Characteristics and Outcomes of Adolescent Births in Nova Scotia: A Retrospective Cohort Study

This study sought to examine the maternal characteristics and outcomes of adolescent births in Nova Scotia.

The investigators conducted a retrospective population-based cohort study using the Nova Scotia Atlee Perinatal Database. Maternal characteristics and maternal and neonatal outcomes of singleton live births between 2006 and 2015 were compared between adolescent (aged 12 to 19) and adult (aged 20 to 35) women. Associations were examined using log-binomial regression models.

Of the 35 111 births that occurred during the study period, 11% were to adolescent mothers. Compared with adult women, adolescents had higher rates of smoking and substance abuse and were of lower socioeconomic status. Adolescent mothers were more than twice as likely as women aged 20 to 35 to smoke during pregnancy. Adolescent women were significantly less likely to have gestational diabetes, need induction of labour, have an assisted vaginal delivery, require a Caesarean section, have a large-for-gestational age infant, or breastfeed at discharge compared with the 20 to 35 age group. Birth of a small-for-gestational age infant and other adverse neonatal outcomes were more frequently seen in adolescents compared with adult women in the unadjusted models, but this difference vanished in models adjusted for sociodemographic factors and smoking.

This study highlights disparities in socioeconomic characteristics and health behaviours between births in adolescent and adult mothers and suggests that a targeted multidisciplinary approach would be valuable for the pregnant adolescent. The role of antenatal support for pregnant adolescents is reinforced because sociodemographic factors and smoking accounted for differences in neonatal outcomes relative to adult women.