A comparison between pregnancy outcome in women in 15 to 19 and 20 to 35 years age group

The role of maternal age on adverse pregnancy outcomes among primiparous women with singleton birth: a retrospective cohort study in urban areas of China

BACKGROUND

Both young and advanced maternal age pregnancies have strong associations with adverse pregnancy outcomes; however, there is limited understanding of how these associations present in an urban environment in China. This study aimed to analyze the associations between maternal age and pregnancy outcomes among Chinese urban women.

METHODS

We performed a population-based study consisting of 60,209 singleton pregnancies of primiparous women whose newborns were delivered after 20 weeks' gestation between January 2012 and December 2015 in urban areas of China. Participants were divided into six groups (19 or younger, 20-24, 25-29, 30-34, 35-39, 40 or older). Pregnancy outcomes include gestational diabetes mellitus (GDM), preeclampsia, placental abruption, placenta previa, premature rupture of membrane (PROM), postpartum hemorrhage, preterm birth, low birthweight, small for gestational age (SGA), large for gestational age (LGA), fetal distress, congenital microtia, and fetal death. Logistic regression models were used to assess the role of maternal age on the risk of adverse pregnancy outcomes with women aged 25-29 years as the reference group.

RESULTS

The risks of GDM, preeclampsia, placenta previa, and postpartum hemorrhage were decreased for women at a young maternal age and increased for women with advanced maternal age. Both young and advanced maternal age increased the risk of preterm birth and low birthweight. Young maternal age was also associated with increased risk of SGA (aOR 1.64, 95% CI 1.46-1.83) and fetal death (aOR 2.08, 95% CI 1.35-3.20). Maternal age over 40 years elevated the odds of placental abruption (aOR 3.44, 95% CI 1.47-8.03), LGA (aOR 1.47, 95% CI 1.09-1.98), fetal death (aOR 2.67, 95% CI 1.16-6.14), and congenital microtia (aOR 13.92, 95% CI 3.91-49.57). There were positive linear associations between maternal age and GDM, preeclampsia, placental abruption, placenta previa, PROM, postpartum hemorrhage, preterm birth, LGA and fetal distress (all P for linear trend < .05), and a negative linear association between maternal age and SGA (P for linear trend < .001). The analysis of the associations between maternal age and adverse fetal outcomes showed U-shape for preterm birth, low birth weight, SGA, fetal death and congenital microtia (all P for quadratic trend < .001).

CONCLUSIONS

Advanced maternal age predisposes women to adverse obstetric outcomes. Young maternal age manifests a bidirectional effect on adverse pregnancy outcomes. The findings may contribute to improving women's antenatal care and management.

Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy

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.