prospective, population-based multi-country research study of all pregnant women in defined geographic areas across 7 sites in six low-middle income countries (Kenya, Zambia, India, Pakistan, Guatemala and Argentina). The study population for this analysis was restricted to women aged 24 years or less, who gave birth to infants of at least 20 weeks' gestation and 500g or more. We compared adverse pregnancy maternal and perinatal outcomes among pregnant adolescents 15-19 years, < 15 years, and adults 20-24 years.Results: A total of 269,273 women were enrolled from January 2010 to December 2013. Of all pregnancies 11.9% (32,097/269,273) were in adolescents 15-19 years, while 0.14% (370/269,273) occurred among girls < 15 years. Pregnancy among adolescents 15-19 years ranged from 2% in Pakistan to 26% in Argentina, and adolescent pregnancies < 15 year were only observed in sub-Saharan Africa and Latin America. Compared to adults, adolescents did not show increased risk of maternal adverse outcomes. Risks of preterm birth and LBW were significantly higher among both early and older adolescents, with the highest risks observed in the < 15 years group. Neonatal and perinatal mortality followed a similar trend in sub-Saharan Africa and Latin America, with the highest risk in early adolescents, although the differences in this age group were not significant. However, in South Asia the risks of neonatal and perinatal death were not different among adolescents 15-19 years compared to adults.Conclusions: This study suggests that pregnancy among adolescents is not associated with worse maternal outcomes, but is associated with worse perinatal outcomes, particularly in younger adolescents. However, this may not be the case in regions like South Asia where there are decreasing rates of adolescent pregnancies, concentrated among older adolescents. The increased risks observed among adolescents seems more likely to be associated with biological immaturity, than with socio-economic factors, inadequate antenatal or delivery care.