Pregnancy in adolescence

Abstract

According to WHO, adolescence extends from ages 10 to 19. Adolescent pregnancies are mostly unplanned, with 16 million live births and five millions abortions a year worldwide. Ninety-five percent teenage pregnancies occur in poor countries, mainly in Africa. The USA shows the highest adolescent pregnancy rate in Western countries. 207,000 live births and 160,000 abortions occurred in EU teens in 2011. Low income family, low education, unemployment, disadvantaged neighborhood, poor school results, belonging to ethnic minorities, mental deficits promote teen pregnancy, with the bigger risks because of the lower socioeconomic level. The younger the girl, the worse the outcomes, with preterm delivery, preeclampsia, eclampsia, urinary infections, anemia, depression, school abandonment, unqualified jobs, social security needs, and early death. Newborns risk low birth weight, infections, IUGR, SIDS, and death. Typical teen risk factors are: still ongoing growth, still developing genitalia, low BMI, short cervix, inadequate pelvis, low central body fat, genital infections, stress, depression, poverty, black race, insufficient prenatal cares, smoking, alcohol, substance abuse, school dropout, sexual promiscuity, sexual abuse, and poor support. Still growing mothers and fetuses compete for nutrients with high maternal weight gain and low neonatal birth weight. Pregnant teens require close follow-up, adequate weight gain, possible cervical cerclage, screening of both STDs and sexual abuse, and psychosocial support. During labor, slow progression, dystocias, and neonatal complications often occur, so teens should deliver in high level hospitals. After delivery, promotion of breastfeeding, screening of depression, prevention of repeated pregnancy are mandatory. Specific features and proper management of adolescent pregnancy are discussed.