Perinatal outcomes of teenage pregnancies according to gravidity and obstetric history

Purpose Teenage pregnancy is a significant public health issue. The aim of this study was to compare the perinatal outcomes of teenage primigravidae and secundigravidae who previously had an induced abortion or a live-birth. Methods In this population-based retrospective cohort study, we used routinely collected perinatal data from 1990 to 1999 from Lower Saxony, Germany. The main outcomes were perinatal and neonatal mortality, stillbirth, preterm birth, and very low birth weight (VLBW). There were 10,354 births among teenagers (12–18 years). After exclusion of girls with multiple births, two or more previous pregnancies, a previous spontaneous abortion, or a previous stillbirth, the remaining 8669 subjects were stratified into primigravidae (n = 7695) and secundigravidae one previous live-birth (n = 767) or one previous induced abortion (n = 207). Bivariate and multivariable logistic regression analyses (adjusted for smoking status, nationality, partner status, and maternal height and weight at first and last antenatal visit) were conducted to calculate odds ratios (OR) with 95% confidence intervals (CI). Results Compared with primigravidae (referent group), teenagers with a second live-birth had higher risks of perinatal mortality (OR = 2.11, 95% CI = 1.13, 3.95) and of neonatal mortality (OR = 4.30, 95% CI = 1.77, 10.49) and teens with a previous induced abortion had higher risk of stillbirth (OR = 3.41, 95% CI = 1.04, 11.19) and preterm birth (OR = 2.21, 95% CI = 1.07, 4.58) in crude analyses. Adjusted for all confounders, teens with a second live-birth were more likely to experience perinatal mortality (OR = 2.32, 95% CI = 1.12, 4.81) and neonatal mortality (OR = 4.67, 95% CI = 1.60, 13.66), and teenagers with a previous induced abortion had a higher risk of VLBW (OR = 2.90, 95% CI = 1.10, 7.69). Conclusion Among teens, the second pregnancy bears greater risks than the first one. The prevention of the second pregnancy during adolescence should be paramount.