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Maternal, Obstetric and Neonatal Outcomes Across Early Adolescent, Late Adolescent and Adult Pregnancies: A
Ismail Baglar1, Fatih Sanlikan2, Esra Keles3
1Kartal City Hospital, Department of Gynecologic & Obstetric, Istanbul, Turkey.
Objective:
Adolescent pregnancy is associated with increased obstetric and neonatal risks; however, adolescents represent a heterogeneous population. This study aimed to compare maternal, obstetric, and neonatal outcomes across early adolescent, late adolescent, and adult pregnancies.
Methods:
This retrospective multicenter cohort study included deliveries recorded between January 2015 and December 2024 in two tertiary obstetric centers. Adolescent pregnancies were categorized as early adolescent (≤17 years) and late adolescent (18-19 years) and compared with adult pregnancies (20-34 years). Adult pregnancies were selected using random sampling at a 1:2 ratio to construct the analytic cohort. Maternal, obstetric, and neonatal outcomes were evaluated. Multivariable logistic regression analysis was performed to assess the independent association between maternal age groups and adverse neonatal outcomes after adjusting for potential confounders.
Results:
Among 51,750 deliveries, 3,726 adolescent pregnancies were identified (prevalence 7.2%). The final analytic cohort included 3,726 adolescent and 7,452 adult pregnancies. Adolescent pregnancies were associated with higher rates of preterm birth, low birth weight, and neonatal intensive care unit (NICU) admission compared with adult pregnancies. In adjusted analyses, early adolescent pregnancies demonstrated significantly increased risks of low birth weight, preterm birth, and NICU admission compared with adult pregnancies. Composite severe neonatal outcome rates were higher in adolescent pregnancies than in adult pregnancies. Numerically higher rates were observed among early adolescents.
Conclusion:
Adolescent pregnancies were associated with increased risks of adverse neonatal outcomes compared with adult pregnancies. Although effect estimates were numerically higher among early adolescents, direct statistical comparisons between adolescent subgroups were not performed. These findings support consideration of age-specific differences when evaluating adolescent pregnancies.
