BMJ 2001;323:476 ( 1 September )

Papers

Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: population based retrospective cohort study

Gordon C S Smith, specialist registrar in maternal-fetal medicine, ^a Jill P Pell, consultant. ^b

^a Department of Obstetrics and Gynaecology, University of Glasgow, Queen Mother's Hospital, Glasgow G3 8SH, ^b Department of Public Health, Greater Glasgow Health Board, Glasgow G3 8YU

Correspondence to: G C S Smith, Department of Obstetrics and Gynaecology, University of Cambridge, Rosie Hospital, Cambridge CB2 2SW gcss2{at}cam.ac.uk

Objective: To determine whether first and second births among teenagers are associated with increased risk of adverse perinatal outcomes after confounding variables have been taken into account.
Design: Population based retrospective cohort study using routine discharge data for 1992-8.
Setting: Scotland.
Main outcome measures: Stillbirth, preterm delivery, emergency caesarean section, and small for gestational age baby among non-smoking mothers aged 15-19 and 20-29.
Results: The 110 233 eligible deliveries were stratified into first and second births. Among first births, the only significant difference in adverse outcomes by age group was for emergency caesarean section, which was less likely among younger mothers (odds ratio 0.5, 95% confidence interval 0.5 to 0.6). Second births in women aged 15-19 were associated with an increased risk of moderate (1.6, 1.2 to 2.1) and extreme prematurity (2.5, 1.5 to 4.3) and stillbirth (2.6, 1.3 to 5.3) but a reduced risk of emergency caesarean section (0.7, 0.5 to 1.0).
Conclusions: First teenage births are not independently associated with an increased risk of adverse pregnancy outcome and are at decreased risk of delivery by emergency caesarean section. However, second teenage births are associated with an almost threefold risk of preterm delivery and stillbirth.

What is already known on this topic Teenage mothers are more likely to deliver prematurely and to have a perinatal death than older women Teenage mothers are also more likely to smoke, be having a first baby, and live in adverse social circumstances What this study adds Non-smoking women aged 15-19 having a first birth were not at increased risk of adverse obstetric outcomes compared with women aged 20-29 after potential confounding variables were adjusted for Non-smoking women aged 15-19 having a second birth were at significantly increased risk of both premature delivery and stillbirth compared with women aged 20-29

---

© BMJ 2001
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Teenage pregnancy is not a public health problem

Debbie Lawlor, Mary Shaw, and Sarah Johns
BMJ 2001 323: 1428. [Extract] [Full Text]

Teenagers' risk of adverse events is not increased for first birth
BMJ 2001 323: 0. [Full Text]

This article has been cited by other articles:

• Chen, X.-K., Wen, S. W., Fleming, N., Demissie, K., Rhoads, G. G, Walker, M. (2007). Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol 36: 368-373 [Abstract] [Full text]  
• Peterson, W. E., Sword, W., Charles, C., DiCenso, A. (2007). Adolescents' Perceptions of Inpatient Postpartum Nursing Care. Qual Health Res 17: 201-212 [Abstract]  
• Smith, G. C., Shah, I., White, I. R, Pell, J. P, Crossley, J. A, Dobbie, R. (2006). Maternal and biochemical predictors of spontaneous preterm birth among nulliparous women: a systematic analysis in relation to the degree of prematurity. Int J Epidemiol 35: 1169-1177 [Abstract] [Full text]  
• Raatikainen, K., Heiskanen, N., Verkasalo, P. K., Heinonen, S. (2006). Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health 16: 157-161 [Abstract] [Full text]  
• Kidger, J. (2005). Stories of Redemption? Teenage Mothers as the New Sex Educators. Sexualities 8: 481-496 [Abstract]  
• Smith, G. C S, Pell, J. P, Dobbie, R. (2003). Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ 327: 313- [Abstract] [Full text]  
• Smith, G. C S, Pell, J. P, Dobbie, R. (2002). Birth order, gestational age, and risk of delivery related perinatal death in twins: retrospective cohort study. BMJ 325: 1004-1004 [Abstract] [Full text]  
• Lawlor, D., Shaw, M., Johns, S. (2001). Teenage pregnancy is not a public health problem. BMJ 323: 1428-1428 [Full text]  

Rapid Responses:

Read all Rapid Responses

Teenage pregnancy is not a public health problem

Debbie A Lawlor, et al.
bmj.com, 5 Sep 2001 [Full text]

Focus On Identifying The Teenagers At Risk Of Adverse Pregnancy Outcomes

Aubrey Cunnington
bmj.com, 16 Sep 2001 [Full text]

Online poll

Find out more >>