RESUMEN
OBJECTIVE: The purpose of this study was to determine obstetrical and neonatal outcome among early adolescent pregnancies (< or =15 years). METHOD: We compared obstetrical and neonatal outcome of early adolescent nulliparas with outcome of nulliparous women aged 20-30 years. RESULTS: Two hundred and one (201) early adolescent nulliparous patients of low socio-economic status were enrolled at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador, and matched for gestational age with 201 low socio-economic nulliparous controls aged 20-30. Mean maternal age of the adolescent group was 14.2+/-0.6 years. The incidence of cervicovaginal infections during current pregnancy was significantly higher among adolescents (trichomoniasis: 11.4% vs. 5% and candidiasis: 27.8% vs. 12.4%, p<0.05). The incidence of eclampsia was higher in adolescents (2.5% vs. 0%, p<0.05). The preterm rate in each group was 4.9%. There were no differences in labor characteristics and the rate of cesarean section, labor complications and abnormal puerperium between both studied groups. Nevertheless, mean neonatal weight was lower and the incidence of low birth weight infants (<2,500 g) and adverse neonatal outcome was significantly higher in the adolescent group (2,837.6+/-454 g vs. 3,017+/-547 g; 19.9% vs. 11.4% [OR=1.92, 95% CI: 1-3.5] and 9.5% vs. 3.5% [OR=2.9, 95% CI: 1.1-7.7] respectively, p<0.05). CONCLUSION: Pregnancy in young adolescents (< or =15 years) of low socio-economic status did not impose adverse obstetrical outcome, however it did increase the risk for low birth weight, adverse neonatal outcome and cervicovaginal infections.
Asunto(s)
Recién Nacido de Bajo Peso , Complicaciones del Embarazo , Resultado del Embarazo , Embarazo en Adolescencia , Clase Social , Adolescente , Adulto , Candidiasis Vulvovaginal/epidemiología , Estudios de Casos y Controles , Niño , Ecuador/epidemiología , Femenino , Humanos , Recién Nacido , Trabajo de Parto Prematuro , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Prospectivos , Vaginitis por Trichomonas/epidemiologíaRESUMEN
OBJECTIVE: Determine social factors related to pregnancy among young adolescents. METHODS: We obtained socio-demographic data from early adolescent nulliparas aged < or = 15 years. RESULTS: During the study period at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador 201 early adolescent nulliparous patients of low socio-economic status were surveyed and compared with 201 low socio-economic nulliparous controls aged 20 to 30. Mean age of adolescents was 14+/-0.6 years, 58.7% of them were aged 14. Age of menarche and sexual initiation was lower among adolescents (11.8+/-0.9 vs 12.8+/-2 years and 12.6+/-1.1 vs 16.2+/-5 years, respectively, p<0.05). A higher rate of adolescents initiated sexually before menarche onset (18.4% vs 5%, p<0.05). The rate of those who wanted to become pregnant, had adequate prenatal care and had knowledge of conception, used contraception or had knowledge of any contraceptive method prior to pregnancy was significantly lower in adolescents (16.9% vs 86.5%; 37.3% vs 94.5%; 18% vs 70.1%; 6.5% vs 89.5%; 42.8% vs 84.5%, respectively, p<0.05). Age of sexual partner was lower in the adolescent group (20.4+/-3.4 vs 30+/-8 years, p<0.05). Compared to controls, higher rates of adolescents were school dropouts, had problems with the law and were involved in domestic violence (87% vs 9.9%, 7.5% vs 0.5%, 44.7% vs 2.5%, respectively, p <0.05). None of the adolescents were living with mother and father in a complete family structure. Parental illiteracy was higher among adolescents (9% vs 3.5%, p < 0.05). CONCLUSION: In this low socio-economic population, early sexual initiation, poor reproductive health knowledge and the disruption of family structure were the main social factors related to pregnancy among adolescents aged 15 or less.