Pregnancy in Adolescence: Is It an Obstetrical Risk?
Pregnancy in Adolescence: Is It an Obstetrical Risk?
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DOI：
10.1016/j.jpag.2015.12.010
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发表时间：
2016-08-01
影响因子：
1.8
通讯作者：
Daglar, Korkut
中科院分区：
文献类型：
--
作者：
Kirbas, Ayse;Gulerman, Hacer C.;Daglar, Korkut
研究目的：青少年怀孕是世界范围内一个重要的公共卫生问题。它与母体和胎儿并发症的风险增加有关。我们的目的是调查青少年怀孕是否会增加围产期并发症的风险。我们主要关注青少年怀孕和早产之间的关系。设计、环境、参与者、干预措施和主要结果测量：我们使用了2008年1月至2009年12月期间在我院分娩的38,646名妇女的记录。该研究包括582名随机选择的怀孕少女和2920名健康胎次和体重指数匹配的20-34岁孕妇。比较两组围产儿结局。结果：初诊时青少年组和对照组的平均胎龄分别为11.2周（8 ~ 31周）和8.5周（7 ~ 28周），差异有统计学意义（P < 0.001）。早产（优势比2.46,95%可信区间1.80 ~ 3.37,P < 0.001）和先兆子痫（优势比2.14,95%可信区间1.30 ~ 3.51,P = 0.002）的风险显著高于未成年母亲。在两组中，最常见的原因是自然早产。结论：如本研究所示，与成人相比，怀孕的青少年在更早的胎龄到医院接受产前护理。在她们到医院就诊时，特别是在妊娠早期，必须建议她们接受超声波扫描以确定胎龄。因此，由于早产和早产的风险增加，在妊娠中期之后增加检查频率是合理的。
Study Objective: Adolescent pregnancy is an important public health problem worldwide. It is associated with increased risk of maternal and fetal complications. We aimed to investigate whether adolescent pregnancies have an increased risk for perinatal complications. We focused primarily on the relationship between adolescent pregnancy and preterm delivery.Design, Setting, Participants, Interventions, and Main Outcome Measures: We used records of 38,646 women who gave birth at our hospital, between January 2008 and December 2009. Five hundred eighty-two randomly selected pregnant adolescents and 2,920 healthy parity and body mass index matched pregnant women 20-34 years of age were included the study. Perinatal outcomes were compared between the groups.Results: The mean gestational ages of the adolescent and control groups at the first prenatal visit were 11.2 (range, 8-31) and 8.5 (range, 7-28) weeks, respectively (P < .001). The risks of preterm delivery (odds ratio, 2.46; 95% confidence interval, 1.80-3.37; P < .001) and preeclampsia (odds ratio, 2.14; 95% confidence interval, 1.30-3.51; P = .002) were significantly greater among the adolescent mothers. In both groups, the most frequent reason was spontaneous preterm delivery.Conclusion: As shown in this study, pregnant adolescents present to hospitals for prenatal care at a much more advanced gestational age compared with adults. At the time they present to the hospital, and particularly in the first trimester, they must be advised to undergo an ultrasound scan to determine the gestational age. As such, it would be reasonable to increase the frequency of examinations after the second trimester, because of the increased risk of preterm labor and preterm birth.