Adolescent pregnancies and associated obstetric and neonatal outcomes: a retrospective study in Western French Guiana

In French Guiana, a multiethnic Amazonian region of the European Union marked by significant social, economic, and health vulnerabilities, the birth rate among teenagers is the highest in Europe. However, data on the associated obstetric and neonatal complications in this context remain scarce. This study aimed to assess the risk of maternal and neonatal complications associated with pregnancy in adolescents. This was a single-center retrospective study conducted at the Western French Guiana Hospital Center between 1 January 2020 and 31 December 2021. All deliveries to mothers aged ≤ 24 years were included. The primary analysis compared maternal and neonatal outcomes between adolescents aged ≤ 19 years and women aged 20–24 years. Secondary analyses compared adolescents aged ≤ 16 years with those aged 17–19 years. Both univariate and multivariable analyses were performed. The prevalence of adolescent pregnancies was 14.4%, with 3.2% involving girls aged ≤ 16 years. The median age at delivery among adolescents was 18 years (IQR 17–19); 32.9% were multiparous, 7.5% of multiparous adolescents had a history of uterine scar, and 29.3% were overweight or obese. Adolescents were highly exposed to sexually transmitted infections, including Chlamydia trachomatis (36.0%), Neisseria gonorrhoeae (15.4%), and active syphilis (2.7%). Compared with women aged 20–24 years, adolescents aged ≤ 19 years received less adequate prenatal care and had higher rates of preeclampsia (5.1% vs. 3.4%; p = 0.037), eclampsia (1.8% vs. 0.4%; p = 0.001), HELLP syndrome (0.5% vs. 0.1%; p = 0.040), and severe anemia (10.2% vs. 5.0%; p < 0.001). Adverse neonatal outcomes were more frequent among adolescents, particularly those aged ≤ 16 years (30.9%), compared with those aged 17–19 years (26.2%) and women aged 20–24 years (18.5%; p < 0.001). However, after multivariable adjustment, neither adolescents aged ≤ 16 years nor those aged 17–19 years were independently associated with adverse neonatal outcomes compared with women aged 20–24 years. Adverse neonatal outcomes were independently associated with hypertensive disorders of pregnancy (aOR 3.21; 95% CI 2.14–4.81), low birth weight (aOR 4.97; 95% CI 3.48–7.11), preterm birth < 37 weeks (aOR 3.14; 95% CI 2.17–4.55), cesarean delivery (aOR 2.61; 95% CI 1.88–3.63), and sexually transmitted infections (aOR 2.42; 95% CI 1.23–4.78). The prevalence of adolescent pregnancy remains high in western French Guiana. Pregnant adolescents are frequently exposed to a negative exposome, including socioeconomic vulnerability, nutritional deficiencies, inadequate prenatal care, and a higher risk of sexually transmitted infections and hypertensive disorders. In this high-risk context, adverse neonatal outcomes are more common than among adult mothers. Early, multidisciplinary, and context-specific care is essential to improving obstetric and neonatal outcomes in this Amazonian population of young mothers.