Outcome of teenage pregnancy in St. Vincent: neonatal outcome and adequacy of milk from teenage mothers

In a longitudional study, pregnancy, neonatal outcome and lactation performance of adolescent and adult primigravidae were examined and compared in 33 randomly selected women (14-25 years) in St. Vincent. The whole group of women were subdivided into three sub-groups: Group I (n=10, age 14-16 years), Group II (n=12, age 17-18 years), and Group III (n=11, age 19-25 years). Detailed data on obstetrical and neonatal (neurological) outcome were collected. After birth, information was obtained on early infant growth, maternal dietary intake and breast milk composition. Milk samples (transitional and mature milk) and maternal dietary information and neonatal anthropometric measurements were collected twice during the first month after birth through home visits. Between the 3 groups no significant differences in obstetric conditions, birthweight and early infant growth were found. The Neurological Optimality Score (NOS) was comparable for all groups, but a trend of more infants diagnosed as neurologically "suspect" infants in the younger age group shows the urgent need for more research in this field. Regarding the analysis of breastmilk samples, apart from lactose content, no major differences in the composition of macro-nutrients were found. Concerning the fatty acid composition of the milk fat, no major differences between the groups occurred, although a small number of individual fatty acids were different between the groups. Early infant growth patterns were similar in all groups. It is concluded that previously reported perinatal problems of healthy teenage primigravidae (14-16 years) were not substantiated fully in this series but neonatal outcome of infants of these mothers suggests that careful developmental follow-up of these children is indicated (AU)

Obstetrical condition and neonatal neurological outcome in Dominica, the Caribbean - a comparative study

Risk factors during pregnancy and delivery and neurological morbidity of newborns were assessed in a birth cohort in Dominica, the Caribbean. The data were compared with two reference groups, one from Grenada, the Caribbean, and the other from Groningen, the Netherlands. Despite variations in cultural and socio-economic situation, the similarities in obstetrical conditions, neonatal neurological morbidity and perinatal relationships between the three groups were more striking than the differences. The Dominican group showed a significantly higher rate of preterm births than the two other groups. Preterm birth was associated with a significant increase in neurological deviancy. In general motility and muscle tone were found to be lower in the Caribbean region than in the Netherlands (AU)

Obstetrical condition and neonatal neurological outcome in Dominica, the Caribbean: a comparative study - abstract

The risk factors during pregnancy and delivery and neurological morbidity of the newborn were assessed in a birth cohort in Dominica, West Indies. The data were compared with those from 2 reference groups from Grenada, West Indies and Groningen, the Netherlands. Despite variations in cultural and socio-economic factors among the 3 groups, the similarities in obstetrical status, neonatal neurological morbidity and perinatal relationships were more striking than the differences. The Dominican group showed a significantly higher rate of preterm births than the other 2 groups. Preterm birth was associated with a significant increase in neurological deviancy. In general, motility and muscle tone were found to be lower in West Indians than in Netherlands newborns (AU)

Neonatal neurological morbidity in relation to obstetrical and social conditions in Grenada (Caribbean)

Neonatal morbidity, in particular neurological morbidity is a more relevant measure of the effectiveness of obstetrical care than perinatal mortality. Neurological morbidity was assessed in a birth cohort in Grenada, and appeared to be lower than in a reference group examined in Groningen, the Netherlands, in 1975-1978. Perinatal mortality, however, was higher. The results support the thesis that some children may have died who, if they would have survived, would have been neurologically abnormal. It is concluded that whereas a decrease in perinatal deaths is an essential goal in Grenada, a concomitant increase in morbidity should be carefully avoided. (AU)