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Abnormal adolescent primiparous pregnancy: association of race, human chorionic somatomammotropin production, and
Insights
This study on adolescent pregnancies found that smoking was linked to spontaneous abortion and fetal loss, but surprisingly less pre-eclampsia. Black mothers had higher rates of low birth weight infants compared to white mothers.
Area of Science:
- Obstetrics and Gynecology
- Adolescent Medicine
- Perinatal Research
Background:
- Adolescent pregnancies present unique challenges, with higher risks of adverse outcomes.
- Understanding racial and lifestyle factors influencing pregnancy in young women is crucial for targeted interventions.
Purpose of the Study:
- To investigate the incidence of abnormal pregnancies in a cohort of young, unmarried, primiparous women.
- To examine the impact of race, smoking, and pre-eclampsia on pregnancy outcomes and infant birth weight.
Main Methods:
- A retrospective study of 417 consecutive, unmarried, primiparous women aged 12-18 years.
- Analysis of pregnancy outcomes, including abnormal pregnancies, birth weight, and fetal loss, stratified by race and smoking status.
- Measurement of human chorionic somatomammotropin (hCS) levels to assess correlation with infant size.
Main Results:
- Black patients had significantly more infants weighing less than 2,500 grams and less weight gain during pre-eclampsia compared to white patients.
- Smoking was more prevalent in normal pregnancies and associated with spontaneous abortion and fetal loss, yet paradoxically less hypertension and pre-eclampsia.
- Lower human chorionic somatomammotropin (hCS) levels after 30 weeks' gestation were associated with smaller infants but did not reliably predict pregnancy outcome.
Conclusions:
- Race significantly influences infant birth weight and maternal weight gain in adolescent pregnancies.
- While smoking is linked to adverse pregnancy events like fetal loss, its relationship with hypertension and pre-eclampsia in this cohort is complex and warrants further investigation.
- Human chorionic somatomammotropin (hCS) levels may correlate with infant size but are not a definitive predictor of pregnancy outcome in this population.
Abstract:
Abnormal pregnancies (33 per cent) were studied in 417 consecutive, unmarried, primiparous women, age 12 to 18 years (black, 54 per cent; white, 46 per cent). Black patients had no increase in abnormal pregnancies but had more infants weighting less than 2,500 grams (p less than 0.01). Black patients with pre-eclampsia gained less weight than white patients (24 versus 34 pounds, p less than 0.05) and had smaller infants (2,834 versus 3,316 grams). In white patients, the mean age at menarche was earlier in women who lost their infants (11.0 versus 12.7 years; p less than 0.01). Smoking was more prevalent in normal pregnancies (47 per cent) than abnormal pregnancies (38 per cent). Spontaneous abortion and fetal loss occurred more often in smokers (p less than 0.01). White women smoked more than blacks (60 versus 37 per cent). In mothers of infants weighting less than 2,500 grams, there were fewer smokers. Unexpectedly, smokers had less hypertension and pre-eclampsia. Human chorionic somatomammotropin values correlated with infant size. Levels of less than 4 mug per milliliter after 30 weeks' gestation were identical in normal and abnormal pregnancies (4.4 per cent). They were associated with small infants but no fetal deaths and did not predict outcome of pregnancy.