The reproductive adolescent

Risks in pregnant teenagers

The teenage population delivering in Malta during 1983-1986 were identified and the maternal characteristics and obstetric outcome of these patients were statistically compared to those of mothers aged 20-29 years. Teenage mothers were more likely to be primigravida and poor attenders for antenatal care. They were more likely to be cigarette smokers and the pregnancies were more frequently complicated by threatened abortion. The perinatal mortality and morbidity was increased from problems of prematurity.

Contraception for the adolescent

The primary care physician is in an excellent position to counsel adolescents about contraception. However, an adequate understanding of the biologic and psychosocial development of this particular age-group is imperative. In addition, communication skills are necessary to advise adolescents on use of contraceptives. The goal in counseling the adolescent about sexuality is to instill a sense of sexual responsibility and to provide individualized instruction in selecting the appropriate birth control method. General factors to remember in selecting the proper method include motivation, moral-ethical responsibility, frequency of intercourse, side effects of the various contraceptive methods, and patient's preference.

Developmental and nutritional determinants of pregnancy outcome among teenagers

To investigate the determinants of low birth weight in infants born to adolescent mothers, we studied the obstetric population attended at the Maternity Hospital of Lima, Peru. From this population, 1256 gravidas, ranging in age from 12 to 25 years, volunteered to participate in this study. Anthropometric and biochemical measurements were used to evaluate the nutritional status and physiological maturity of the mother and newborn. For analytical reasons the young teenaged mothers (less than 15 years) were classified as either still-growing or having completed their growth, depending on their height relative to their parents' height. Similarly, the young teenagers were classified as either gynecologically immature or gynecologically mature depending on whether their gynecological age was less than or greater than 2 years. Our results indicate that young still-growing teenagers, even when matched for nutritional status, have smaller newborns than adult mothers. The data also demonstrate that maternal gynecological age per se does not affect prenatal growth. As inferred from multivariate analyses, it appears that the reduction in birth weight among young teenagers can be explained in part by a decreased net availability of nutrients resulting from the competition for nutrients between the mother's growth needs and the growth needs of her fetus and by an inability of the teenage placenta to maintain placental function adequately for active fetal growth.

Adolescent contraception. Review and recommendations

In the light of the increase in teenage sexual activity over the past decade, the authors review current social, psychological, and educational attitudes. Together with a summary of the legal ramifications, they provide recommendations for treatment of this patient group.

[Course of pregnancy in adolescents registered at the Prenatal Service of the Geraldo de Paula Souza Health Center, São Paulo]

Foram estudados 136 casos de gestações em mulheres abaixo de 20 anos de idade, matriculadas em um serviço de pré-natal. Foi constatada incidência significativamente mais elevada de prematuridade e de baixo peso ao nascer, quando os resultados foram comparados aos de um grupo de gestantes matriculadas no mesmo serviço, Verificou-se ainda que o "status" sócio-econômico das gestantes adolescentes foi significativamente mais baixo. A incidência de cesáreas foi, também, significativamente menor, porém houve uma incidência maior de fórceps. O peso médio do recém-nascido foi significativamente menor na população estudada e, apesar de haver uma grande maioria de primigestas entre as adolescentes, a paridade não teve influência no peso do recém-nascido.

Contraceptive counseling for the younger adolescent woman: a suggested solution to the problem

The younger adolescent woman seeking contraceptive counseling presents clinicians with special problems specific to her age group. These include long-term physiological considerations plus psychological and social dynamics. An individualized clinic program, with emphasis on backup contraceptive methods, is suggested as a comprehensive solution.

Pregnancy in Swedish teenagers. Perinatal problems and social situation

Teenage pregnancies are considered a major problem, socially and medically, in the USA. In the present study, the scope of the problem in a Swedish population was investigated. Primiparas age 17 or less constituted 2% of all 8945 women delivered of babies at the University Hospital in Linköping, 1969-72. The most common obstetrical complications and operations did not occur more often in this age group. The incidence of deliveries before the 36th gestational week was increased 3-fold but no significant differences in intra-uterine growth retardation, asphyxia or perinatal mortality were found. One to two years after the delivery, 70% of the young mothers lived in ordinary nuclear families. Their economic position was worse than in a control group of women 21-29 years old. Barely 10% reached the median income of the control group. This disadvantageous situation was not thought to be caused by their early pregnancies, but rather considered part of the life pattern of an underprivileged group otherwise characterized by a low occupational status of their own fathers, a low educational level and a high frequency of teenage pregnancy among their own mothers.