Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample

Stephanie P W Wong; Jasna Twynstra; Jason A Gilliland; Jocelynn L Cook; Jamie A Seabrook

doi:10.1016/j.jpag.2019.10.006

Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample

J Pediatr Adolesc Gynecol. 2020 Apr;33(2):153-159. doi: 10.1016/j.jpag.2019.10.006. Epub 2019 Oct 18.

Authors

Stephanie P W Wong¹, Jasna Twynstra², Jason A Gilliland³, Jocelynn L Cook⁴, Jamie A Seabrook⁵

Affiliations

¹ School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.
² School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada.
³ Department of Geography, Western University, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada.
⁴ Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada.
⁵ School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada. Electronic address: jseabro2@uwo.ca.

PMID: 31634579
DOI: 10.1016/j.jpag.2019.10.006

Abstract

Study objective: To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors.

Design: Retrospective cohort study using perinatal and neonatal databases.

Setting: Tertiary care hospital in SWO.

Participants: Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older.

Interventions: None.

Main outcome measures: Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia.

Results: Of 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P < .001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P < .001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P < .001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates.

Conclusion: Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.

Keywords: Alcohol drinking; Apgar score; Cannabis; Fetal macrosomia; Infant; Low birth weight; Mental health; Pregnancy in adolescence; Premature birth; Smoking.

MeSH terms

Adolescent
Adult
Case-Control Studies
Databases, Factual
Female
Humans
Infant
Infant, Newborn
Ontario / epidemiology
Pregnancy
Pregnancy Outcome / epidemiology*
Pregnancy in Adolescence / statistics & numerical data*
Retrospective Studies
Risk Factors
Socioeconomic Factors
Young Adult