Adolescence as a social risk factor in pregnancy

Abstract

Objective: To compare teenage pregnancy with adult pregnancy, considering social parameters. Methodology: In a retrospective cohort study, adolescence was compared with adulthood. The study population was admitted to a level II maternity hospital from January 1, 1996 to October 31, 1999. The study group was divided into two groups: patients aged 12 to 19 years (adolescents, or exposed group) and 20 to 34 years (adults, or non-exposed group). A total of 4,956 patients were observed, of which 1,004 (20.3%) were classified as adolescents and 3,952 (79.7%) as adults. Social outcomes (group characteristics) considered were literacy, marital status, uncertainty about the date of the last menstrual period, prenatal care, time of start of prenatal care, smoking, syphilis and nutritional status. Results: There was an association between teenage pregnancy and unmarried marital status (relative risk [RR]=0.65; confidence interval [CI]=0.6-0.7; chi-square [χ 2 ]=164.21; p < 0.001), the existence of doubts regarding the date of the last menstrual period (RR=1.17; CI=1.06-1.28; χ 2 =9.95; p =0.001), lower attendance at prenatal care (RR=0.97; CI=0.95-1; χ 2 =4.19; p =0.04), late initiation of prenatal care (30% of adolescents versus 43% of adults in the first trimester) (χ 2 =44.38; p < 0.001) and low body mass index (BMI) (13.3% of adolescents versus 9.5% of adults). adults) (χ 2 =43.3; p < 0.001). The risk of smoking in pregnant adolescents is lower than in adults (RR=0.76; CI=0.63-0.93; χ 2 =7.43; p =0.006). There was no statistically significant association between teenage pregnancy and illiteracy (RR=1; CI=0.99-1.01; χ 2 =0.05; p =0.82) and positive serology for syphilis (RR=1.08; CI=0.68-1.7; χ 2 =0.1; p =0.74). Conclusions: We observed that adolescence influences several social outcomes of pregnancy and that some represent a social risk for pregnant adolescents compared to adult women. Pregnancy in adolescence is associated with unmarried marital status, lower frequency of prenatal consultations, later start of prenatal care, and greater difficulty in correctly reporting the date of the last menstrual period. Smoking is less related to pregnancy in adolescence. Regarding illiteracy and syphilis serology, we did not find statistically significant differences, which makes the social risk similar for both pregnant adolescents and adults.