Association of adverse perinatal outcomes and adolescent pregnancy at Maharat Nakhon Ratchasima Hospital

Abstract

Background: Adolescent pregnancy remains a major global public health concern and has been reported to lead to adverse maternal and neonatal outcomes.

Objective: To study perinatal outcomes, specifically preterm birth, low birth weight and birth asphyxia between adolescent and adult pregnancies.

Methods: A retrospective cohort study utilized delivery records of women aged below 35 years who delivered between January 1 and December 31, 2023. Participants were categorized as adolescent (<20 years) or adult (20–34 years). Maternal and neonatal outcomes were compared. Multivariable logistic regression was employed to identify independent factors associated with adverse neonatal outcomes.

Results: Among 4,338 singleton deliveries, 8.6% were adolescent mothers. Adolescent mothers were significantly more likely to have inadequate antenatal care and demonstrated higher rates of complications, including preterm labor pain, PPROM, chorioamnionitis, HIV, and syphilis. They also had a significantly increased stillbirth rate compared to adults. Infants born to adolescents showed significantly higher incidences of preterm birth, low birth weight (LBW), small for gestational age (SGA), birth asphyxia, neonatal jaundice, and neonatal unit admission. After controlling for confounding factors, adolescent pregnancy remained independently associated with all these adverse neonatal outcomes.

Conclusions: Adolescent pregnancy is a critical and independent risk factor for multiple adverse perinatal outcomes. The findings underscore the need for early ANC registration, targeted screening and treatment for infectious diseases, and the implementation of confidential, adolescent-friendly reproductive health services to significantly improve maternal and neonatal health in this vulnerable population.