Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study

Fundación Valle Del Lili, Santiago de Cali, Valle del Cauca, Colombia
American Journal of Obstetrics and Gynecology (Impact Factor: 4.7). 03/2005; 192(2):342-9. DOI: 10.1016/j.ajog.2004.10.593
Source: PubMed


This study was undertaken to determine whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes.
We studied 854,377 Latin American women who were younger than 25 years during 1985 through 2003 using information recorded in the Perinatal Information System database of the Latin American Center for Perinatology and Human Development, Montevideo, Uruguay. Adjusted odds ratios were obtained through logistic regression analysis.
After an adjustment for 16 major confounding factors, adolescents aged 15 years or younger had higher risks for maternal death, early neonatal death, and anemia compared with women aged 20 to 24 years. Moreover, all age groups of adolescents had higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants. All adolescent mothers had lower risks for cesarean delivery, third-trimester bleeding, and gestational diabetes.
In Latin America, adolescent pregnancy is independently associated with increased risks of adverse pregnancy outcomes.

Download full-text


Available from: José M Belizán, Jan 29, 2014
  • Source
    • "The current literature on gestational diabetes mellitus (GDM) is somewhat unresolved. Several studies discussed lower rates of GDM in adolescents [13] [19] [25] [29], while others noted a significantly higher risk in teenagers [20] [30]. On the other hand, some studies found no significant difference in the risk of GDM between the different age groups [23] [24] [27] [31]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the risks and consequences of young maternal age on both the mother and the newborn. A comprehensive literature review on the risks and consequences of adolescent pregnancy was performed. Young maternal age is associated with an increased risk of maternal anemia, infections, eclampsia and preeclampsia, emergency cesarean delivery, postpartum depression and inadequate breastfeeding initiation. Infants of teenage mothers are more likely to be premature and have a low birth weight, and are at an increased risk for respiratory distress syndrome and autism later in life. Adolescent pregnancy is a prevalent phenomenon associated with increased risks of both maternal and neonatal complications during and after pregnancy. Being aware of such adverse outcomes is imperative to improving prenatal and perinatal care. Pregnancy progression can also be influenced by the mother's culture, environment, and economic status; advancement in which may be a possible course for future improvement.
    Journal of Neonatal-Perinatal Medicine 03/2015; 8(1). DOI:10.3233/NPM-15814038
  • Source
    • "In the present study, 56% of all women with eclampsia were aged 20 years or younger and 50% of all maternal deaths occurred in this age group. Overall, 85% of all births among adolescent mothers occur in low-income countries [19]. Given that adolescent pregnancy is more common in these countries and that the frequency of eclampsia is increased among teenaged girls, the incidence of eclampsia in lowincome countries is likely to be high. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe the maternal outcome among women with eclampsia with and without HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). A cross-sectional study of women with eclampsia was undertaken in 14 maternity units in Latin America between January 1 and December 31, 2012. Outcomes were compared between women with and without concomitant HELLP syndrome. Logistic regression analysis was performed to identify independent risk factors of maternal mortality. There were 196 eclampsia cases among 115 038 deliveries; 142 (72.4%) women had eclampsia alone and 54 (27.6%) women had concomitant HELLP syndrome. Severe systolic hypertension (≥160mm Hg), severe diastolic hypertension (≥110mm Hg), and hypertensive encephalopathy were significantly more common among women with HELLP than among those with eclampsia alone (P=0.01 for all). There were 8 (4.1%) maternal deaths, all in the group with HELLP syndrome, and 18 (9.1%) perinatal deaths. In a multivariate regression model, maternal mortality was significantly associated with low platelet count and severe systolic hypertension (P<0.05). Eclampsia with HELLP syndrome is a dangerous complication associated with pregnancy. Low platelet count secondary to HELLP syndrome and severe systolic hypertension were independently associated with maternal mortality from eclampsia. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
    International Journal of Gynecology & Obstetrics 02/2015; 129(3). DOI:10.1016/j.ijgo.2014.11.024 · 1.54 Impact Factor
  • Source
    • "Maternal causes constitute the leading cause of death among adolescent females [3] [11]. An analysis of data from 14 countries in Latin America for the period 1985e2003 found that girls aged under 16 years have four times higher risk of dying in pregnancy or childbirth than women aged 20e24 years [12]. Adolescent pregnancy is independently associated with increased risks of low birth weight, preterm delivery, severe neonatal conditions, and early neonatal death (because of the increased risk of preterm birth) [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in addressing adolescent sexual and reproductive health and rights. The key recommendations are to link the provision of sexuality education and sexual and reproductive health (SRH) services; build awareness, acceptance, and support for youth-friendly SRH education and services; address gender inequality in terms of beliefs, attitudes, and norms; and target the early adolescent period (10-14 years). The many knowledge gaps, however, point to the pressing need for further research on how to best design effective adolescent SRH intervention packages and how best to deliver them. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
    Journal of Adolescent Health 01/2015; 56(1 Suppl):S1-6. DOI:10.1016/j.jadohealth.2014.09.015 · 3.61 Impact Factor
Show more