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)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
January 19,
2018
Received:
October 11,
2017
Footnotes
Competing interests: See Acknowledgements.
Identification
Copyright
Copyright © 2018 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
