Document Detail


Reproductive outcomes in adolescents who had a previous birth or an induced abortion compared to adolescents' first pregnancies.
MedLine Citation:
PMID:  18237387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recently, attention has been focused on subsequent pregnancies among teenage mothers. Previous studies that compared the reproductive outcomes of teenage nulliparae and multiparae often did not consider the adolescents' reproductive histories. Thus, the authors compared the risks for adverse reproductive outcomes of adolescent nulliparae to teenagers who either have had an induced abortion or a previous birth.
METHODS: In this retrospective cohort study we used perinatal data prospectively collected by obstetricians and midwives from 1990-1999 (participation rate 87-98% of all hospitals) in Lower Saxony, Germany. From the 9742 eligible births among adolescents, women with multiple births, >1 previous pregnancies, or a previous spontaneous miscarriage were deleted and 8857 women <19 years remained. Of these 8857 women, 7845 were nulliparous, 801 had one previous birth, and 211 had one previous induced abortion. The outcomes were stillbirths, neonatal mortality, perinatal mortality, preterm births, and very low birthweight. Bivariate and multivariable logistic regression models were conducted.
RESULTS: In bivariate logistic regression analyses, compared to nulliparous teenagers, adolescents with a previous birth had higher risks for perinatal [OR = 2.08, CI = 1.11,3.89] and neonatal [OR = 4.31, CI = 1.77,10.52] mortality and adolescents with a previous abortion had higher risks for stillbirths [OR = 3.31, CI = 1.01,10.88] and preterm births [OR = 2.21, CI = 1.07,4.58]. After adjusting for maternal nationality, partner status, smoking, prenatal care and pre-pregnancy BMI, adolescents with a previous birth were at higher risk for perinatal [OR = 2.35, CI = 1.14,4.86] and neonatal mortality [OR = 4.70, CI = 1.60,13.81] and adolescents with a previous abortion had a higher risk for very low birthweight infants [OR = 2.74, CI = 1.06,7.09] than nulliparous teenagers.
CONCLUSION: The results suggest that teenagers who give birth twice as adolescents have worse outcomes in their second pregnancy compared to those teenagers who are giving birth for the first time. The prevention of the second pregnancy during adolescence is an important public health objective and should be addressed by health care providers who attend the first birth or the abortion and the follow-up care. Also, health care workers should attempt to improve the pregnancy outcomes of subsequent teenage pregnancies by addressing modifiable risk factors, for example, supporting smoking cessation and utilization of prenatal care.
Authors:
Birgit Reime; Beate A Schücking; Paul Wenzlaff
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-31
Journal Detail:
Title:  BMC pregnancy and childbirth     Volume:  8     ISSN:  1471-2393     ISO Abbreviation:  BMC Pregnancy Childbirth     Publication Date:  2008  
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-03-25     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  100967799     Medline TA:  BMC Pregnancy Childbirth     Country:  England    
Other Details:
Languages:  eng     Pagination:  4     Citation Subset:  IM    
Affiliation:
Faculty of Nursing and Healthcare, University of Applied Sciences of the Saarland, Goebenstr, 40, 66117 Saarbrücken, Germany. breime@nursing.ubc.ca
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced*
Adolescent
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Female
Germany
Gravidity*
Humans
Infant Mortality
Infant, Newborn
Logistic Models
Multivariate Analysis
Pregnancy
Pregnancy Outcome / epidemiology*
Pregnancy in Adolescence / statistics & numerical data*
Premature Birth / epidemiology*
Retrospective Studies
Risk Assessment
Stillbirth / epidemiology*
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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