Watts, Kim
(2010)
Does teenage pregnancy and childbirth really increase risk?: exploring outcomes through secondary analysis of NHS data.
PhD thesis, University of Nottingham.
Abstract
This retrospective cohort study, examined pregnancy and birth related outcomes for 32,895 births between 1st January 1992 and 31st December 2001 in two maternity units in the East Midlands.
The study compared seven outcomes in younger teenagers (<16 year), older teenagers (17-19 years) and a comparison group (20-25 year olds). The sample included 1105 births to younger teenagers, 6923 to older teenagers and 24867 to the comparative group. 14824 were to primiparous women and 18071 were to multiparous women of which 1711 births to multiparous women were rapid repeat births (<18 months of a previous birth).
Results showed that compared to those in their early 20s, primiparous teenagers had an increased risk of antepartum haemorrhage (APH) (<16, OR=1.67,95% CI 1.262 to 2.227; 17-19, OR=1.48,95% CI 1.253 to 1.751) and low Apgar score (<16, OR=1.36,95% CI 1.102 to 1.669; 17-19, OR=1.15, 95% CI 1.023 to 1.297) but were less likely to have an instrumental birth (<16, 0R=0.64,95% CI 0.499 to 0.819; 17-19, OR=0.708,95% CI 0.622 to 0.807) or perineal trauma (<16, OR=0.63,95% CI 0.534 to 0.745; 17-19, OR=0.667, 95% CI 0.608 to 0.734). Teenagers had a similar statistical risk as the comparative group for lower segment Caesarean section (LSCS), low birth weight (LBW) and premature birth.
Compared to those in their early 20s multiparous older teenagers had a reduced risk of both instrumental (OR= 0.711, 95% CI 0.555 to 0.912) and perineal trauma (OR=0.863, 95% CI 0.752 to 0.99 1) but in younger teenagers there was a similar risk. Multiparous teenagers were at an increased risk of premature birth (<16, OR=1.934,95% CI 1.153 to 3.243; 17-19, OR=1.227,95% CI 1.043 to 1.442) but for LSCS, low Apgar score and low birth weight a similar statistical risk was found as the comparative group.
When comparing multiparous teenagers with primiparous teenagers, multiparous teenagers had a reduced risk of instrumental birth (OR=0.429, 95% CI 0.339 to 0.541), perineal trauma (OR=0.668, 95% CI 0.595 to 0.750), low Apgar score (OR=0.782,95% CI 0.664 to 0.921) and LBW (OR=0.760, 95% CI 0.587 to 0.982) but an increased risk of premature birth (OR=1.269, 95% CI 1.061 to 1.517). For the remaining outcomes both primiparous and multiparous teenagers had a similar statistical risk.
Teenagers having a rapid repeat birth had a reduced risk of instrumental birth (OR=0.32, 0.110 to 0.931) but an increased risk for premature birth (OR=1.617 95% CI 1.150 to 2.272). For APH, Apgar score and LBW teenagers having a rapid repeat birth had a similar statistical risk to those who had not.
In conclusions teenagers should not be treated as a homogenous group and outcomes should be investigated separately for age groupings and parity as teenagers birth well and only APII and neonatal complications are worse in some groups of teenagers.
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