Adverse reproductive outcomes in minors: New approaches to solving an old problem

Introduction. Teenage pregnancy is recognized by WHO as a serious public health problem, it is widespread throughout the world: both in developed and developing countries. Aim. To demonstrate the resources of the regional service of pediatric and adolescent gynecology to reduce unwanted reproductive outcomes in minors. Materials and methods. The study was conducted in obstetric hospitals of the Tyumen region, medical institutions providing outpatient gynecological care to minors. Contingent: 1703 minors with pregnancies completed in 2016–2023. Depending on the pregnancy outcome, the study contingent was divided into two groups. Group 1: 1,173 teenage girls with pregnancies that ended in childbirth. Group 2: 531 teenage girls with an abortive outcome of pregnancy. A separate review of clinical cases of ectopic pregnancy in minors is given (3 cases). Results. During the period under review, 156,747 pregnancies ended in childbirth in the Tyumen Region (excluding the KhantyMansi Autonomous Okrug – Yugra and the Yamalo-Nenets Autonomous Okrug). Over 6 years, there was a decrease from 23,791 to 17,164 births, i.e. by 27.9%. Statistics on childbirth and abortive outcomes in minors demonstrate a significant reduction in the number of completed pregnancies in minors: from 282 in 2016 to 175 in 2023 (-37.9%). The frequency of pregnancies with an abortive outcome in minors is higher than in adult women. Medical abortion accounts for almost ¾ of pregnancy terminations in minors. There is no significant decrease in the frequency of pregnancy terminations in adolescent girls among minors. Conclusion. A stable improvement in the situation in this area is possible provided that state programs (federal, regional) are developed and implemented, targeted funding for activities aimed at preserving the reproductive health of children and adolescents, and grant support for scientific research.