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A ONE YEAR RETROSPECTIVE REVIEW OF OUTCOMES OF TEENAGE PREGNANCYMM Faisal, S Balakrishnan, M Rouse

Obstetrics and Gynaecology Department, Penang Hospital, Penang

Objectives

WHO defines teenage pregnancy as pregnancy in women aged 10-19 years of age. We have noticed a significant increase in teenage pregnancy in our centre recently. We have thus reviewed all our teenage mothers who delivered in 2011 and looked at the outcome of the pregnancy in relation to complications to both mother and baby.

Methods

The incidence of teenage pregnancy at our centre is 15.6 per 1000 births. A total of 82 birth were recorded, of which 57.3% were Malays (47), 25.6% were Chinese (21), 7.3% were Indians (6) and 6.1% were foreigners (5). Of these patients, 65.8% (54) had late bookings, 8.5% (7) were un-booked and only 25.7% (21) were booked. The median gestation of booking was 22 weeks.

Results

The most common pregnancy related illness among teenage mothers was anaemia (Hb <10gd/l) which involved 37.8% of cases (31) followed by bronchial asthma 4.7% (4), gestational diabetes 4.6% (3 cases) hypertension 3.6% (3 cases) and intravenous drug user 1.2% (1 case). 42.6% of the female were single parents at the time of delivery while 57.4% of them were married prior to delivery. The median age of delivery was 19 years old. Most delivered via spontaneous vaginal delivery – 76.9% (63) cases with only 23.1% (19) delivered via caesarean section. This is comparatively lower than the caesarean rates for adults (age >19 years) at our centre 30.8%. The incidence of low birth weight (birth weight <2500g) is only 24.3% (20). The overall median birth weight is 2800g with the median age of 38 weeks gestation at delivery.

Conclusions

References

The incidence of teenage pregnancy is 15.6 per 1000 live births females which are higher compared to the Malaysian incidence of 12.6 per 1000 live birth¹. Of particular concern were the high rates of single parents (42.6%). This is a possible cause for late antenatal bookings. Early booking is important, especially for the detection and treatment of a certain conditions such as anaemia. Therefore it is of no surprise that this review found a high incidence of anaemia (37.8%) which is also reported in several studies ²’⁴’⁵. However there appears to be no significant increase in other pregnancy related illness (bronchial asthma, gestational diabetes, hypertension) while caesarean rates in the adolescents group also appears to be relatively lower than the adult group which is consistent with several studies ²’³’⁴’⁵’⁶. The favourable outcome with regards to low birth weight and premature delivery is however not consistent with most studies which reports a higher incidence of preterm delivery and low birth weight . In summary, the results of our review is mostly consistent with several studies done worldwide.

OPTIONALLOGO HERE

OPTIONALLOGO HERE

1. Millenium Development Goal 5, Malaysia 2005 ;Section 5.3 Adolescent birth rates

2. Osbourne GK, Howart RCL, Jordan MM. The obstetric outcome of Teenage Pregnancy. Br J Obstet Gynaecal 1981; 88: 215-221

3. Kurup A, Viegas O, Singh K, Ratnam SS. Pregnancy outcome in unmarried teenage nulligravidae in Singapore. Int Gynaecol Obstet 1989; 30:3095-311

4. Konje JC, Palmar A, Watson A, Hay DM, Imrie A. Early teenage pregnancy in Hull. Br J Obstet Gynaecal 1992; 99:969-973

5. Conally G, Kennely S, Conroy R, Byrne P. Teenage pregnancy in Rotunda Hospital. Irish Med J 1998; 91: 209-112

6. Jolly MC, Sebire N, Harris J, Robinson S, Regan N. Obstetric risk in pregnancy in women less than 18 years old Obstet Gynaecal 2000; 96: 962-966

7. Otterblad Olauson P, Cnattingius S,Haglund B. Teenage Pregnancy and risk of late fetal death and mortality. Br Obstet Gynaecol 1999; 106:116-121

8. Hediger ML, Scholl TO, Belsky DH, Ances IG, Salmon RW. Pattern of weight gain: effects of birth weight and preterm delivery. Obstet Gynaecal 1989; 74 :6-12

9. Adolescent Pregnancy. Issues in adolescent health and development, World Health Organization, 2004

We retrospectively reviewed all the mothers who delivered at the age of 19 years and below for the year 2011. A total of 82 patients were identified. We reviewed their marital status, racial distribution, timing of booking and pregnancy related complications (e.g. anaemia, hypertension, diabetes) . Finally we reviewed the gestation at delivery, mode of delivery as well as the baby’s birth weight .

Booked

Late Booking

Un-booked

0 10 20 30 40 50 60

Fig 1: Booking of antenatal cases

Fig 2: Antenatal Medical Problems in Teenage Pregnancy

IVDUHypertensionDiabetesBronchial asthmaAnaemia* We defined late bookings as pregnant

women registering at antenatal care after 14 weeks of gestation and un-booked cases as cases never being booked at the time of delivery.