Maternal and Neonatal Outcomes among Adolescent and Adult Mothers: A Comparative Cross-Sectional Study from a Tertiary Referral Hospital in Egypt

Abstract Introduction: Adolescent pregnancy remains a global public health challenge that contributes to adverse maternal and neonatal outcomes and hinders progress toward the Sustainable Development Goals (SDGs), particularly SDG 3 on ensuring healthy lives and promoting well-being for all. Objectives: To compare the maternal and neonatal outcomes of adolescent and optimal-age pregnancies among women at a tertiary referral hospital in Alexandria, Egypt, and describe their sociodemographic and clinical characteristics. Methods: A hospital-based comparative cross-sectional study was conducted at El Shatby University Hospital, Alexandria, Egypt, between September 2024 and March 2025. A total of 800 women were enrolled using convenience sampling and categorized into adolescent (<20 years) and optimal-age (20–30 years) groups. Sociodemographic, obstetric, and neonatal data were collected through structured interviews and medical record review. Outcomes were compared using descriptive and inferential statistical tests, with statistical significance set at p < 0.05. Results: Of the 800 participants, 19.4% were adolescents. Compared with women aged 20–30 years, adolescent mothers had significantly higher rates of urinary tract infection (34.0% vs. 25.0%, p = 0.025), preterm labour (25.8% vs. 14.4%, p = 0.001), premature rupture of membranes (40.6% vs. 27.3%, p = 0.001), and low birth weight (34.8% vs. 22.8%, p < 0.001). They also had higher rates of birth before 34 weeks (28.4% vs. 19.0%) and neonatal intensive care unit admission (36.0% vs. 22.0%) (both p < 0.001). Conclusion: Adolescent pregnancy was associated with increased maternal and neonatal morbidity. Preventive strategies and timely, high-quality antenatal care are needed to reduce its health burden and improve maternal and neonatal outcomes.