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Outcomes from adolescent pregnancies

As paediatricians, teen pregnancies concern us in two ways: both the mother and the baby may be our patients. So we should pay attention to a systematic review by Canadian authors which looked at the evidence for determinants of poor outcomes in this group (Amjad S et al. Paediatric and Perinatal Epidemiology. doi: 10.1111/ppe.12529). The authors found 31 studies which related social determinants of health with outcomes in mothers under 18 years, such as preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). Sixteen of the studies were from the USA. Not surprisingly, non-white mothers did much worse. In a meta-analysis of 5 such studies, African American teen mothers had a 67% greater chance of preterm delivery (OR 1.67) or LBW (OR 1.53), compared with white mothers. A broad range of social determinants were consistently associated with higher rates of PTB, LBW and SGA in various studies, including illiteracy, low economic status, and living in rural areas.

The authors ask the question of whether these poor outcomes are primarily biological, in that younger girls’ bodies may be less adapted to childbirth, or socio-economic. Their conclusion is firmly the latter. After all, historically, it was the …

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