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Matasariu DR, Dumitrascu I, Bujor IE, Cristofor AE, Boiculese LV, Mandici CE, Grigore M, Socolov D, Nechifor F, Ursache A. Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021. Diagnostics (Basel) 2023; 13:2186. [PMID: 37443580 DOI: 10.3390/diagnostics13132186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/10/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Although the rates of adolescent pregnancies appear to have dropped according to the World Health Organization (WHO), the decrease in the age of the first menarche and better nutrition seems to contribute to the otherwise high rate of adolescent pregnancy worldwide, despite the efforts of different organizations to improve upon this trend. We conducted a population-based retrospective cohort study from January 2015 to December 2021 using our hospitals' database. We totaled 2.954 adolescent and 6.802 adult pregnancies. First, we compared younger adolescents' outcomes with those of older adolescents, as well as with adolescents aged between 18 and 19 years old; secondly, we compared adolescent pregnancies with adult ones. We detected higher percentages of cephalo-pelvic disproportion (43.2%), cervical dystocia (20.7%), and twin pregnancy (2.7%) in underage adolescents compared with 32%, 14.1%, and 1% in older underage adolescents, respectively, and 15.3%, 3.1%, and 0.6% in older ones. As teens became older, the likelihood of malpresentations and previous C-sections rose, whereas the likelihood of vaginal lacerations declined. When comparing adolescents with adult women, we found more cases that required episiotomy (48.1% compared with 34.6%), instrumental delivery (2.1% compared with 1%), and cervical laceration (10.7% compared with 8.4%) in the adolescent group, but the rates of malpresentation (11.4% compared with 13.5%), previous C-section (13.9% compared with 17.7%), and placenta and vasa praevia (4.5.6% compared with 14%) were higher in the adult women group. Adolescent pregnancy is prone to being associated with higher risks and complications and continues to represent a challenge for our medical system.
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Affiliation(s)
- Daniela Roxana Matasariu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Irina Dumitrascu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Iuliana Elena Bujor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Alexandra Elena Cristofor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Lucian Vasile Boiculese
- Biostatistics, Department of Preventive Medicine and Interdisciplinarity, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Cristina Elena Mandici
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Mihaela Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Florin Nechifor
- Department Clinics, Faculty of Veterinary Medicine, Iasi University of Life Sciences (IULS), 700489 Iasi, Romania
| | - Alexandra Ursache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
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Hinojosa-Gonzalez DE, Ramonfaur D, Morales-Palomino KL, Tellez-Giron VC, Latapi X, Insua J, Hernández-Escobar C, Apodaca-Ramos I, Flores-Villalba E. Relationship of Age at Menarche, Coitarche and First Gestation: A Retrospective Cohort Analysis. Eur J Obstet Gynecol Reprod Biol X 2023; 18:100189. [PMID: 37095764 PMCID: PMC10121602 DOI: 10.1016/j.eurox.2023.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction Teenage pregnancy is defined as a pregnancy occurring between ages 10 and 19 (Loredo-Abdlá et al., 2017; Belitzky, 1985; Kaplanoglu et al., 2015), and is associated with increased morbidity and mortality for both mother and child. Several factors have been identified with increased risk of a teenage pregnancy, including incomplete sexual education awareness and increased exposure at a young age. In addition, an earlier onset of sexual intercourse, or coitarche, has been linked to a higher risk of teenage pregnancy. Early menarche, defined as first menstruation before the age of 12 has been previously identified as a risk factor for an earlier coitarche, possibly linking an early menarche with a higher incidence of teenage pregnancy. This study aims to compare and determine the relationship between the incidence of teenage pregnancy with early menarche and coitarche in a low income setting. Design Setting Participants Interventions Main Outcome Measures A cross sectional review of electronic records of women admitted for delivery in a second level center in northeastern Mexico, being a low-income setting, where 814 teenage and 1474 adult mothers were included. Results Primigravid teenagers had earlier menarche and coitarche than adult counterparts and opted for postpartum contraception more frequently. Linear regression analysis revealed significant unadjusted beta coefficients between age at first pregnancy and coitarche (0.839) and menarche (0.362). Menarche and coitarche had a significant linear regression association of 0.395. Conclusion We found amongst primigravid patients that teenagers had earlier menarche and coitarche than adults, which in turn correlated to their age at their first pregnancy.
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Affiliation(s)
| | - Diego Ramonfaur
- Harvard Medical School, Division of Postgraduate Medical Education, 25 Shattuck St, Boston, MA 02115, United States
| | | | | | - Ximena Latapi
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo, León 64000, Mexico
- Correspondence to: Av. Batallon de San Patricio 112, Real San Agustín, 66278 San Pedro Garza García, Mexico.
| | - Jesús Insua
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo, León 64000, Mexico
| | - Claudia Hernández-Escobar
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo, León 64000, Mexico
| | - Irasema Apodaca-Ramos
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo, León 64000, Mexico
| | - Eduardo Flores-Villalba
- Harvard Medical School, Division of Postgraduate Medical Education, 25 Shattuck St, Boston, MA 02115, United States
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Karaca SY, Adıyeke M, İleri A, İleri H, Vural T, Özmüş DN, Şimşek E, Özeren M. Identifying the Risk Factors Associated with Surgical Site Infection Following Cesarean Section in Adolescent Mothers. J Pediatr Adolesc Gynecol 2022; 35:472-477. [PMID: 35031447 DOI: 10.1016/j.jpag.2021.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/17/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE This study aimed to determine the modifiable risk factors associated with surgical site infection (SSI) after cesarean section in adolescent pregnant patients. DESIGN Retrospective case-control study SETTING: Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey PARTICIPANTS: Pregnant adolescents (≤ 19 years) who underwent cesarean section at our institution between January 2014 and March 2021 INTERVENTIONS AND MAIN OUTCOME MEASURES: To determine the modifiable and nonmodifiable risk factors associated with SSI following cesarean section in adolescents. The diagnosis of SSI was made according to the criteria defined by the Centers for Disease Control and Prevention (CDC). RESULTS SSI was diagnosed in 62 (2.9%) of 2105 adolescent mothers who underwent cesarean section. Univariate and multivariate analyses confirmed that body mass index (BMI) (OR = 2.35; 95% CI, 1.3-4.78), induction of labor (OR = 1.9; 95% CI, 1.2-3.71), and preoperative hemoglobin values less than 10 g/dl (OR = 2.1; 95% CI, 1.2-4.46) were risk factors for SSI in adolescent mothers. Patient- and operation-related risk factors did not reach the level of statistical significance. CONCLUSIONS BMI, labor induction, and antenatal anemia were independent risk factors for SSI in adolescents. Among these, BMI and anemia were modifiable patient-related risk factors. Addressing obesity in adolescents and treating prenatal anemia could be the first steps toward preventing SSI.
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Affiliation(s)
- Suna Yıldırım Karaca
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey; Ege University, Institute of Health Sciences, Department of Stem Cell, Izmir, Turkey
| | - Mehmet Adıyeke
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
| | - Alper İleri
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
| | - Hande İleri
- Alsancak State Hospital, Department of Family Medicine, Izmir, Turkey.
| | - Tayfun Vural
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
| | - Doğay Nurtaç Özmüş
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
| | - Ecem Şimşek
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
| | - Mehmet Özeren
- Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey
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Gong Y, Chai J, Yang M, Sun P, Sun R, Dong W, Li Q, Zhou D, Yu F, Wang Y, Yan X, Zhang J, Zhang Y, Jiang L, Ba Y, Zhou G. Effects of ambient temperature on the risk of preterm birth in offspring of adolescent mothers in rural henan, China. ENVIRONMENTAL RESEARCH 2021; 201:111545. [PMID: 34171374 DOI: 10.1016/j.envres.2021.111545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/20/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A number of studies have explored the association between ambient temperature and preterm birth (PTB), but rarely among adolescent mothers. OBJECTIVES To estimate the effects of ambient temperature on the risk of PTB and gestational age of newborns delivered by adolescent mothers in rural areas of Henan province. METHODS We obtained 5394 medical records of adolescent mothers with results of pre-pregnancy physical examination and pregnancy outcomes from the National Free Preconception Health Examination Project (NFPHEP) in Henan province. Meteorological information was obtained from the China Meteorological Data Sharing Service System. Individual exposure levels were evaluated with an inverse distance-weighted model. A multiple logistic regression model and multiple linear regression model were used to estimate the effects of ambient temperature on the risk of PTB and gestational age, respectively. Stratified and interaction analyses were also performed. RESULTS Of newborns in this study, 3.45% (186/5394) were PTB. Mean, maximum and minimum temperature during the entire pregnancy, especially the last 1-4 weeks of pregnancy, were positively associated with the risk of PTB and negatively associated with gestational age (P < 0.05). Nevertheless, a masking effect was observed that gestational age was positively associated with ambient temperature during the first trimester of pregnancy, due to the strongly inverse correlation between ambient temperature during the early and late stages of pregnancy. Stratified analyses showed that increasing temperature during the last 1-4 weeks of pregnancy increased the risk of PTB and decreased gestational age in newborns born in the cold season (P < 0.05). Furthermore, interaction analyses showed that birth season modified the effects of temperature on the gestational age (Pinteraction < 0.10). CONCLUSIONS Elevated ambient temperature can decrease gestational age and increase the risk of PTB in offspring of adolescent mothers in rural areas. The birth season may modify the effects of temperature on gestational age.
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Affiliation(s)
- Yongxiang Gong
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Meng Yang
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Panpan Sun
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Renjie Sun
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Wei Dong
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Qinyang Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Dezhuang Zhou
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Yuhong Wang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Xi Yan
- Department of Neurology, Henan Provincial People's Hospital; Zhengzhou University People's Hospital; Henan University People's Hospital, Zhengzhou, Henan, 450001, PR China.
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Yawei Zhang
- Department of Environment Health Science, Yale University School of Public Health, New Haven, CT, USA.
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
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Thapa P, Thapa P, Shrestha DB, Budhathoki P, Karki B, Mahat B. Teenage pregnancy and the sociodemographic attributes as a major contributor: Findings from an urban referral center in Nepal. World J Obstet Gynecol 2021; 10:16-25. [DOI: 10.5317/wjog.v10.i2.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/16/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Teenage pregnancy is a challenging issue worldwide. Yet, despite the increased health risk and socioeconomic impact of teenage pregnancy, the numbers remain high in Nepal.
AIM To determine the prevalence and sociodemographic factors associated with teenage pregnancy in Nepal.
METHODS A hospital-based cross-sectional study was conducted in the Paropakar Maternity and Women’s Hospital from April to August 2017. A total of 1359 mothers were assessed and interviewed regarding their reproductive history and sociodemographic attributes. Ethical approval from the Nepal Health Research Council, permission from the concerned hospital, and consent from study subjects were obtained.
RESULTS Of the 5526 deliveries, 679 (12.3%) were teenage pregnancy deliveries. The majority (85.1%) of mothers (out of 1359) were married at < 20 years of age, with a mean age of marriage of 17.57 years (± 1.994, range: 12-25 years). Marriage age was a significant determinant of teenage pregnancy (odds ratio [OR] 2.423 [2.262-2.596]; P < 0.001). Likewise, a love marriage (OR: 2.018 [1.585-2.570]; P < 0.001) and first teenage pregnancy (OR: 3.622 [3.265-4.017]; P < 0.001) were significant determinants for subsequent teen pregnancies. Knowledge of family planning methods (OR: 0.474; 0.288-0.779; P = 0.003) and use of any methods of family planning utilization (OR: 0.345; 0.248-0.479; P = 0.000) significantly lowered the chance of teenage pregnancy.
CONCLUSION Teenage pregnancy occupies a substantial proportion of total deliveries in the Nepalese maternity hospital. In addition, early pregnancy was significantly associated with age and type of marriage, education level, knowledge, and practice of contraceptive methods.
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Affiliation(s)
- Puja Thapa
- Department of Anesthesiology, Nepalese Army Institute of Health Sciences (NAIHS), Shree Birendra Hospital, Chhauni, Kathmandu 44600, Nepal
| | - Pukar Thapa
- Hepatology Unit (Internal Medicine), National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu 44600, Nepal
| | - Dhan Bahadur Shrestha
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL 60608, United States
| | - Pravash Budhathoki
- Department of Internal Medicine, Bronxcare Health System, Bronx, NY 10457, United States
| | - Binod Karki
- Gastroenterology Unit, Internal Medicine, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu 44600, Nepal
| | - Bimita Mahat
- Department of Obstetrics and Gynecology, Kathmandu Medical College, Sinamangal, Kathmandu 44600, Nepal
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Kohan S, Allahverdizadeh S, Farajzadegan Z, Ghojazadeh M, Boroumandfar Z. Transition into the sexual and reproductive role: a qualitative exploration of Iranian married adolescent girls' needs and experiences. Reprod Health 2021; 18:157. [PMID: 34315487 PMCID: PMC8314486 DOI: 10.1186/s12978-021-01208-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/18/2021] [Indexed: 12/02/2022] Open
Abstract
Background It is necessary to invest in married adolescent girls’ health because of their roles in promoting the community and health of the next generation. Meanwhile, there are many concerns about their sexual and reproductive health. The International Conference on Population and Development emphasized the importance of access to adolescent girls to reproductive health services and counseling. In Iran, about 24% of registered marriages are to girls under 19, while their sexual and reproductive health needs have neglected. Therefore, this study aimed to identify married adolescent girls’ reproductive and sexual needs. Methods/design Data were obtained through in-depth, semi-structured individual interviews with 36 participants, including 11 women who got married at 10 to 21 years of age, two mothers whose daughters were married in adolescence, and 23 healthcare providers and policymakers. The participants were selected through purposive sampling with maximum variation. Data collection continued until data saturation. The interviews were analyzed by qualitative content analysis. Similar codes were merged, and sub-categorization was performed, whereby similar categories were combined until the main categories that emerged. Results The results revealed five main categories: preparing for marriage, enhancing awareness and decision—making power on sexual and reproductive health issues, developing adolescent-friendly sexual and reproductive services, providing tailored pregnancy and childbirth services, and preparing adolescents for motherhood. Conclusion Adolescents step into marital life without the required life skills or physical and mental preparedness. They often become pregnant due to social pressures and lack of access to contraception. Therefore, in countries like Iran, where there is a high frequency of early marriage, families, education, and the health system should prepare the necessary foundation to support these adolescents and provide tailored and comprehensive sexual and reproductive health services. Married adolescent girls have unique sexual and reproductive health needs; however, the appropriate services have not always been provided. This was a qualitative study conducted in Iran to explore married adolescent girls’ reproductive and sexual needs. We found that married adolescent girls were not prepared for marriage and had limited awareness and decision-making power on sexual and reproductive issues. There is a need to develop adolescent-friendly sexual and reproductive services. It is essential to give tailored pregnancy and childbirth services and prepare adolescents for motherhood. Adolescents step into marital life without the required life skills and physical and mental preparedness. They do not have the proper knowledge and ability to decide on sexuality and reproductive issues. Therefore, families, education, and health system should prepare the necessary foundation to support and empower these adolescents, and provide tailored and comprehensive sexual and reproductive health services.
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Affiliation(s)
- Shahnaz Kohan
- Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shirin Allahverdizadeh
- Student Research Center, Midwifery and Reproductive Health Department, Nursing & Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Department of Community and Preventive Medicine, Medicine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Boroumandfar
- Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
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Öcal DF, Aycan Z, Dağdeviren G, Kanbur N, Küçüközkan T, Derman O. Vitamin D deficiency in adolescent pregnancy and obstetric outcomes. Taiwan J Obstet Gynecol 2020; 58:778-783. [PMID: 31759526 DOI: 10.1016/j.tjog.2019.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the rates of vitamin D deficiency in adolescent pregnants and its influence on the obstetric outcomes. MATERIALS AND METHODS A total of 300 singleton pregnant women aged between 14 and 20 years, were divided into three groups according to their gestational weeks (100 pregnant adolescents from each trimester). Randomly selected 300 singleton pregnant women older than 20 years of age with the similar gestational ages were designed as the control group at the same time period. We divided serum 25(OH)D levels into three categories deficiency, inadequacy and adequate levels according to the Endocrine Society guidelines. Serum 25(OH)D levels were also evaluated according to age, seasons and gestational periods. Adverse obstetric outcomes were recorded. RESULTS Overall, 86% of the subjects were found to have deficient 25(OH)D levels (<20 ng/ml). The levels indicated an inadequate state in 72 subjects (12%) and only 12 (2%) women had adequate 25 (OH) D levels. Among adult pregnant women the rates of deficient, inadequate and adequate levels were 88.3%, 11%, and 0.7% respectively. Among adolescent pregnant women these rates were 83.7%, 13%, and 3.3% respectively. The lowest 25(OH)D levels occurred during the winter while the highest levels were detected during the summer in both groups. Calcidiol, 25(OH)D, was a significant predictor for preterm delivery (AUC = 0,909; p < 0,001) and also for SGA (AUC = 0,915; p < 0,001). Maternal age was another significant predictor for SGA (AUC = 0,787; p < 0,001) and preterm delivery (AUC = 0,785; p < 0,001). CONCLUSION We found a high incidence of 25(OH)D deficiency in Turkish pregnant women. Adolescent age and low 25(OH)D levels are significant risk factors for PTD and SGA. Effective prophylaxis programs for vitamin D deficieny and/or fortification of foods with vitamin D are essential in pregnant women especially in the winter season.
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Affiliation(s)
- Doğa F Öcal
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
| | - Zehra Aycan
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Pediatric Endocrinology, Turkey
| | - Gülşah Dağdeviren
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey
| | - Nuray Kanbur
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Adolescent Medicine, Turkey
| | - Tuncay Küçüközkan
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey
| | - Orhan Derman
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Adolescent Medicine, Turkey
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Fory JA, Olivera MJ. Caracterización de la población gestante adolescente atendida en el Hospital Militar Central de Bogotá D.C., Colombia. 2012-2015. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n2.70818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. A pesar de que en Colombia hay una alta prevalencia de embarazos en adolescentes, aún no se han establecido los resultados obstétricos y perinatales adversos en esta población.Objetivo. Caracterizar los desenlaces obstétricos y perinatales de las gestantes adolescentes atendidas en el Hospital Militar Central de Bogotá D.C., Colombia.Materiales y métodos. Estudio observacional, retrospectivo y transversal realizado mediante la revisión de las historias clínicas de 147 gestantes adolescentes atendidas entre mayo de 2012 y diciembre de 2015 en el Hospital Militar Central de Bogotá D.C.Resultados. El promedio de edad fue 17±1.5 años; 59.8% eran estudiantes (secundaria y educación superior) y 64.6%, solteras. En cuanto a los controles prenatales, 127 (86.4%) los iniciaron tardíamente y 108 (73.5%) tuvieron menos de 4. La frecuencia general de complicaciones obstétricas fue 27.9%, entre las que se destacan los trastornos hipertensivos del embarazo (10.2%) y la amenaza de parto pretérmino (8.2%); no se presentaron muertes maternas. Por su parte, las patologías neonatales más comunes fueron ictericia neonatal (4.8%) y síndrome de dificultad respiratoria (3.4%).Conclusiones. Las complicaciones se presentaron con mayor frecuencia en las adolescentes que iniciaron los controles prenatales de forma tardía, por lo que se deben implementar estrategias para garantizar el inicio temprano de estos controles y la adherencia a los mismos. Además, es necesario evaluar el impacto de los programas de planificación familiar en esta población.
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Teenage Pregnancy: Obstetric and Perinatal Outcome in a Tertiary Centre in Indonesia. Obstet Gynecol Int 2020; 2020:2787602. [PMID: 32273894 PMCID: PMC7136788 DOI: 10.1155/2020/2787602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 02/14/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022] Open
Abstract
Background The incidence of teenage pregnancy is increasing in the world. It is a high-risk condition leading to adverse perinatal and obstetric outcomes. This study aims to evaluate the obstetric and perinatal outcomes of teenage pregnancy in Indonesian population. Method A retrospective study was conducted to evaluate obstetric and perinatal outcomes among teenagers and average maternal age (AMA) women. We assessed all singleton live pregnancies during the year period of 2013 in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. Results We studied 1,676 eligible subjects during the one-year period in our centre. The prevalence of teenage pregnancy (12 to 19 years old) was 11.40% (191/1676). We found higher prevalence of eclampsia (AOR: 4.03; 95% CI: 1.73–9.39), preterm delivery (AOR: 1.5; 95% CI: 0.88–2.53), anaemia at labour (AOR: 2.42; 95% CI: 1.60–3.67), postpartum haemorrhage (AOR: 2.59; 95% CI: 0.86–7.37), and low birth weight (AOR: 2.28; 95% CI: 1.60–3.25) among teenagers. However, caesarean section was found to be significantly lower among teenage pregnancies. Conclusion Teenage pregnancy carries significant obstetric complications that should draw physicians' serious attention. A holistic, comprehensive antenatal, and preventive program should be conducted to prevent teenage pregnancy-related adverse outcomes.
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Baş EK, Bülbül A, Uslu S, Baş V, Elitok GK, Zubarioğlu U. Maternal Characteristics and Obstetric and Neonatal Outcomes of Singleton Pregnancies Among Adolescents. Med Sci Monit 2020; 26:e919922. [PMID: 32087083 PMCID: PMC7055197 DOI: 10.12659/msm.919922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Adolescent pregnancy remains a global public health issue with serious implications on maternal and child health, particularly in developing countries The aim of this study was to investigate maternal characteristics and obstetric and neonatal outcomes of singleton pregnancies among adolescents. Material/Methods A total of 241 adolescent women who gave birth to singletons between January 2015 and December 2015 at our hospital were included in this descriptive cross-sectional study. Data on maternal sociodemographic and obstetric characteristics as well as neonatal outcome were recorded. Results Primary school education (66.0%), lack of regular antenatal care (69.7%), religious (36.7%) and consanguineous (37.0) marriage, Southeastern Anatolia hometown (34.9%) and Eastern Anatolia hometown (21.2%) were noted in most of the adolescent pregnancies, while 95% were desired pregnancies within marriage. Pregnancy complications were noted in 19.5% (preeclampsia in 5.8%) and cesarean delivery was performed in 44.8% of adolescent pregnancies. Preterm delivery rate was 27.0% (20.3% were in >34 weeks). Overall, 13.3% of neonates were admitted to neonatal intensive care unit (NICU) in the postpartum period (prematurity in 28.1%), while 25.3% were re-admitted to NICU admission in the post-discharge 1-month (hyperbilirubinemia in 55.7%). Adolescent pregnancies were associated considerably high rates of fetal distress at birth (28.7%), preterm delivery (26.9%), and re-admission to NICU after hospital discharge (25.3%). Conclusions In conclusion, our findings indicate that along with considerably high rates of poor antenatal care, maternal anemia and cesarean delivery, adolescent pregnancies were also associated with high rates for fetal distress at birth, preterm delivery, and NICU re-admission within post-discharge 1-month.
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Affiliation(s)
- Evrim Kiray Baş
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Department of Neonatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Vedat Baş
- Department of Pediatrics, Istanbul Arel University, Istanbul, Turkey
| | - Gizem Kara Elitok
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Umut Zubarioğlu
- Department of Neonatology, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
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Rexhepi M, Besimi F, Rufati N, Alili A, Bajrami S, Ismaili H. Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy. Open Access Maced J Med Sci 2019; 7:760-766. [PMID: 30962834 PMCID: PMC6447330 DOI: 10.3889/oamjms.2019.210] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/03/2019] [Accepted: 03/05/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Adolescent pregnancy, defined as a pregnancy in girls aged 10 to 19 years. Adolescent mothers are at high risk for maternal and neonatal complications. AIM To compare maternal, perinatal and neonatal outcomes in adolescents and adult women aged 20-24 years. MATERIAL AND METHODS This retrospective cohort study included all singleton pregnancies during a three-year period (January 2016-December 2018) who gave birth in a Clinical Hospital in Tetovo, Republic of Macedonia. After exclusion criteria, a total of 932 cases were reviewed and divided into two groups: one of the teenage mothers (< 19 years old) (115 women) and the other of adult mothers (20-24 years old) (817 women). RESULTS Of the total number of 5643 births, 128 (2.27%) were from adolescent pregnancies. Of them, nulliparous adolescent women were 115 (2.04%). Adolescents compare to adult mothers had a higher rate of urinary tract infections (33% vs. 22%), increased rate of maternal anemia (26% vs. 15%), preterm birth, small for gestational age newborns (25.2% vs. 17.1%), lower high school attendance (0 vs. 21.9%) and inadequate prenatal care. Spontaneous labour was more common in adolescents (73% vs 63.5%), while Caesarean sections were less common than in women aged 20-24 years (25.2% vs 33.5%). The rate of other perinatal outcomes was not significantly different between the 2 groups. CONCLUSIONS The results of the study showed that the frequencies of some maternal, perinatal and neonatal complications were considerably higher in adolescent mothers.
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Affiliation(s)
- Meral Rexhepi
- Department of Gynecology and Obstetrics, Clinical Hospital, Tetovo, Republic of Macedonia
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
| | - Florin Besimi
- Department of Gynecology and Obstetrics, Clinical Hospital, Tetovo, Republic of Macedonia
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
| | - Nagip Rufati
- Department of Gynecology and Obstetrics, Clinical Hospital, Tetovo, Republic of Macedonia
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
| | - Arian Alili
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
| | - Sani Bajrami
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
| | - Hysni Ismaili
- Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
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Abstract
Early marriages/child marriages, defined as formal marriages or informal unions before age 18, have been studied within other adolescence issues in Turkey. Adolescence pregnancies resulting from early marriages in Turkey should not be evaluated without considering the socio-cultural context. This is because this problem occurs mostly under the marriage structure even if it is too early (under the age of 18) and families approve of such marriages. The purpose of this study is to discuss adolescent pregnancies as a result of early marriages in Turkey in accordance with the socio-cultural context pertaining to the social structure of Turkey.
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Barut MU. Adölesan Gebelerin Maternal ve Fetal Sonuçlarının Değerlendirilmesi. DICLE MEDICAL JOURNAL 2018. [DOI: 10.5798/dicletip.457244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Kaya AE, Başbuğ A, Sönmez CI, Barut C, Şengün Y, Çağlar M. Late adolescent pregnancies, maternal and fetal outcomes. FAMILY PRACTICE AND PALLIATIVE CARE 2017. [DOI: 10.22391/fppc.327993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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İnalöz EY. BÖLGEMİZDEKİ ADÖLESAN GEBELİKLERİN MATERNAL VE PERİNATAL SONUÇLAR ÜZERİNE ETKİLERİNİN DEĞERLENDİRİLMESİ. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2017. [DOI: 10.17944/mkutfd.323227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Bas EK, Bulbul A, Uslu S, Bas V, Zubarioglu U. Child motherhood: the incapability remains. World J Pediatr 2017; 13:283. [PMID: 28474280 DOI: 10.1007/s12519-017-0040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Evrim Kiray Bas
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey.
| | - Ali Bulbul
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
| | - Sinan Uslu
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
| | - Vedat Bas
- Istanbul Arel University, Istanbul, Turkey
| | - Umut Zubarioglu
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
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Abstract
Neonatologists receive highly varied and largely inadequate training to acquire and maintain communication and palliative care skills. Neonatology fellows often need to give distressing news to families and frequently face unique communication challenges. While several approaches to teaching these skills exist, practice opportunities through simulation and role play will likely provide the most effective learning.
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Affiliation(s)
- Natalia Henner
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Ave, Box 36, Chicago, IL 60611-2605.
| | - Renee D Boss
- Division of Neonatology, Johns Hopkins School of Medicine, Berman Institute of Bioethics, Baltimore, MD
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Yuce T, Aker SS, Seval MM, Kalafat E, Soylemez F. Obstetric and neonatal outcomes of adolescent pregnancy. North Clin Istanb 2015; 2:122-127. [PMID: 28058352 PMCID: PMC5175089 DOI: 10.14744/nci.2015.86158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/09/2015] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE We performed a retrospective study to evaluate adolescent pregnancies as for gestational complications, and prinatal outcomes. METHODS We evaluated 341 pregnants whose data we could reach regarding gestational, and perinatal complications. RESULTS In our study group anemia (35.4%), preeclampsia/eclampsia (1.45%), premature membrane rupture (1.4%), intrauterine growth retardation (3.81%), and instrumental delivery (0.3%) were seen in indicated incidence rates. CONCLUSION In our retrospective study, we found lower our complication rates in adolescent age group when compared with the adult age group, and other studies performed in adolescents. Since our hospital is a tertiary health care institute, and we monitorized our patients closely, our incidence rates can be better than those cited in the literature. As long as proper antenatal surveillance is employed, adolescent mothers do not seem to have increased risk for most of obstetric complications.
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Affiliation(s)
- Tuncay Yuce
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seda Sahin Aker
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Murat Seval
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erkan Kalafat
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Feride Soylemez
- Department of Obstetric and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
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Kaplanoglu M, Bülbül M, Konca C, Kaplanoglu D, Tabak MS, Ata B. Gynecologic age is an important risk factor for obstetric and perinatal outcomes in adolescent pregnancies. Women Birth 2015. [PMID: 26205092 DOI: 10.1016/j.wombi.2015.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Adolescent pregnancy is an important public health problem. Physiological maturity affects obstetric and perinatal outcomes. Almost all assessments of adolescent pregnancies are based on chronological age. Gynecologic age (GA) is defined as age in years at conception minus age at menarche and it is an indicator of physiological maturity. AIM To compare obstetric and perinatal outcomes between adult and adolescent pregnancies as categorized according to GA. METHODS In this retrospective study, 233 adolescent pregnant women were divided into two groups based on GA≤3 years (101 women) and GA>3 years (132 women). Their obstetric and perinatal results were compared with 202 adult pregnancies who gave birth in the same period. FINDINGS Gestational age at delivery, APGAR scores, birth weight, and incidence of preterm birth, admission to neonatal intensive care unit (NICU), intrauterine growth restriction, low birth weight, and premature rupture of membranes were significantly different between the study groups. Compared to adolescent pregnancies with GA>3 years, adolescent pregnancies with GA≤3 years had significantly lower birth weight, gestational age, APGAR scores, and significantly higher incidence of intrauterine growth restriction, low birth weight and admission to NICU. CONCLUSION Low GA is associated with an increased rate of obstetric and perinatal complications in adolescent pregnancies. Although the main aim is the prevention of adolescent pregnancies, a detailed evaluation of such pregnancies including determination of the gynecological age together with a multidisciplinary approach may decrease potential complications.
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Affiliation(s)
- Mustafa Kaplanoglu
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey.
| | - Mehmet Bülbül
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Capan Konca
- Adiyaman University School of Medicine, Department of Pediatrics, Adiyaman, Turkey
| | - Dilek Kaplanoglu
- Adiyaman University Education and Research Hospital, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Mehmet Selcuk Tabak
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Barıs Ata
- Koç University School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J OBSTET GYNAECOL 2014; 33:346-50. [PMID: 23654312 DOI: 10.3109/01443615.2013.767786] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of the study was to analyse and compare demographic characteristics and clinical outcomes of pregnancies in adolescent, advanced age and normal reproductive age women. All completed pregnancies in a 6-month period, registered by the family practitioners in Denizli province, were included into the study. A face-to-face questionnaire was used to gather information. Participants were asked for demographic information, pregnancy outcome and obstetric history, obstetric and neonatal problems. Overall 5,882 pregnancies in different age groups: 296 (5%) adolescent (< 20-years-old); 4,957 (84.3%) normal reproductive age (20-35-years-old) and 629 (10.7%) advanced age (> 35-years-old ) (group III), were included into the study. Adolescent women had a lower educational status (p < 0.01), and family played a major role in decision of marriage (p < 0.01). Birth weight of the baby was lower in adolescents (p < 0.01). While adolescents tended to deliver vaginally (OR = 1.9, p < 0.01), elderly women were more prone to operative delivery (OR = 1.2, p < 0.05). Risk of caesarean section rate was higher in elderly nulliparous women (OR = 2.2, p 0.01). The number of spontaneous and induced abortions were increased with age (p < 0.01). Antenatal problems were seen least frequently in normal reproductive age women. Both antenatal (OR = 1.7, p < 0.01) and neonatal problems (OR = 1.5, p < 0.05), were significantly higher in advanced age pregnancy. It was concluded that with sufficient antenatal care, adolescent pregnancy is not associated with an increase in adverse pregnancy outcome, except low birth weights. Advanced maternal age is more likely to be associated with increased obstetric, maternal and neonatal complications.
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Affiliation(s)
- A Karabulut
- Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.
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Ozer E, Nacar MC, Yildirim A, Enginyurt O, Din H, Evcuman D. Underage mothers in Turkey. Med Sci Monit 2014; 20:582-6. [PMID: 24714663 PMCID: PMC3997199 DOI: 10.12659/msm.890341] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 01/22/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND All individuals under the age of 18 are considered as children by the Convention on the Rights of Children. Underage mothers are a pediatric-age group of children that become pregnant and give birth. It may be unfamiliar in Western countries, but in Middle-Eastern countries ruled by religious laws and old-fashioned traditions, it is common for an older man to marry a girl. The aim of this study was to describe the status of underage mothers within the framework of children's rights and to draw attention to this issue. We presented this study to increase awareness and sensitivity, and to scrutinize and discuss these topics. MATERIAL AND METHODS We retrospectively investigated cases of underaged pregnant girls who applied to Forensic Science Department outpatient clinics and Obstetrics and Gynecology Department outpatient clinics of Gaziosmanpasa University Faculty of Medicine between 2003 and 2013. Results We accessed records of 163 underage mothers (≤ 18 age). Mean age was 16.9 ± 0.83 (14-18 years). Gravida and parity rates increased proportionately with increasing age. Most of our cases were 16 and 17 years of age (n: 117, 71.8%). CONCLUSIONS Underage motherhood is not only a medical issue; it is a multi-dimensional problem with social, economic, traditional, religious, and legal aspects.
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Affiliation(s)
- Erdal Ozer
- Faculty of Medicine, Department of Forensic Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Mehmet Can Nacar
- Faculty of Medicine, Department of Gynecology and Obstetrics, Gaziosmanpasa University, Tokat, Turkey
| | - Ali Yildirim
- Faculty of Medicine, Department of Forensic Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Ozgur Enginyurt
- Department of Family Medicine, Ordu University, Ordu, Turkey
| | - Hasan Din
- Department of Forensic Medicine, Council of Forensic Medicine Kayseri, Kayseri, Turkey
| | - Durmus Evcuman
- Department of Forensic Medicine, Council of Forensic Medicine Istanbul, Istanbul, Turkey
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Bildircin FD, Kurtoglu E, Kokcu A, Işik Y, Ozkarci M, Kuruoglu S. Comparison of perinatal outcome between adolescent and adult pregnancies. J Matern Fetal Neonatal Med 2013; 27:829-32. [DOI: 10.3109/14767058.2013.829816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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23
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Liran D, Vardi IS, Sergienko R, Sheiner E. Adverse perinatal outcome in teenage pregnancies: is it all due to lack of prenatal care and ethnicity? J Matern Fetal Neonatal Med 2012; 26:469-72. [DOI: 10.3109/14767058.2012.738262] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Uzun AK, Orhon FS, Baskan S, Ulukol B. A comparison between adolescent mothers and adult mothers in terms of maternal and infant outcomes at follow-ups. J Matern Fetal Neonatal Med 2012; 26:454-8. [PMID: 23020604 DOI: 10.3109/14767058.2012.733748] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the risk factors of adolescent pregnancies and to ascertain the effects of this condition on the maternal and infant outcomes. METHODS The study was carried out on 100 adolescent mothers less than 20 years of age and on a same number of adult mothers between 22 and 32 years of age and their infants. A socio-demographic attributes questionnaire form, a pregnancy follow-up and birth history form, and a mother and infant follow-up form were used. RESULTS The mean age of the adolescent mothers was 17.8 ± 0.7 years and that of the adult mothers was 26 ± 0.3 years. Income level of 83% of the families of adolescent mothers and 69% of the families of adult mothers was below the poverty line (p < 0.05). Dropout rate (i.e. rate of those not attending any school) was 36% in the adolescent group and 21% in the adult group. Rate of exclusively breastfeeding during the first 2 months was 40% in adolescents and 62% in adults (p < 0.01). Higher rates of adolescent mothers felt themselves inadequate infant care and with 7% of them experiencing problems in accessing a healthcare institution. CONCLUSIONS Properly following up adolescent pregnancies during prenatal and postnatal periods may be helpful for preventing the negative impacts on mother and infant health.
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Affiliation(s)
- Aysun Kara Uzun
- Department of Pediatrics, Etlik Zubeyde Hanim Gynecology and Obstetrics Education and Research Hospital, Ankara, Turkey
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Vieira CL, Coeli CM, Pinheiro RS, Brandão ER, Camargo KR, Aguiar FP. Modifying effect of prenatal care on the association between young maternal age and adverse birth outcomes. J Pediatr Adolesc Gynecol 2012; 25:185-9. [PMID: 22297275 DOI: 10.1016/j.jpag.2011.12.070] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 12/15/2011] [Accepted: 12/19/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objectives were to investigate the prevalence of adverse birth outcomes according to maternal age range in the city of Rio de Janeiro, Brazil, in 2002, and to evaluate the association between maternal age range and adverse birth outcomes using additive interaction to determine whether adequate prenatal care can attenuate the harmful effect of young age on pregnancy outcomes. METHODS A cross-sectional analysis was performed in women up to 24 years of age who gave birth to live children in 2002 in the city of Rio de Janeiro. To evaluate adverse outcomes, the exposure variable was maternal age range, and the outcome variables were very preterm birth, low birth weight, prematurity, and low 5-minute Apgar score. The presence of interaction was investigated with the composite variable maternal age plus prenatal care. The proportions and respective 95% confidence intervals were calculated for adequate schooling, delivery in a public maternity hospital, and adequate prenatal care, and the outcomes according to maternal age range. The chi-square test was used. The association between age range and birth outcomes was evaluated with logistic models adjusted for schooling and type of hospital for each prenatal stratum and outcome. Attributable proportion was calculated in order to measure additive interaction. RESULTS Of the 40,111 live births in the sample, 1.9% corresponded to children of mothers from 10-14 years of age, 38% from 15-19 years, and 59.9% from 20-24 years. An association between maternal age and adverse outcomes was observed only in adolescent mothers with inadequate prenatal care, and significant additive interaction was observed between prenatal care and maternal age for all the outcomes. CONCLUSION Adolescent mothers and their newborns are exposed to greater risk of adverse outcomes when prenatal care fails to comply with current guidelines.
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Affiliation(s)
- C L Vieira
- Institute of Studies of Public Health, Federal University of Rio de Janeiro, Praça Jorge Machado Moreira - Ilha do Fundão - Cidade Universitária da UFRJ, Rio de Janeiro.
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Thaithae S, Thato R. Obstetric and perinatal outcomes of teenage pregnancies in Thailand. J Pediatr Adolesc Gynecol 2011; 24:342-6. [PMID: 22099731 DOI: 10.1016/j.jpag.2011.02.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Revised: 02/08/2011] [Accepted: 02/15/2011] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To determine whether, when controlling for confounding factors, there was still an association of adolescence with adverse outcomes. DESIGN Retrospective case control study. SETTING Seven Bangkok Metropolitan Administration General Hospitals. PARTICIPANTS Charts of all women aged 19 and younger (n = 1,354) having singleton live births in 2004, 2005, and 2006 were retrieved. For the adult group, 1,389 charts of mothers between the ages of 20 and 34 delivering singleton babies were selected using proportionate systematic random sampling. Maternal age was divided into 3 groups: 11-15, 16-19, and 20-34. MAIN OUTCOME MEASURES Obstetric and perinatal outcomes. RESULTS After statistically controlling for known confounding factors, teenage pregnancy was associated with increased risks of anemia (11-15: AOR = 1.81, P < 0.001; 16-19: AOR = 1.48, P < 0.01), very preterm deliveries (11-15: AOR = 2.18, P < 0.05), very low birth weight babies (11-15: AOR = 6.98, P < 0.05; 16-19: AOR = 9.86, P < 0.01), newborn admission to Intensive Care Unit (11-15: AOR = 1.93, P < 0.01; 16-19: AOR = 2.10, P < 0.01), and postpartum complications (11-15: AOR = 3.33, P < 0.01). The rates of cesarean delivery (11-15: AOR 0.58, P < 0.01; 16-19: AOR = 0.57, P < 0.01), operative delivery (11-15: AOR = 0.49, P < 0.01), and oxytocin augmentation (16-19: AOR = 0.66, P < 0.01) were less frequent in younger mothers. CONCLUSION Independent of known confounding factors, teenage pregnancy was associated with increased risks of adverse maternal and neonatal outcomes requiring clinical and outreach interventions from health care providers.
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Affiliation(s)
- Suparp Thaithae
- Department of Obstetrics and Gynecology Nursing, Kuakarun College of Nursing, Dusit, Bangkok, Thailand
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Neves Filho ADC, Leite ÁJM, Bruno ZV, Gomes B. Filho J, Silva CFD. Gravidez na adolescência e baixo peso ao nascer: existe associação? REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJETIVO: Verificar a associação entre gravidez na adolescência (dez a 19 anos) e baixo peso ao nascer. MÉTODOS: Estudo transversal realizado em maternidade terciária entre junho de 2000 a junho de 2001. Por sorteio aleatório simples, foram selecionadas mães adolescentes e não adolescentes entrevistadas no primeiro dia após o parto. Aplicou-se a análise multivariada por meio de regressão logística das variáveis implicadas com o baixo peso ao nascer. RESULTADOS: Foram selecionadas 539 duplas (mães e seus respectivos recém-nascidos), sendo 331 (61,4%) mulheres com 20 anos ou mais e 208 (38,5%) abaixo de 20 anos. Entre as adolescentes, 50 bebês (24%) tiveram idade gestacional <37 semanas, enquanto entre as mães acima de 20 anos, 52 (15,7%) eram prematuros (OR 1,58; IC95% 1,00-2,51). Entre as adolescentes, ocorreram 52 (25%) recém-nascidos com peso <2500g e, entre as adultas, 56 (16,9%) tinham baixo peso (OR 1,64; IC95% 1,05-2,56). Entre as que realizaram pré-natal adequado, a ocorrência de baixo peso foi de 12,3% e de 22,1% no grupo cuja assistência foi inadequada. Nesta casuística, a associação encontrada na análise univariada entre baixo peso e mãe adolescente não se manteve na análise multivariada. CONCLUSÕES: Baixo peso ao nascer em gestações na adolescência não pode ser atribuído isoladamente à idade materna.
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Shrim A, Ates S, Mallozzi A, Brown R, Ponette V, Levin I, Shehata F, Almog B. Is young maternal age really a risk factor for adverse pregnancy outcome in a canadian tertiary referral hospital? J Pediatr Adolesc Gynecol 2011; 24:218-22. [PMID: 21620742 DOI: 10.1016/j.jpag.2011.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 02/06/2011] [Accepted: 02/15/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the risk of adverse pregnancy outcome among teenage mothers within a large tertiary referral center in Canada. METHODS All nulliparous singleton births in the McGill University Health Centre during 2001-2007 were retrieved using the "MOND" database. Patients were divided according to maternal age: <20 years (teenage), and between 20 and 39 years. Obstetric and neonatal complications were compared. RESULTS 9744 nulliparous women were included; 250 (2.6%) were teenage and 9494 (97.4%) were 20-39 years old. Teenage mothers tended to deliver earlier (38.0 vs 39.2 weeks gestation, P < 0.001) and had higher rates of extreme prematurity (OR 4.5, 95% CI 2.5-8.1). Babies of teenage mothers had lower birth weights (3014 g vs 3326 g, P < 0.001), higher rates of NICU admission (OR 2.1, 95% CI 1.5-3.0), congenital anomalies (OR 1.8, 95% CI 1.2-2.6) and combined perinatal and neonatal mortality (OR 3.8, 95% CI 1.9-7.5). Logistic regression analysis showed an association between young maternal age and the risk to have at least one adverse outcome (P < 0.001). CONCLUSIONS Even within a large tertiary referral hospital, teenage mothers carry a greater risk of adverse pregnancy outcome, mainly due to preterm births.
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Affiliation(s)
- Alon Shrim
- Department of Obstetrics and Gynaecology, McGill University - Royal Victoria Hospital, Montreal, Quebec, Canada.
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Sandal G, Erdeve O, Oguz SS, Uras N, Akar M, Dilmen U. The admission rate in neonatal intensive care units of newborns born to adolescent mothers. J Matern Fetal Neonatal Med 2011; 24:1019-21. [DOI: 10.3109/14767058.2010.545905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tasci Y, Demir B, Sipahioglu H, Erkaya S. Caesarean delivery rates in Turkish adolescents. J OBSTET GYNAECOL 2010; 30:594-5. [DOI: 10.3109/01443615.2010.486088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kuo CP, Lee SH, Wu WY, Liao WC, Lin SJ, Lee MC. Birth outcomes and risk factors in adolescent pregnancies: results of a Taiwanese national survey. Pediatr Int 2010; 52:447-52. [PMID: 19863752 DOI: 10.1111/j.1442-200x.2009.02979.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study explores birth outcomes and determinants in adolescent pregnancies, using subjects drawn from the Taiwan Birth Cohort Study (TBCS) from 2005. METHODS Through completed interviews and surveys with mothers or other family members, differences in birth outcomes and personal, pregnancy and social profiles of mothers were analyzed. RESULTS A total of 533 adolescent mothers (<20 years old) and 9347 adult mothers (20-34 years old) were included in our study. There was a significantly higher incidence of low birthweight (LBW) (<2500 g, 10.2% vs 5.6%) and premature birth (<37 weeks, 14.8% vs 8.6%) in the adolescent group. When adjusted for covariates in the multiple-variable model, youth remained a risk factor for LBW (OR = 1.50, 95%CI 1.09, 2.07) and premature delivery (OR = 1.42, 95%CI 1.07, 1.89). Age, prenatal care and weight gain during pregnancy are important predictors of LBW and premature birth. CONCLUSION Adolescent pregnancy carries a high-risk of LBW and premature birth. Inadequate prenatal care and weight gain during pregnancy are contributing factors that could be improved through strategies of health education, family support and case management.
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Affiliation(s)
- Ching-Pyng Kuo
- School of Nursing, Institute of Medicine, Chun Shan Medical University, Taichung, Taiwan
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Current world literature. Curr Opin Pediatr 2009; 21:553-60. [PMID: 19622920 DOI: 10.1097/mop.0b013e3283300b10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dilbaz B, Yildirim BA, Yildirim D, Turgal M, Cengiz H, Dilbaz S. Do contraceptive choices of Turkish married adolescents differ from those of older women? EUR J CONTRACEP REPR 2007; 13:71-6. [PMID: 17886155 DOI: 10.1080/13625180701617589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare contraceptive choices of Turkish married adolescents to those of women of reproductive age and perimenopausal women. METHODS Demographic variables, fertility goals and contraceptive choices of adolescents (Group A, n = 95) were compared with those of women of reproductive age (Group B, n = 5224) and perimenopausal women (Group C, n = 2208). RESULTS All women in the study group were married and had delivered at least once. A past history of voluntary terminations of pregnancy (TOPs) was reported often, although significantly less so by adolescents (43.1%) than by women belonging to the other two groups (66.5 and 77.4%, respectively). The percentage of women who applied no contraception was significantly higher in Group A (p < 0.05). The rate of use of withdrawal, oral contraceptives and intrauterine devices did not differ significantly between the three groups. The percentage of women who were indecisive about future pregnancy or wanted to have more children was greatest in Group A (87.4, 46.9 and 25.7%, respectively; p < 0.05). CONCLUSION The distribution of contraceptive methods used was similar among the three age groups, but the absence of contraception was most frequent in the adolescent group. The adolescents we assessed, being married and having delivered at least once, are a highly selected group and not representative of adolescents in general. Nevertheless, their contraceptive choices did not differ from those of older women. The incidence of TOPs among them was quite high. Minimization of the frequent neglect of application of contraceptive measures by adolescents requires improvement of family planning services for this age group.
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Affiliation(s)
- B Dilbaz
- Ministry of Health Ankara Etlik Maternity and Women's Health Research and Teaching Hospital, Ankara, Turkey.
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Aum JA, Jung HJ, Huh JW, Hong SY. Factors influencing birth weight premature infants. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.10.954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ji A Aum
- Department of Pediatrics, Il Sin Christian Hospital, Busan, Korea
| | - Hee Jin Jung
- Department of Pediatrics, Il Sin Christian Hospital, Busan, Korea
| | - Jae Won Huh
- Department of Pediatrics, Il Sin Christian Hospital, Busan, Korea
| | - Su Young Hong
- Department of Pediatrics, Il Sin Christian Hospital, Busan, Korea
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