Type of publication:
*Moores K.L., Ritchie J., *Calcott G., *Underwood M. , *Oates S.
BJOG: An International Journal of Obstetrics and Gynaecology, April 2015, vol./is. 122/(319)
Introduction The UK has the highest rate of teenage pregnancy across Western Europe; however, the rate has been reducing and is currently at its lowest since 1969. Perceptions exist of worse outcomes in teenage pregnancies among healthcare professionals and the public alike. The review sought to determine outcomes of teenage pregnancy (2013-2014) and compare rates of teenage pregnancy (2008-2013) at Shrewsbury and Telford Hospitals (SaTH) NHS Trust and compare with local population outcomes. Methods A 12-month retrospective review of teenage pregnancy outcomes and comparison with outcomes of all deliveries at SaTH between April 2013 and March 2014, a total of 4916 deliveries, was conducted. Data sources included the MEDWAY Hospital Database. Recorded pregnancy outcomes were classified into two categories: outcomes in mothers aged 19 years or younger at time of delivery and outcomes in all mothers who delivered at SaTH in the study period. Parameters assessed included mode of delivery; blood loss; perineal trauma; birthweight; Apgar scores. Teenage pregnancy rates over the last 6 years were compared to recorded rates in 1996. Results The rate of teenage pregnancy has continued to reduce; especially in those aged <16 years. Over 90% of teenage mothers had a vaginal delivery and were half as likely to require caesarean delivery (RR 0.49; 95% CI 0.33-0.75). Low rates of instrumental deliveries were seen in each category; no failed instrumental deliveries occurred among teenage mothers. Teenage mothers were not at a statistically significant increased risk of preterm delivery; however, mean term birthweights were lower among teenage mothers; 3302 g compared with 3464 g in the total population; and mean Apgar scores were the same in both groups. No difference was seen in rates of severe perineal trauma; however, more than 60% of teenage mothers had an intact perineum. Furthermore, teenage mothers had significantly lower rates of postpartum haemorrhage (RR 0.66, 95% CI 0.48-0.90). Conclusion Thus, one may suggest a lower risk of harm to teenage parturients and their babies compared with the local population, contrary to current general beliefs.