Second births to teenage mothers increase risk of adverse outcome


LONDON (Reuters Health) – Although first births to nonsmoking, teenage mothers are not associated with an increased risk of adverse outcomes, second births have a significantly increased risk of premature delivery and stillbirth, according to a report by UK researchers in the British Medical Journal for September 1.

Dr. Gordon C. S. Smith, now with the University of Cambridge, and Dr. Jill P. Pell from the Greater Glasgow Health Board, collected data from the Scottish morbidity record 2 database on 110,233 first and second singleton births among nonsmoking women. The mothers were 15 to 29 years of age and gave birth between 1992 and 1998.

Among these women the researchers looked for incidence of stillbirth, preterm delivery, emergency caesarean section, low birthweight, and neonatal death.

For first births, multivariate analysis revealed that among women 15 to 19 years of age there was no increased risk of any of these adverse outcomes compared with women 20 to 29 years of age.

However, for second births, teenage mothers were at a significantly increased risk of having an infant of moderate (33-36 weeks) or extreme (24-32 weeks) prematurity (adjusted odds ratio 1.6 and 2.5, respectively), or a stillbirth (adjusted odds ratio 2.6), compared with women 20 to 29 years of age, the researchers report.

For both first and second births, teenage mothers had a lower risk of emergency caesarean section compared with older women, they found.

"Our findings suggest a causal relation between second teenage birth and adverse pregnancy outcome," Drs. Smith and Pell note. The nature of that relation, however, remains unknown.

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