Evaluation of the dedicated teenage pregnancy service in a tertiary Obstetric unit in the Republic of Ireland from 2005-2022.

Abstract

Study objective: This study aimed to evaluate teenage pregnancy rates, outcomes, and demographic shifts from 2005 to 2022 in a large, tertiary maternity hospital with a dedicated teen pregnancy service, considering evolving ethnic profiles, changing parity, and national developments in reproductive healthcare.

Methods: Prospectively gathered data from annual reports, medical records, and the teenage pregnancy service included maternal age, ethnicity, parity, chlamydia screening, delivery mode, birth weight, and neonatal outcomes. Descriptive statistics and comparative analyses were performed.

Results: Teenage pregnancy declined from 3.3% (2005) to 1.8% (2022), mirroring national trends. However, the proportion of Roma mothers rose from 11.5% in 2015 to 43.5% in 2022. Delivery outcomes were stable, with higher spontaneous vaginal delivery rates compared to the general obstetric cohort delivering an infant >/=500g. Neonatal outcomes, including preterm birth, low birth weight, and stillbirth, remained consistently low. Despite targeted measures, attendance at the six-week postnatal clinic remained poor, signalling ongoing challenges in postpartum engagement and follow-up for this cohort overall.

Conclusions: Teenage pregnancy rates fell alongside improved contraception access, education, and socioeconomic factors. Yet, the increasing representation of Roma mothers underscores the need for culturally appropriate interventions to address healthcare inequities. Stable obstetric outcomes suggest effective antenatal care, but poor postnatal attendance highlights an area for improvement. Strengthened postpartum support and tailored services are essential to ensure optimal outcomes for teenage mothers, particularly those from marginalised ethnic backgrounds. Expanding immediate postpartum contraception services, reinforcing mental health support, and fostering community partnerships may further enhance outcomes for adolescent parents.