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Research article
The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China
Li Wang
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2940-5461
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China.
Methods: There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10-19 years) and adult group (aged 20-34 years). The adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years), the adult group was divided into two subgroups (aged 20-24 years, aged 25-34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy.
Results: Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41-0.73). Women aged 10-19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08-1.30), stillbirth (aRR: 2.58, 95%CI: 1.83-3.62), neonatal death (aRR: 2.63, 95%CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36-9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74-15.33) compared with the women aged 25-34 years. Younger adults (20-24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20-1.32), stillbirth (aRR: 1.45, 95%CI: 1.23-1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21-1.90) compared with women aged 25-34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy.
Conclusions: The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.
Keywords
Adolescent, Pregnancy, Maternal outcomes, Perinatal outcomes
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CURRENT STATUS: Under Revision
Version 4
Posted 15 May, 2020
No community comments so far
Editorial decision: Minor revision
On 30 Apr, 2020
Editor assigned
On 29 Apr, 2020
Editor invited
On 28 Apr, 2020
Submission checks complete
On 12 Nov, 2019
No comments provided
Editorial decision: Minor revision
On 22 Apr, 2020
Review #2 received
Received 07 Apr, 2020
Review #3 received
Received 07 Apr, 2020
Reviewer #2 agreed
On 05 Apr, 2020
Reviewer #3 agreed
On 05 Apr, 2020
Review #1 received
Received 03 Apr, 2020
Reviewers invited
Invitations sent on 02 Apr, 2020
Reviewer #1 agreed
On 02 Apr, 2020
Editor assigned
On 01 Apr, 2020
Submission checks complete
On 31 Mar, 2020
Editor invited
On 31 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 12 Mar, 2020
Review #3 received
Received 09 Mar, 2020
Reviewer #4 agreed
On 04 Mar, 2020
Reviewer #3 agreed
On 10 Feb, 2020
Review #1 received
Received 05 Feb, 2020
Review #2 received
Received 05 Feb, 2020
Reviewers invited
Invitations sent on 28 Jan, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Reviewer #2 agreed
On 28 Jan, 2020
Editor assigned
On 17 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor invited
On 16 Jan, 2020
No comments provided
Editorial decision: Major revision
On 18 Dec, 2019
Review #1 received
Received 01 Dec, 2019
Review #2 received
Received 01 Dec, 2019
Reviewer #2 agreed
On 18 Nov, 2019
Reviewers invited
Invitations sent on 18 Nov, 2019
Reviewer #1 agreed
On 18 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 24 Oct, 2019
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China
Li Wang
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2940-5461
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 4
Posted 15 May, 2020
No community comments so far
Editorial decision: Minor revision
On 30 Apr, 2020
Editor assigned
On 29 Apr, 2020
Editor invited
On 28 Apr, 2020
Submission checks complete
On 12 Nov, 2019
No comments provided
Editorial decision: Minor revision
On 22 Apr, 2020
Review #2 received
Received 07 Apr, 2020
Review #3 received
Received 07 Apr, 2020
Reviewer #2 agreed
On 05 Apr, 2020
Reviewer #3 agreed
On 05 Apr, 2020
Review #1 received
Received 03 Apr, 2020
Reviewers invited
Invitations sent on 02 Apr, 2020
Reviewer #1 agreed
On 02 Apr, 2020
Editor assigned
On 01 Apr, 2020
Submission checks complete
On 31 Mar, 2020
Editor invited
On 31 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 12 Mar, 2020
Review #3 received
Received 09 Mar, 2020
Reviewer #4 agreed
On 04 Mar, 2020
Reviewer #3 agreed
On 10 Feb, 2020
Review #1 received
Received 05 Feb, 2020
Review #2 received
Received 05 Feb, 2020
Reviewers invited
Invitations sent on 28 Jan, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Reviewer #2 agreed
On 28 Jan, 2020
Editor assigned
On 17 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor invited
On 16 Jan, 2020
No comments provided
Editorial decision: Major revision
On 18 Dec, 2019
Review #1 received
Received 01 Dec, 2019
Review #2 received
Received 01 Dec, 2019
Reviewer #2 agreed
On 18 Nov, 2019
Reviewers invited
Invitations sent on 18 Nov, 2019
Reviewer #1 agreed
On 18 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 24 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China.
Methods: There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10-19 years) and adult group (aged 20-34 years). The adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years), the adult group was divided into two subgroups (aged 20-24 years, aged 25-34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy.
Results: Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41-0.73). Women aged 10-19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08-1.30), stillbirth (aRR: 2.58, 95%CI: 1.83-3.62), neonatal death (aRR: 2.63, 95%CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36-9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74-15.33) compared with the women aged 25-34 years. Younger adults (20-24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20-1.32), stillbirth (aRR: 1.45, 95%CI: 1.23-1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21-1.90) compared with women aged 25-34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy.
Conclusions: The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.
Figure 1
Figure 2
Figure 3
Figure 4