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Characteristics and Outcomes of Adolescent Births in Nova Scotia: A Retrospective Cohort Study

      Abstract

      Objective

      This study sought to examine the maternal characteristics and outcomes of adolescent births in Nova Scotia.

      Methods

      The investigators conducted a retrospective population-based cohort study using the Nova Scotia Atlee Perinatal Database. Maternal characteristics and maternal and neonatal outcomes of singleton live births between 2006 and 2015 were compared between adolescent (aged 12 to 19) and adult (aged 20 to 35) women. Associations were examined using log-binomial regression models.

      Results

      Of the 35 111 births that occurred during the study period, 11% were to adolescent mothers. Compared with adult women, adolescents had higher rates of smoking and substance abuse and were of lower socioeconomic status. Adolescent mothers were more than twice as likely as women aged 20 to 35 to smoke during pregnancy. Adolescent women were significantly less likely to have gestational diabetes, need induction of labour, have an assisted vaginal delivery, require a Caesarean section, have a large-for-gestational age infant, or breastfeed at discharge compared with the 20 to 35 age group. Birth of a small-for-gestational age infant and other adverse neonatal outcomes were more frequently seen in adolescents compared with adult women in the unadjusted models, but this difference vanished in models adjusted for sociodemographic factors and smoking.

      Conclusion

      This study highlights disparities in socioeconomic characteristics and health behaviours between births in adolescent and adult mothers and suggests that a targeted multidisciplinary approach would be valuable for the pregnant adolescent. The role of antenatal support for pregnant adolescents is reinforced because sociodemographic factors and smoking accounted for differences in neonatal outcomes relative to adult women.

      Résumé

      Objectif

      Cette étude visait à examiner les caractéristiques et les issues maternelles d'adolescentes ayant donné naissance en Nouvelle-Écosse.

      Méthodologie

      Les chercheurs ont conduit une étude de cohorte rétrospective dans la population générale à l'aide de la base de données périnatales Atlee de la Nouvelle-Écosse. Ils ont comparé les caractéristiques de la mère et les issues maternelles et néonatales pour les naissances vivantes uniques survenues entre 2006 et 2015 entre les mères adolescentes (de 12 à 19 ans) et les mères adultes (de 20 à 35 ans). Les liens ont été étudiés à l'aide de modèles de régression log-binomial.

      Résultats

      Des 35 111 naissances survenues durant la période étudiée, 11 % étaient de mères adolescentes. Comparativement aux adultes, les adolescentes présentaient des taux plus élevés de tabagisme et de problèmes de consommation, et étaient de statuts socio-économiques plus faibles. Les adolescentes étaient plus de deux fois plus susceptibles de fumer durant la grossesse que les femmes de 20 à 35 ans. Le diabète gestationnel, le déclenchement du travail, l'accouchement vaginal assisté, la césarienne, les bébés grand pour l'âge gestationnel (GAG) et l'allaitement au congé étaient significativement moins fréquents chez les adolescentes que chez les femmes de 20 à 35 ans. Les issues néonatales indésirables, dont la naissance de bébés petit pour l'âge gestationnel (PAG), étaient plus fréquentes chez les adolescentes que chez les adultes selon les modèles non ajustés; cette différence disparaissait toutefois dans les modèles tenant compte des facteurs sociodémographiques et du tabagisme.

      Conclusion

      Cette étude fait ressortir les différences entre les mères adolescentes et adultes sur le plan des caractéristiques socio-économiques et des comportements relatifs à la santé, et laisse croire qu'une approche multidisciplinaire ciblée serait efficace auprès des adolescentes enceintes. L'étude souligne aussi l'importance du soutien prénatal pour les adolescentes puisque les facteurs sociodémographiques et le tabagisme étaient responsables de différences dans les issues néonatales par rapport aux adultes.

      Key Words

      Abbreviations:

      GDM (gestational diabetes mellitus), NSAPD (Nova Scotia Atlee Perinatal Database), RR (risk ratio), STI (sexually transmitted infection)
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