4. Fathers and partners should be included as much as possible in
pregnancy care and prenatal/infant care education. (III-B)
5. A first-trimester ultrasound is recommended not only for the usual
reasons for properly dating the pregnancy, but also for assessing
the increased risks of preterm birth. (I-A)
6. Counselling about all available pregnancy outcome options
(abortion, adoption, and parenting) should be provided to any
adolescent with a confirmed intrauterine gestation. (III-A)
7. Testing for sexually transmitted infections (STI) (II-2A) and
bacterial vaginosis (III-B) should be performed routinely upon
presentation for pregnancy care and again in the third trimester;
STI testing should also be performed postpartum and when
needed symptomatically.
a. Because pregnant adolescents are inherently at increased
risk for preterm labour, preterm birth, and preterm pre-labour
rupture of membranes, screening and management of
bacterial vaginosis is recommended. (III-B)
b. After treatment for a positive test, a test of cure is needed 3
to 4 weeks after completion of treatment. Refer partner for
screening and treatment. Take the opportunity to discuss
condom use. (III-A)
8. Routine and repeated screening for alcohol use, substance
abuse, and violence in pregnancy is recommended because of
their increased rates in this population. (II-2A)
9. Routine and repeated screening for and treatment of mood
disorders in pregnancy is recommended because of their
increased rates in this population. The Edinburgh Postnatal
Depression Scale administered in each trimester and postpartum,
and more frequently if deemed necessary, is one option for such
screening. (II-2A)
10. Pregnant adolescents should have a nutritional assessment,
vitamins and food supplementation if needed, and access to a
strategy to reduce anemia and low birth weight and to optimize
weight gain in pregnancy. (II-2A)
11. Conflicting evidence supports and refutes differences in
gestational hypertension in the adolescent population; therefore,