Perinatal outcomes in adolescent pregnancies: A retrospective analysis of 3.6 million deliveries from 2000-2019 in Florida.

Study objective: We aimed to compare the risk of adverse obstetrical outcomes in adolescent deliveries to adult deliveries in Florida, and to compare the risks between younger and older teenage deliveries.

Methods: We conducted a population-based retrospective cohort study using a linked maternal-infant database of livebirths in Florida from 2000 to 2019. Demographic and clinical characteristics, and obstetric and neonatal outcomes of interest were compared by groups with 5-year intervals, using ages 25-29 as reference. Marginal standardization was used to estimate risk ratios (RR) and 95% confidence intervals (CI) representing the association between maternal age and outcomes of interest. A p-value < 0.05 was considered statistically significant.

Results: Of the 3,614,274 deliveries, adolescent pregnancy (10-19-year-olds) comprised 8.1% of deliveries. Teenage deliveries had higher rates of fetal growth restriction and low birth weight, and were less likely to have a cesarean birth, premature rupture of membranes, and adequate prenatal care. Preterm birth, respiratory distress syndrome, neonatal/infant death, and maternal sepsis were also significantly higher in teens, with highest rates among the youngest teen deliveries. Younger teens also had selectively increased risk of hypertensive disorders (HTNP).

Conclusion: Adolescent mothers are at increased risk for several obstetric and neonatal outcomes, with the youngest mothers are at highest risk of certain outcomes. These results suggest that tailoring prenatal and intrapartum care in teenage pregnancies may be warranted, however larger studies are needed to corroborate our findings.