Semin Reprod Med 2022; 40(01/02): 098-106
DOI: 10.1055/s-0041-1734020
Review Article

Complications of Pregnancy in Adolescents

Logan Todhunter
1   Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
,
Megan Hogan-Roy
1   Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
,
1   Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
› Author Affiliations

Abstract

Teenage pregnancy is a complex issue that can have negative socioeconomic and health outcomes. About 11% of births worldwide are by adolescents aged between 15 and 19 years and middle- and low-income countries account for more than 90% of these births. Despite the downward trend in international adolescent pregnancy rates, 10 million unplanned adolescent pregnancies occur annually. Adolescents are also at increase risks of poor obstetric outcomes including preterm delivery, low birth weight, eclampsia, postpartum hemorrhage, anemia, and infant, as well as maternal morbidity. Important additional considerations include increased risk of depression, poor social support, and the need for a multidisciplinary approach to their obstetric care. We look to highlight both the unique socioeconomic and medical factors to consider when caring for these patients and demonstrate that these factors are intertwined.



Publication History

Article published online:
10 August 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Ganchimeg T, Ota E, Morisaki N. et al; WHO Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG 2014; 121 (Suppl. 01) 40-48
  • 2 World Health Organization. WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Health Outcomes Among Adolescents in Developing Countries. Geneva, Switzerland: World Health Organization; 2011
  • 3 Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health 2015; 56 (02) 223-230
  • 4 Malabarey OT, Balayla J, Klam SL, Shrim A, Abenhaim HA. Pregnancies in young adolescent mothers: a population-based study on 37 million births. J Pediatr Adolesc Gynecol 2012; 25 (02) 98-102
  • 5 World Health Organization. Core Competencies in Adolescent Health and Development for Primary Care Providers. Geneva, Switzerland: World Health Organization; 2015
  • 6 Hamilton BE, Martin JA, Osterman MJK. Births: Provisional Data for 2020. Vital Statistics Rapid Release; No 12. Hyattsville, MD: National Center for Health Statistics; May 2021
  • 7 United Nations Population Fund. State of World Population 1998: The New Generations. New York, NY: United Nations Population Fund; 1998
  • 8 United Nations Children's Emergency Fund. The Progress of Nations. New York, NY: United Nations Children's Emergency Fund; 1998
  • 9 World Health Organization. Adolescent Pregnancy. Geneva, Switzerland: World Health Organization; 2020
  • 10 Abdelaal H, Mohamed MA, Aly H. Racial disparity, depression, and birth outcomes among pregnant teens. Matern Child Health J 2018; 22 (10) 1400-1406
  • 11 SmithBattle LI. Reducing the stigmatization of teen mothers. MCN Am J Matern Child Nurs 2013; 38 (04) 235-241 , quiz 242–243
  • 12 Foster J, Burgos R, Tejada C. et al. A community-based participatory research approach to explore community perceptions of the quality of maternal-newborn health services in the Dominican Republic. Midwifery 2010; 26 (05) 504-511
  • 13 Trotman G, Chhatre G, Darolia R, Tefera E, Damle L, Gomez-Lobo V. The effect of centering pregnancy versus traditional prenatal care models on improved adolescent health behaviors in the perinatal period. J Pediatr Adolesc Gynecol 2015; 28 (05) 395-401
  • 14 Centering Pregnancy. Centering Healthcare Institute Inc.; Updated 2021. Accessed May 7, 2021 at: https://www.centeringhealthcare.org/what-we-do/centering-pregnancy
  • 15 World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva, Switzerland: World Health Organization; 2016
  • 16 Novick G, Sadler LS, Kennedy HP, Cohen SS, Groce NE, Knafl KA. Women's experience of group prenatal care. Qual Health Res 2011; 21 (01) 97-116
  • 17 Usta IM, Zoorob D, Abu-Musa A, Naassan G, Nassar AH. Obstetric outcome of teenage pregnancies compared with adult pregnancies. Acta Obstet Gynecol Scand 2008; 87 (02) 178-183
  • 18 Abebe AM, Fitie GW, Jember DA, Reda MM, Wake GE. Teenage pregnancy and its adverse obstetric and perinatal outcomes at Lemlem Karl Hospital, Tigray, Ethiopia, 2018. BioMed Res Int 2020; 2020: 3124847
  • 19 Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol 2007; 36 (02) 368-373
  • 20 Menacker F, Martin JA, MacDorman MF, Ventura SJ. Births to 10-14 year-old mothers, 1990-2002: trends and health outcomes. Natl Vital Stat Rep 2004; 53 (07) 1-18
  • 21 Fleming N, Ng N, Osborne C. et al. Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can 2013; 35 (03) 234-245
  • 22 Conde-Agudelo A, Belizán JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study. Am J Obstet Gynecol 2005; 192 (02) 342-349
  • 23 Phipps MG, Sowers M. Defining early adolescent childbearing. Am J Public Health 2002; 92 (01) 125-128
  • 24 Lao TT, Ho LF. The obstetric implications of teenage pregnancy. Hum Reprod 1997; 12 (10) 2303-2305
  • 25 Perry RL, Mannino B, Hediger ML, Scholl TO. Pregnancy in early adolescence: are there obstetric risks?. J Matern Fetal Med 1996; 5 (06) 333-339
  • 26 Rasheed S, Abdelmonem A, Amin M. Adolescent pregnancy in Upper Egypt. Int J Gynaecol Obstet 2011; 112 (01) 21-24
  • 27 Hidalgo LA, Chedraui PA, Chávez MJ. Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study. Arch Gynecol Obstet 2005; 271 (03) 207-211
  • 28 Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health 2006; 16 (02) 157-161
  • 29 Chen CW, Tsai CY, Sung FC. et al. Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan. Child Care Health Dev 2010; 36 (02) 232-240
  • 30 Stevens-Simon C, Barrett J, McGregor JA, French J, Persutte W. Short cervix: a cause of preterm delivery in young adolescents?. J Matern Fetal Med 2000; 9 (06) 342-347
  • 31 Bridges NA, Cooke A, Healy MJ, Hindmarsh PC, Brook CG. Growth of the uterus. Arch Dis Child 1996; 75 (04) 330-331
  • 32 Stevens-Simon C, Beach RK, McGregor JA. Does incomplete growth and development predispose teenagers to preterm delivery? A template for research. J Perinatol 2002; 22 (04) 315-323
  • 33 Cotch MF, Pastorek II JG, Nugent RP. et al; The Vaginal Infections and Prematurity Study Group. Trichomonas vaginalis associated with low birth weight and preterm delivery. Sex Transm Dis 1997; 24 (06) 353-360
  • 34 Akoh CC, Pressman EK, Cooper E, Queenan RA, Pillittere J, O'Brien KO. Prevalence and risk factors for infections in a pregnant adolescent population. J Pediatr Adolesc Gynecol 2017; 30 (01) 71-75
  • 35 Scholl TO, Hediger ML, Salmon RW, Belsky DH, Ances IG. Association between low gynaecological age and preterm birth. Paediatr Perinat Epidemiol 1989; 3 (04) 357-366
  • 36 Hediger ML, Scholl TO, Schall JI, Krueger PM. Young maternal age and preterm labor. Ann Epidemiol 1997; 7 (06) 400-406
  • 37 Committee on Practice Bulletins—Obstetrics, The American College of Obstetricians and Gynecologists. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol 2012; 120 (04) 964-973
  • 38 Zhu BP, Rolfs RT, Nangle BE, Horan JM. Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med 1999; 340 (08) 589-594
  • 39 Gestational Hypertension and Preeclampsia. ACOG Practice Bulletin, Number 222. Obstet Gynecol 2020; 135 (06) 237-260
  • 40 Leppälahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open 2013; 3 (08) e003225
  • 41 Jain LH, Van Eyk N, Woolcott C, Kuhle S. Characteristics and outcomes of adolescent births in Nova Scotia: a retrospective cohort study. J Obstet Gynaecol Can 2018; 40 (11) 1459-1465
  • 42 Althabe F, Moore JL, Gibbons L. et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: the Global Network's Maternal Newborn Health Registry study. Reprod Health 2015; 12 (Suppl. 02) S8
  • 43 Katz Eriksen JL, Melamed A, Clapp MA, Little SE, Zera C. Cesarean delivery in adolescents. J Pediatr Adolesc Gynecol 2016; 29 (05) 443-447
  • 44 Tyrberg RB, Blomberg M, Kjølhede P. Deliveries among teenage women - with emphasis on incidence and mode of delivery: a Swedish national survey from 1973 to 2010. BMC Pregnancy Childbirth 2013; 13: 204
  • 45 Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang CC, Gomez-Lobo V. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol 2016; 29 (02) 130-136
  • 46 Azevedo WF, Diniz MB, Fonseca ES, Azevedo LM, Evangelista CB. Complications in adolescent pregnancy: systematic review of the literature. Einstein (Sao Paulo) 2015; 13 (04) 618-626
  • 47 Torvie AJ, Callegari LS, Schiff MA, Debiec KE. Labor and delivery outcomes among young adolescents. Am J Obstet Gynecol 2015; 213 (01) 95.e1-95.e8
  • 48 Landy HJ, Laughon SK, Bailit JL. et al; Consortium on Safe Labor. Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. Obstet Gynecol 2011; 117 (03) 627-635
  • 49 Shveiky D, Patchen L, Chill HH, Pehlivanova M, Landy HJ. Prevalence and location of obstetric lacerations in adolescent mothers. J Pediatr Adolesc Gynecol 2019; 32 (02) 135-138
  • 50 Sekhar DL, Murray-Kolb LE, Kunselman AR, Paul IM. Identifying factors predicting iron deficiency in United States adolescent females using the ferritin and the body iron models. Clin Nutr ESPEN 2015; 10 (03) e118-e123
  • 51 Young MF, Pressman E, Foehr ML. et al. Impact of maternal and neonatal iron status on placental transferrin receptor expression in pregnant adolescents. Placenta 2010; 31 (11) 1010-1014
  • 52 Chantrapanichkul P, Chawanpaiboon S. Adverse pregnancy outcomes in cases involving extremely young maternal age. Int J Gynaecol Obstet 2013; 120 (02) 160-164
  • 53 Neal S, Mahendra S, Bose K. et al. The causes of maternal mortality in adolescents in low and middle income countries: a systematic review of the literature. BMC Pregnancy Childbirth 2016; 16 (01) 352
  • 54 Nove A, Matthews Z, Neal S, Camacho AV. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. Lancet Glob Health 2014; 2 (03) e155-e164
  • 55 Grønvik T, Fossgard Sandøy I. Complications associated with adolescent childbearing in Sub-Saharan Africa: a systematic literature review and meta-analysis. PLoS One 2018; 13 (09) e0204327