Births to teenagers: trends and obstetric outcomes.

OBJECTIVE: To compare the trends and obstetric outcomes of pregnancy in teenage women with those of adult women. METHODS: We analyzed a 19-year (1975-1993) computerized perinatal data base with data on 69,096 births collected prospectively from a single inner-city tertiary medical center. RESULTS: Of all the births, 1875, (2.7%) were to teenagers 12-15 years old and 17,359 (25.3%) were to teenagers 16-19 years old. Over the study period, the number and proportion of births to teenagers of both age groups declined (P < .001 in both cases). The proportions of teenagers 12-15 and 16-19 years old were highest among blacks (4.1% and 28.1%, respectively), followed by Hispanics (2.4%, 24.7%) and whites (1.6%, 23.1%). More than 95% of teenagers had no private health insurance coverage (staff), significantly higher than the 81.6% of mothers aged 20 years or older (P < .001). More than 8.1% of teenagers 12-15 years old had two or fewer prenatal care visits, significantly higher than 6.8% for teenagers 16-19 years old and 7.1% for adults (P < .001). The average gestational age and birth weight were significantly lower for teenagers 12-15 years old compared with those 16-19 years old and adults. Patients 16-19 years of age had longer gestational age and higher birth weight than the adults. The proportion of primary cesarean deliveries among teenagers 12-15 years old was 11.6%, significantly higher than 9.4% for those 16-19 years old and 10.2% for adults (P < .001). CONCLUSION: On average, females 16-19 years old had better obstetric outcomes than adults, whereas obstetric outcomes for those 12-15 years old were worse than for adults. Therefore, all teenagers should not be grouped together when their obstetric outcomes are compared with those of adults.