Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America

Cross-sectional study

Conde-Agudelo, Agustin MD, MPH
Belizán, José M. MD, PhD
Lammers, Cristina MD, MPH

^aDepartment of Obstetrics and Gynecology, Fundacion Clinica Valle del Lili, Cali, Colombia
^bLatin American Center for Perinatology and Human Development (CLAP), Division of Health Promotion and Protection, Pan American Health Organization, World Health Organization, Montevideo, Uruguay

Reprints not available from the authors.

Received for publication June 1, 2004; revised October 1, 2004; accepted October 6, 2004

American Journal of Obstetrics and Gynecology 192(2):p 342-349, February 2005.

Objective

This study was undertaken to determine whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes.

Study design

We studied 854,377 Latin American women who were younger than 25 years during 1985 through 2003 using information recorded in the Perinatal Information System database of the Latin American Center for Perinatology and Human Development, Montevideo, Uruguay. Adjusted odds ratios were obtained through logistic regression analysis.

Results

After an adjustment for 16 major confounding factors, adolescents aged 15 years or younger had higher risks for maternal death, early neonatal death, and anemia compared with women aged 20 to 24 years. Moreover, all age groups of adolescents had higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants. All adolescent mothers had lower risks for cesarean delivery, third-trimester bleeding, and gestational diabetes.

Conclusion

In Latin America, adolescent pregnancy is independently associated with increased risks of adverse pregnancy outcomes.