RESUMEN
OBJECTIVE: To compare the course of teenage pregnancies and deliveries with that in women between the ages of 20 and 29. DESIGN: Observational. SETTING: The Netherlands. METHOD: Using data from the 1989 National Obstetric Database (LVR), 4500 teenage pregnancies were studied, to compare the risk of preterm birth, low birth weight and delivering a small for gestational age (SGA) baby between teenagers and older women. RESULTS: Women between the ages of 13 and 19 ran one and a half times as high a risk of having a preterm baby as women between the ages of 20 and 29 years (p < 0.0001). The risk of intrauterine death was 4 times as high for age 13-17 and 2 times as high for age 18-19 compared with older women (p < 0.0001). These results were found for teenage mothers of Dutch origin as well as for young mothers of foreign descent. Deliveries by teenagers were more often spontaneous, were of shorter duration and less often needed assistance than deliveries in older mothers (p < 0.001). CONCLUSION: Even in the Netherlands, with the lowest teenage pregnancy rate in the Western world and a prenatal care system generally considered of high quality, teenage pregnancies have less favourable outcomes than those in older women. Since we had no information on cultural background, socioeconomic status or life style, further research into determinants of outcomes of Dutch teenage pregnancies is indicated.
PIP: The objective was to compare the course of teenage pregnancies and deliveries with those of women between the ages of 20 and 29, using data from the 1989 National Obstetric Database (LVR) when approximately 76% of cases conducted by obstetricians were registered. 4500 teenage pregnancies were studied to compare the risk of preterm birth, low birth weight and delivering a small for gestational age (SGA) baby between teenagers and older women. In the 13-17 year age group, 61.5% were of foreign origin. The 13-17 age group had the lowest percentage of delivery at home, with 10%. Women 13-19 years old ran 1.5 times as high a risk of having a preterm baby as women age 20-29 (p 0.0001). The likelihood of SGA delivery was increased only in the 18-19 age group (13.2%) compared to 11% in the 20-29 age group. The risk of death within 24 hours after delivery was also increased because of the risk of intrauterine death, which was 4 times as high for age 13-17 (1.6%) and 2 times as high for age 18-19 (0.7%) compared with women age 20-29 (0.4%) (p 0.0001). These results were found for teenage mothers of Dutch origin as well as for young mothers of foreign descent. Deliveries by teenagers were more often spontaneous, were of shorter duration and less often needed assistance than deliveries in older mothers (p 0.001). The incidence of home delivery was low in both age groups (8.5%), and it was the same for both Dutch and foreign origin groups. Even in the Netherlands, with the lowest teenage pregnancy rate in the Western world and a prenatal care system generally considered of high quality, teenage pregnancies have less favorable outcomes than those in older women. Since the study was conducted without information on cultural background, socioeconomic status or life style, further research into determinants of outcomes of Dutch teenage pregnancies is indicated.