Pregnancy Is Most Dangerous for the Very Young
When preteen children or very young teenagers become pregnant, they face higher rates of complications and a greater risk of winding up in the intensive care unit than older teens do, a new study finds.
The question about what happens when a young girl goes through pregnancy and delivery takes on more relevance after the U.S. Supreme Court overturned Roe v. Wade in June and subsequent abortion restrictions were enacted in numerous states.
For this study, researchers examined more than 90,000 delivery records for pregnant girls ages 10 to 19, comparing outcomes for the youngest girls with those of teens who are older.
"Our study discovered that when it comes to childbirth, a pregnant child or very young adolescent is not simply a 'little' adolescent,' said study author Katherine Goodman, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine.
"We found 10- to 13-year-olds had a 56% higher risk of preterm delivery and a 32% higher risk of cesarean delivery, compared to those ages 14 to 17," Goodman said in a school news release.
Data came from the Premier Healthcare Database, a national resource that includes data on about one-fourth of all U.S. hospital discharges. The researchers studied cases from January 2019 through May 2021.
In pregnant girls ages 10 to 13, preterm delivery occurred in 18.5% of cases compared to 11.6% in teens ages 14 to 17 and 10.5% in older teens ages 18 to 19.
In the youngest girls, about 22% had a cesarean delivery compared to 16.4% of girls ages 14 to 17 and 20.1% of teens ages 18 to 19.
Even when accounting for race, ethnicity, type of insurance and obesity status, the youngest girls had significantly increased pregnancy risks compared to those who were just a few years older.
In the study, about 68,000 of the pregnancies were in teens ages 18 to 19, while nearly 23,000 were in girls ages 14 to 17 and 206 were in girls ages 10 to 13. In the youngest group, more than two-thirds of the patients identified as Black or Hispanic.
"The study findings demonstrate that an emphasis on pregnancy prevention and appropriate care if pregnancy occurs is important -- with access to the full range of options, including abortion, if the pregnancy is not desired," said study first author Dr. Beth Pineles, an assistant professor in the University of Pennsylvania's Division of Maternal-Fetal Medicine and Department of Obstetrics and Gynecology.
The data on ICU admissions is preliminary and warrants confirmation in future studies, the study authors noted. They said they found it notable that girls ages 10 to 13 had ICU admission rates that were three times higher than those ages 14 to 19.
“These complicated birth outcomes matter. They can have lifelong consequences for both mother and child,” Goodman said. “Mothers who deliver preterm have a greater likelihood of developing hypertension and mental health problems, including postpartum depression and post-traumatic stress disorder. Children born preterm have a greater risk of neurodevelopmental and respiratory problems."
The findings were published Nov. 1 in the Journal of the American Medical Association.
“While pregnancy in very young girls remains uncommon in the U.S., the racial and ethnic disparities remain stark and point to a pressing health need that we as a nation must address in order to close the health care inequity gap,” said Dr. Mark Gladwin, vice president for medical affairs at the University of Maryland, Baltimore.
The U.S. Centers for Disease Control and Prevention has more on pregnancy complications.
SOURCE: University of Maryland School of Medicine, news release, Nov. 1, 2022