Pregnancy, birth, and neonatal complications among teenage primiparous: A Swedish population-based cohort study

To investigate pregnancy, birth, and neonatal outcomes among primiparous women below 20 years of age in Sweden between 2010 and 2022.

A nationwide cohort study, encompassing all births among primiparous below 30 years. The risk of adverse perinatal outcomes was compared among teenagers and those in the 20-29-year age group. Logistic regression was used to estimate crude and adjusted odds ratios, along with 95% confidence intervals.

In crude analyses, teenage mothers had an increased risk of placental abruption (OR 1.39, 95% CI 1.05-1.85), though this association became non-significant after adjustment (aOR 1.22, 95% CI 0.91-1.63). Teenagers had lower odds of labour induction and instrumental delivery, but an elevated risk of postpartum sepsis (OR 1.41, 95% CI 1.12-1.79). Infants of teenage mothers had higher risks of preterm birth before 34 weeks (OR 1.26, 95% CI 1.11-1.42) and before 37 weeks (OR 1.13, 95% CI 1.05-1.22). The crude risks of SGA and neonatal mortality were increased (OR 1.41, 95% CI 1.30-1.54; and OR 1.71, 95% CI 1.16-2.52) respectively, but became no longer significant after adjustments.

Teenage mothers have increased risks of preterm birth and postpartum sepsis, while the risks of most pregnancy complications are lower or comparable to those of older mothers. Continued efforts are warranted to address the social and biological vulnerabilities of teenage mothers and to ensure equitable access to high-quality perinatal care.