MEDICAL RISKS OF ADOLESCENT PREGNANCYPregnant adolescents younger than 17 years have a higher incidence of medical complications involving mother and child than do adult women, although these risks may be greatest for the youngest teenagers.17,48 The incidence of having a low birth weight infant (<2500 g) among adolescents is more than double the rate for adults, and the neonatal death rate (within 28 days of birth) is almost 3 times higher.49 The mortality rate for the mother, although low, is twice that for adult pregnant women.15,17Adolescent pregnancy has been associated with other medical problems including poor maternal weight gain, prematurity (birth at <37 weeks' gestation), pregnancy-induced hypertension, anemia, and STDs. Approximately 14% of infants born to adolescents 17 years or younger are preterm versus 6% for women 25 to 29 years of age.49 Young adolescent mothers (14 years and younger) are more likely than other age groups to give birth to underweight infants, and this is more pronounced in black adolescents.1,50–53Biological factors that have been associated consistently with negative pregnancy outcomes are poor nutritional status, low prepregnancy weight and height, parity, and poor pregnancy weight gain.51,52 Many social factors have also been associated with poor birth outcomes, including poverty, unmarried status, low educational levels, smoking, drug use, and inadequate prenatal care.54 Both biological and social factors may contribute to poor outcomes in adolescents. Adolescents also have high rates of STDs, substance use, and poor nutritional intake, all of which contribute to the risk of preterm delivery.52 Interventions, such as prenatal intake of folic acid as a strategy for prevention of spina bifida, can be effective at decreasing observed disparities between adolescents and older women.55
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