Risks of Adverse Neonatal Outcomes in Early Adolescent Pregnancy Using Group Prenatal Care as a Strategy for Public Health Policies: A Retrospective Cohort Study in Brazil

Background: Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care.Objective: To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services.Methods: This retrospective cohort study followed pregnant adolescents (aged 10–17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10–13 years were compared to those of adolescents aged 14–15 years and 16–17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences.Results: Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7–11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10–13 age group, 8.7% for the 14–15 age group and 12.1% for the 16–17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10–13, 14–15, and 16–17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups (p > 0.05). The infants born to mothers aged 10–13 years presented significantly (p < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range.Conclusions: Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.

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The implications for advanced maternal age on pregnancy complications and adverse neonatal outcomes

Perinatal Journal ◽

10.2399/prn.21.0293005 ◽

2021 ◽

Vol 29 (3) ◽

pp. 200-209

Author(s):

Zeynep Gedik Özköse ◽

Süleyman Cemil Oğlak

Keyword(s):

Birth Weight ◽

Cesarean Section ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

Apgar Scores ◽

Adverse Neonatal Outcomes ◽

Adverse Pregnancy ◽

Nicu Admission

Objective This study aimed to determine the effect of advanced maternal age (AMA) on maternal and neonatal outcomes in pregnant women aged ≥35 years compared with patients aged 30–34 years. Also, we aimed to analyze the risk estimates of potential confounders to identify whether these variables contributed to the development of adverse pregnancy outcomes or not. Methods This retrospective cohort study included 2284 pregnant women aged ≥35 years at the time of delivery who was delivered in a tertiary referral hospital from January 1, 2016, to December 31, 2020. We further classified these women into two subgroups: 35–39 years as early AMA (EAMA), and ≥40 years as very AMA (VAMA). Pregnancy complications and adverse neonatal outcomes were recorded. Results Compared to younger women, pregnant AMA women had significantly higher risks of complicated pregnancies, including a higher risk of gestational diabetes mellitus (GDM, p<0.001), polyhydramnios (p<0.001), cesarean section (p<0.001), stillbirths (p<0.001), major fetal abnormality (p<0.001), preterm delivery (p<0.001), lower birth weight (p<0.001), lower 5-minute Apgar scores (p<0.001), lower umbilical artery blood pH values (p<0.001), neonatal intensive care unit (NICU) admission (p<0.001), and length of NICU stay (p<0.001). Conclusion We found a strong and significant association between VAMA and adverse pregnancy outcomes, including an increased risk of GDM, polyhydramnios, cesarean section, and adverse neonatal outcomes, including a higher risk of stillbirths, preterm delivery, lower birth weight, lower 5-minute Apgar scores, and NICU admission.

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Effects of a Prenatal Care Intervention for Adolescent Mothers on Birth Weight, Repeat Pregnancy, and Educational Outcomes at One Year Postpartum

The Journal of Perinatal Education ◽

10.1624/105812402x88588 ◽

2002 ◽

Vol 11 (1) ◽

pp. 35-38 ◽

Cited By ~ 27

Author(s):

Kathleen Ford ◽

Linda Weglicki ◽

Trace Kershaw ◽

Cheryl Schram ◽

Paulette J. Hoyer ◽

...

Keyword(s):

Birth Weight ◽

Prenatal Care ◽

Low Birth Weight ◽

Adolescent Mothers ◽

Unplanned Pregnancy ◽

Care Program ◽

Control Group ◽

Pregnant Adolescents ◽

One Year ◽

Experimental Group

About one-third of adolescent mothers receive inadequate prenatal care, and babies born to young mothers are more likely to be of low birth weight. The objective of this study is to evaluate a peer-centered prenatal care program for adolescent mothers. Pregnant adolescents were randomly assigned to an experimental or control group in a mastery modeling peer-support intervention designed to improve long- and short-term perinatal outcomes. A sample of 282 urban pregnant adolescents (94% African American, 4% Caucasian, 2% other) participated in the study. Participants were recruited from five clinics located mainly in Detroit, Michigan. Participants in the experimental group received care in a small group setting and learned to perform critical measurements with a peer partner during prenatal visits. Participants in the control group received individual prenatal care in the same clinics. Outcome measures included birth weight, years of schooling completed at one year postpartum, planned and unplanned pregnancy at one year postpartum, and employment and school attendance at one year postpartum. Mothers in the experimental group had a lower rate of low birth weight (6.6% vs. 12.5%, p=0.08). The rate of unplanned pregnancy was also lower for adolescents in the experimental group (13.4% vs. 15.9%), although this difference was not statistically significant. Adolescents who participated in the intervention were more likely to have continued their education during the pregnancy and the postpartum year. The mastery modeling, peer-centered, prenatal care program produced some positive pregnancy outcomes for adolescent mothers.

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Is adolescent pregnancy a risk factor for low birth weight?

Revista de Saúde Pública ◽

10.1590/s0034-89102013000100003 ◽

2013 ◽

Vol 47 (1) ◽

pp. 11-19 ◽

Cited By ~ 16

Author(s):

Alzira Maria D'avila Nery Guimarães ◽

Heloísa Bettiol ◽

Luiz De Souza ◽

Ricardo Q Gurgel ◽

Maria Luiza Dória Almeida ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Birth Weight ◽

Prenatal Care ◽

Low Birth Weight ◽

Adolescent Pregnancy ◽

Adolescent Mothers ◽

Northeastern Brazil ◽

Smoking During Pregnancy ◽

The Impact

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

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Effect of maternal antenatal influenza vaccination on adverse neonatal outcomes in terms of premature birth, small-for-gestational age and low birth weight: A comparative study

International Journal of Medical Science and Public Health ◽

10.5455/ijmsph.2016.18052016510 ◽

2016 ◽

Vol 5 (11) ◽

pp. 2378

Author(s):

Mokhtar Shatla ◽

Mohammed Khayat ◽

Majd Ahmed ◽

Aamer Alzahrani ◽

Aymen Khadrawi ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Comparative Study ◽

Influenza Vaccination ◽

Gestational Age ◽

Small For Gestational Age ◽

Premature Birth ◽

Neonatal Outcomes ◽

Adverse Neonatal Outcomes

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The Risk of Adverse Neonatal Outcomes With Maternal Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa122 ◽

2020 ◽

Cited By ~ 2

Author(s):

Kristel K Leung ◽

Parul Tandon ◽

Vivek Govardhanam ◽

Cynthia Maxwell ◽

Vivian Huang

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care ◽

Neonatal Outcomes ◽

Increased Risk ◽

Adverse Neonatal Outcomes ◽

Inflammatory Bowel ◽

Active Disease

Abstract Background Patients with inflammatory bowel disease (IBD) may be at increased risk of adverse neonatal outcomes. The aim of this study was to determine pooled incidences and risk factors for these outcomes. Methods Medline, Embase, and Cochrane Library were searched through May 2019 for studies reporting adverse neonatal outcomes in IBD. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results The pooled incidence of preterm birth, low birth weight, congenital anomalies, and infants transferred to the neonatal intensive care unit was 8.6% (95% CI, 7.0%–10.1%), 8.9% (95% CI, 7.3%–10.5%), 2.1% (95% CI, 1.6%–2.6%), and 4.9% (95% CI, 2.9%–6.9), respectively. Compared with healthy controls, patients with IBD were more likely to deliver infants with low birth weight (<2500 grams; OR, 2.78; 95% CI, 1.16–6.66) and infants admitted to the intensive care unit (OR, 3.33; 95% CI, 1.83–6.05). Patients with Crohn’s disease had an increased incidence of congenital anomalies (OR, 3.03; 95% CI, 1.43–6.42). Among IBD patients, active disease was associated with increased incidence of preterm birth (OR, 2.06; 95% CI, 1.21–3.51), low birth weight (OR, 2.96; 95% CI, 1.54–5.70), and small for gestational age (OR, 2.62; 95% CI, 1.18–5.83). Antitumor necrosis factor (anti-TNF) use during pregnancy was associated with an increased incidence of neonatal intensive care unit admission (OR, 2.42; 95% CI, 1.31–4.45) and low birth weight (OR, 1.54; 95% CI, 1.01–2.35). Conclusions Patients with IBD, particularly with active disease or requiring anti-TNF therapy, may be at increased risk of developing adverse neonatal outcomes.

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Determinants of neonatal and post-neonatal mortality in the City of São Paulo

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2003000400009 ◽

2003 ◽

Vol 6 (4) ◽

pp. 345-358 ◽

Cited By ~ 12

Author(s):

Carla Jorge Machado ◽

Kenneth Hill

Keyword(s):

Birth Weight ◽

Infant Mortality ◽

Prenatal Care ◽

Low Birth Weight ◽

Neonatal Mortality ◽

Child Mortality ◽

Infant Death ◽

Neonatal Death ◽

Apgar Scores ◽

The City

INTRODUCTION: Child Mortality (mortality of children less than five years) has declined considerably in the developing world in the 1990s, but the Infant Mortality has declined less. Therefore, to further reduce child mortality it is important to understand the determinants of neonatal and post-neonatal mortality. MATERIAL AND METHODS: We probabilistically matched 209628 live births and 3842 infant death records from the City of São Paulo, birth cohort of 1998. Data came from SINASC and SIM. We then used logistic regression to analyze the following risk factors of neonatal and post-neonatal mortality: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. RESULTS AND CONCLUSION: Infants of older mothers were less likely to die in the neonatal period; infants of adolescent mothers were more likely to die in both periods. Parities four or higher increased the likelihood of post-neonatal death. Cesarean delivery was not found to be associated with infant mortality. Low number of prenatal care visits, low birth weight, preterm birth and low Apgar scores were associated with neonatal death; Low number of prenatal care visits, low birth weight, and low Apgar scores were associated with post-neonatal death. Finally, having a mother live in a highest developed community decreased the likelihood of infant death, suggesting that unmeasured factors are behind such association.

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Group Prenatal Care Reduces Risk of Preterm Birth and Low Birth Weight: A Matched Cohort Study

Journal of Women s Health ◽

10.1089/jwh.2017.6817 ◽

2019 ◽

Vol 28 (1) ◽

pp. 17-22 ◽

Cited By ~ 4

Author(s):

Shayna D. Cunningham ◽

Jessica B. Lewis ◽

Fatma M. Shebl ◽

Lisa M. Boyd ◽

Marc A. Robinson ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Preterm Birth ◽

Prenatal Care ◽

Low Birth Weight ◽

Group Prenatal Care ◽

Matched Cohort ◽

Matched Cohort Study

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Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

Current Women s Health Reviews ◽

10.2174/1573404816999201009160848 ◽

2020 ◽

Vol 16 ◽

Author(s):

Reza Omani-Samani ◽

Saman Maroufizadeh ◽

Nafise Saedi ◽

Nasim Shokouhi ◽

Arezoo Esmailzadeh ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Cesarean Section ◽

Pregnant Women ◽

Maternal Age ◽

Unwanted Pregnancy ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

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