Comparison of medical issues in antenatal and perinatal periods in early youth, adolescent, and young adult mothers in Taiwan: a 10-year nationwide study

BMC Pregnancy and Childbirth

Kuang-Hua Huang⁴  Yu-Tung Huang³  Yung-Chieh Lin²  Chun-Che Huang¹ 

[1] Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan;Department of Pediatrics, National Cheng Kung University Hospital, & Graduate Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;The Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, Taiwan;Department of Health Service Administration, China Medical University, Taichung, Taiwan

关键词: Medical issues;    Delivery;    Maternal age;    Adolescents;   

Others  :  1125718
DOI  :  10.1186/1471-2393-14-260

 received in 2014-04-15, accepted in 2014-08-01,  发布年份 2014

【 摘 要 】

Background

Limited information is available concerning investigating the separate effect of teenage childbirth on medical issues in the antenatal and perinatal periods. Therefore, this study aimed to assess medical problems in antenatal and perinatal periods among early youth, adolescent and young adult mothers in Taiwan.

Methods

This retrospective population-based cohort study was conducted by using data from Taiwan’s National Health Insurance Research Database. A total of 335,590 mothers aged less than 25 years who had singleton births were identified between 2002 and 2011. Univariate and multivariate logistic regression analyses were conducted to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) of each medical problem category in the antenatal and perinatal periods.

Results

Compared with mothers aged 20–24 years, adolescents (16–19 years) and early youth mothers (≤15 years), particularly those aged 10–15, had a significantly higher risk of intrauterine growth retardation (IUGR, OR = 1.37, 95% CI: 1.00–1.89) and preterm delivery (OR = 2.98, 95% CI: 2.48–3.58) after adjusting for demographic characteristics and clinical factors. Additionally, adolescents mothers were at an increased risk of anemia (OR = 1.32, 95% CI: 1.24–1.40), oligohydramnios (OR = 1.21, 95% CI: 1.12–1.32), failed labor induction (OR = 1.33, 95% CI: 1.24–1.43), and fetal distress (OR = 1.20, 95% CI: 1.14–1.26) after adjustment.

Conclusions

Not all young mothers in our study experienced the same magnitude of increased medical problems in the antenatal and perinatal periods. However, a sufficiently higher probability of having IUGR and preterm delivery was observed among early youth and adolescent mothers.

【 授权许可】

   
2014 Huang et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Da Silva AA, Simões VM, Barbieri MA, Bettiol H, Lamy-Filho F, Coimbra LC, Alves MT: Young maternal age and preterm birth. Paediatr Perinat Epidemiol 2003, 17:332-339.
• [2]World Health Organization (WHO): Maternal, Newborn, Child and Adolescent Health: Adolescent Pregnancy. 2012. Available from http://www.who.int/maternal_child_adolescent/topics/maternal/adolescent_pregnancy/en/index.html webcite. Accessed April 2014
• [3]Lee SH, Yen CH, Wu WY, Lee MC: A review on adolescent childbearing in Taiwan: its characteristics, outcomes and risks. Asia Pac J Public Health 2007, 19:40-42.
• [4]Sawyer SM, Afifi RA, Bearinger LH, Blakemore SJ, Dick B, Ezeh AC, Patton GC: Adolescence: a foundation for future health. Lancet 2012, 379:1630-1640.
• [5]Gibbs CM, Wendt A, Peters S, Hogue CJ: The impact of early age at first childbirth on maternal and infant health. Paediatr Perinat Epidemiol 2012, 26:259-284.
• [6]Aruda MM, McCabe M, Burke P, Litty C: Adolescent pregnancy diagnosis and outcomes: a six-year clinical sample. J Pediatr Adolesc Gynecol 2008, 21:17-19.
• [7]Chen CW, Tsai CY, Sung FC, Lee YY, Lu TH, Li CY, Ko MC: Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan. Child Care Health Dev 2010, 36:232-240.
• [8]De Vienne CM, Creveuil C, Dreyfus M: Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: a cohort study. Eur J Obstet Gynecol Reprod Biol 2009, 147:151-156.
• [9]Kongnyuy EJ, Nana PN, Fomulu N, Wiysonge SC, Kouam L, Doh AS: Adverse perinatal outcomes of adolescent pregnancies in Cameroon. Matern Child Health J 2008, 12:149-154.
• [10]Liran D, Vardi IS, Sergienko R, Sheiner E: Adverse perinatal outcome in teenage pregnancies: is it all due to lack of prenatal care and ethnicity? J Matern Fetal Neonatal Med 2012, 26:469-472.
• [11]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, 36:368-373.
• [12]Kuo CP, Lee SH, Wu WY, Liao WC, Lin SJ, Lee MC: Birth outcomes and risk factors in adolescent pregnancies: results of a Taiwanese national survey. Pediatr Int 2010, 52:447-452.
• [13]Sagili H, Pramya N, Prabhu K, Mascarenhas M, Rani PR: Are teenage pregnancies at high risk? A comparison study in a developing country. Arch Gynecol Obstet 2012, 285:573-577.
• [14]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, 192:342-349.
• [15]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.
• [16]Rocha RC, De Souza E, Soares EP, Nogueira ES, Chambô Filho A, Guazzelli CA: Prematurity and low birth weight among Brazilian adolescents and young adults. J Pediatr Adolesc Gynecol 2010, 23:142-145.
• [17]Tang CH, Wang HI, Hsu CS, Su HW, Chen MJ, Lin HC: Risk-adjusted cesarean section rates for the assessment of physician performance in Taiwan: a population-based study. BMC Public Health 2006, 6:246-254.
• [18]De Vera MA, Bérard A: Antidepressant use during pregnancy and the risk of pregnancy-induced hypertension. Br J Clin Pharmacol 2012, 74:362-369.
• [19]Schoenfisch AL, Dement JM, Rodríguez-Acosta RL: Demographic, clinical and occupational characteristics associated with early onset of delivery: findings from the Duke Health and Safety Surveillance System, 2001-2004. Am J Ind Med 2008, 51:911-922.
• [20]Henry OA, Gregory KD, Hobel CJ, Platt LD: Using ICD-9 codes to identify indications for primary and repeat cesarean sections: agreement with clinical records. Am J Public Health 1995, 85:1143-1146.
• [21]Lin HC, Sheen TC, Tang CH, Kao S: Association between maternal age and the likelihood of a cesarean section: a population-based multivariate logistic regression analysis. Acta Obstet Gynecol Scand 2004, 83:1178-1183.
• [22]Khashan AS, Baker PN, Kenny LC: Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study. BMC Pregnancy Childbirth 2010, 10:36-43.
• [23]Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV: Anaemia in low-income and middle-income countries. Lancet 2011, 378:2123-2135.
• [24]Treffers PE, Olukoya AA, Ferguson BJ, Liljestrand J: Care for adolescent pregnancy and childbirth. Int J Gynaecol Obstet 2001, 75:111-121.