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Further evidence of reproductive immaturity among gynecologically young pregnant adolescents
C Stevens-Simon1, E R McAnarney
1Department of Pediatrics, University of Rochester Medical Center, New York, USA.
Objective:
To obtain further information about the reproductive maturity of adolescents who become pregnant soon after menarche. We hypothesized that the length of the follicular phase of the menstrual cycle antedating conception is related inversely to the gynecological age of the adolescent mother at conception.
Design:
Observational clinical study.
Setting:
Pregnant volunteers in a multidisciplinary adolescent-oriented maternity program.
Patients:
Pregnant adolescents with accurate pregnancy dating.
Main Outcome Measure:
We studied the difference between the estimated date of confinement (EDC) computed from the stated last menstrual period (EDCLMP) and the EDC computed from ultrasound studies (EDCUS) in a group of 66, 12 to 19 year olds. A prolonged follicular phase was defined as EDCUS-EDCLMP > 0 and shortened follicular phase was defined as EDCUS-EDCLMP < or = 0.
Results:
Pearson correlations revealed a statistically significant inverse relationship between gynecological age and the duration of the follicular phase antedating conception when the follicular phase was prolonged. Within this subgroup of patients EDCUS exceeded EDCLMP by 15.6 +/- 7.3 days when conception occurred within 3 years of menarche and 6.2 +/- 6.0 days when conception occurred > or = 3 years after menarche.
Conclusions:
Our findings support the hypothesis that some adolescents conceive before establishing a fully mature adult ovulatory pattern.