Adolescent pregnancy: critical review for the clinician

Adolescent pregnancy is a major health and socioeconomic problem with unique medical and psychosocial consequences for the patient and society. Consequently, it demands our attention and understanding of the problem and its causative factors. Survey data have documented that a majority of adolescents are sexually active, and that currently, almost 1 in 10 adolescents become pregnant each year. Over the last 2 decades, comprehensive adolescent pregnancy programs have shown that the high frequency of adverse obstetric and neonatal outcomes are closely associated with low socioeconomic status, poor prenatal nutrition and general health, and chemical use, but not maternal age. These adverse medical consequences and the psychosocial problem of the parents and infant are treatable with programs that adapt to the patient population and provide extensive support, education, and counseling in addition to continuity obstetric care initiated early in the pregnancy. One of the greatest needs of the adolescent is a competent and caring adult to serve as an advocate to guarantee access to medical and support services. To this end, responsible and qualified professionals who can relate to adolescents should resume this role in the coordination of a comprehensive care approach. This approach will not only reduce the medical risks associated with adolescent pregnancy, but it will decrease the number of repeat teenage pregnancies, promote school retention, increase compliance with health care regimens for the parent and child, and stimulate personal growth and development. All communities should develop programs to promote optimal medical care, psychosocial support, necessary financial support, and accessible education, since adolescent pregnancy occurs in all social, racial, ethnic, and economic groups in all parts of our country. Finally, the role of the adolescent father should be continually emphasized as a potential source of support to the adolescent mother and their infant and a stabilizer in the teenage family unit. In accord with such emphasis, recognition should be afforded to the psychologic and interpersonal needs of the adolescent father.