Original Study| Volume 29, ISSUE 1, P18-21, February 2016

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Factors That Affect Perinatal Outcomes of the Second Pregnancy of Adolescents


      Study Objective

      We assessed factors that might affect perinatal outcomes in second pregnancies in adolescents.

      Design, Setting, Participants, Interventions, Main Outcome Measures

      This longitudinal retrospective study was carried out on 66 adolescents who experienced 2 deliveries during their adolescence. Data were collected for the first and second pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) for adverse perinatal outcomes in the second pregnancy were calculated using a logistic regression model and SPSS software (version 17.0 for Windows; SPSS Inc, Chicago, IL). A P value < .05 was considered to indicate statistical significance.


      Body mass index, number of antenatal care visits, weight gain during pregnancy, incidence of anemia, smoking status, gestational week at delivery, cesarean section rate, and birth weight were similar between the first and second pregnancies of these adolescents. Neonatal intensive care unit admission rate, preeclampsia rate, low neonatal birth weight rate, and 5-minute Apgar scores <7 were significantly higher in the first than in the second pregnancy (P < .001). Age of 16 years or younger at the time of first pregnancy (OR = 1.5; 95% CI, 0.9-2.1; P < .01), less than an 18-month interval between births (OR = 1.4; 95% CI, 0.2-1.7; P < .04), presence of gestational complications in the first pregnancy (OR = 1.9; 95% CI, 1.0-3.4; P < .01), and the presence of perinatal complications in the first pregnancy (OR = 1.3; 95% CI, 1.0-1.9; P < .01) were found to be significant indicators for adverse neonatal outcomes in second pregnancies of adolescents.


      We found that the second pregnancies of adolescents were associated with fewer adverse perinatal outcomes than were their first pregnancies. However, some factors regarding the presence of perinatal complications in the first pregnancy, such as maternal age of 16 years or younger at the time of the first pregnancy and interval between first and second pregnancy of less than 18 months, were found to increase the risk of adverse perinatal outcomes for the second births.

      Key Words

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        • Klein J.D.
        American Academy of Pediatrics Committee on Adolescent pregnancy: current trends and issues.
        Pediatrics. 2005; 116: 281
        • Mahavarkar S.H.
        • Madhu C.K.
        • Mule V.D.
        A comparative study of teenage pregnancy.
        J Obstet Gynaecol. 2008; 28: 604
        • Braine T.
        Adolescent pregnancy: a culturally complex issue.
        Bull World Health Organ. 2009; 87: 410
        • Raneri L.G.
        • Wiemann C.M.
        Social ecological predictors of repeat adolescent pregnancy.
        Perspect Sex Reprod Health. 2007; 39: 39
        • Carpenter M.W.
        • Coustan D.R.
        Criteria for screening tests for gestational diabetes.
        Am J Obstet Gynecol. 1982; 144: 768
        • American College of Obstetricians and Gynecologists Committee on Practice Bulletins and Obstetrics
        ACOG practice bulletin: diagnosis and management of pre-eclampsia and eclampsia: number 33, January 2002.
        Obstet Gynecol. 2002; 99: 159e67
        • Conde-Agudelo A.
        • Belizan J.M.
        • Lammers C.
        Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study.
        Am J Obstet Gynecol. 2005; 192: 342
        • Chen X.K.
        • Wen S.W.
        • Fleming N.
        Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study.
        Int J Epidemiol. 2007; 36: 368
        • Haldre K.
        • Rahu K.
        • Karro H.
        Is a poor pregnancy outcome related to young maternal age? A study of teenagers in Estonia during the period of major socio-economic changes (from 1992 to 2002).
        Eur J Obstet Gynecol Reprod Biol. 2007; 131: 45
        • Mahfouz A.A.
        • el-Said M.M.
        • al-Erian R.A.
        Teenage pregnancy: are teenagers a high risk group?.
        Eur J Obstet Gynecol Reprod Biol. 1995; 59: 17
        • Lawlor D.
        • Shaw M.
        • Johns S.
        Teenage pregnancy is not a public health problem.
        BMJ. 2001; 323: 1428
        • Amini S.B.
        • Catalano P.M.
        • Dierker L.J.
        Births to teenagers: trends and obstetric outcomes.
        Obstet Gynecol. 1996; 87: 668
        • Cunnington A.J.
        What's so bad about teenage pregnancy?.
        J Fam Plann Reprod Health Care. 2001; 27: 36
        • Olausson P.O.
        • Cnattingius S.
        • Haglund B.
        Does the increased risk of preterm delivery in teenagers persist in pregnancies after the teenage period?.
        BJOG. 2001; 108: 721
        • de Vienne C.M.
        • 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
        • Sawchuk L.A.
        • Burke S.D.
        • Benady S.
        Assessing the impact of adolescent pregnancy and the premarital conception stress complex on birth weight among young mothers in Gibraltar's civilian community.
        J Adolesc Health. 1997; 21: 259
        • Bai J.
        • Wong F.W.
        • Bauman A.
        Parity and pregnancy outcomes.
        Am J Obstet Gynecol. 2002; 186: 274
        • Ball S.J.
        • Pereira G.
        • Jacoby P.
        Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother.
        BMJ. 2014; 349: g4333
        • Liu X.
        • Zhang W.
        Effect of maternal age on pregnancy: a retrospective cohort study.
        Chin Med J (Engl). 2014; 127: 2241
        • Smith G.C.
        • Pell J.P.
        Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: population based retrospective cohort study.
        BMJ. 2001; 323: 476
        • Partington S.N.
        • Steber D.L.
        • Blair K.A.
        Second births to teenage mothers: risk factors for low birth weight and preterm birth.
        Perspect Sex Reprod Health. 2009; 41: 101
        • Meade C.S.
        • Ickovics J.R.
        Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy.
        Soc Sci Med. 2005; 60: 661
        • Conde-Agudelo A.
        • Rosas-Bermudez A.
        • Kafury-Goeta A.C.
        Birth spacing and risk of adverse perinatal outcomes: a meta-analysis.
        J Am J Obstet Gynecol. 2006; 295: 1809
        • Blankson M.L.
        • Cliver S.P.
        • Goldenberg R.L.
        Health behavior and outcomes in sequential pregnancies of black and white adolescents.
        JAMA. 1993; 269: 1401
        • Polit D.F.
        • Kahn J.R.
        Early subsequent pregnancy among economically disadvantaged teenage mothers.
        Am J Public Health. 1986; 76: 167
        • Furstenberg Jr., F.F.
        • Brooks-Gunn J.
        • Morgan S.P.
        Adolescent mothers and their children in later life.
        Fam Plann Perspect. 1987; 19: 142
        • Coard S.I.
        • Nitz K.
        • Felice M.E.
        Repeat pregnancy among urban adolescents: sociodemographic, family, and health factors.
        Adolescence. 2000; 35: 193