Adolescent Pregnancy: How Age Affects Outcomes [ID 1367]

INTRODUCTION: Pregnant adolescents face many physical, social, and psychological obstacles that affect pregnancy outcomes. These challenges are heightened for early adolescents (EA), ages 10–14. We examined obstetric outcomes in EA, and compared these to late adolescents (LA), ages 15–17. METHODS: This was a retrospective cohort study of patients delivering in a single health system from May 1, 2013, to April 30, 2023. Adolescents (10–17 years) at time of delivery and delivering greater than 20 weeks were included. Demographic, pregnancy, antenatal and intrapartum details were abstracted from the electronic medical record. Exposure of interest was age at delivery, 10–14 (EA) versus 15–17 (LA). Primary outcome was preterm birth (PTB). Secondary outcomes included gestational age at delivery (GAdel), gestational hypertensive disorders (preX), cesarean delivery (CD), and postpartum hemorrhage (PPH). Secondary analysis compared outcomes between exposure groups using bivariate statistics, with regression models to control for confounders. RESULTS: Of 455 patients, 419 (92.1%) were LA and 36 (7.9%) were EA. EA was associated with later presentation to prenatal care ( P =.02) and more chronic hypertension (cHTN) ( P <.001). Spontaneous PTB occurred in 17% of EA. Only 6% had CD, 42% had preX, 11% had PPH, and the median GAdel was 38.7 weeks (IQRL, 37.6, 39.9). Compared to LA, EA had higher rates of preX (42% versus 25%, P =.03) and spontaneous PTB (17% versus 12%, P =.35), and lower rates of cesarean (6% versus 19%, P =.05). After controlling for cHTN and late prenatal care, no differences in rates of PTB, cesarean, or PreX were seen between LA and EA. CONCLUSIONS/IMPLICATIONS: Rates of spontaneous PTB and preX are high among all adolescents. Although rates did not differ significantly between EA and LA, given the associated morbidities, more research is needed to determine how to best support these high-risk pregnancies.