Review shows poor outcomes for teen mothers
Irish Times 14/08/2007

by Michelle McDonagh

Teenagers from socially deprived areas in Ireland and Britain are up to six times more likely to become pregnant than teenagers from other areas and are much less likely to opt for a terdmination, according to a new review. And in the long term, the offspring of adolescents have poorer cognitive development, lower education attainment, more frequent criminal activity and a higher risk of abuse, neglect and behavioural problems during childhood says the review.

Author of the review, consultant obstetrician at Cork University Maternity Hospital Dr Louise Kenny, has highlighted the urgent need for more research into the causes of the poor outcome of pregancy in teenage mothers. The many adverse outcomes of teenage pregnancy in Ireland and Britain, which include premature delivery, low-birth weight of babies and increased neonatal mortality, have been outlined in the new review.

"Despite the magnitude of the problem, it is unknown whether the poor outcomes of teenage pregnancy are partly attributable to the biological challenges presented by young maternal age or whether they are solely the consequence of sociodemographic factors," said Dr Kenny.

The review paper, Management of Teenage Pregnancy, carried out by Dr Kenny and clinical research fellow Richard Horgan, has been published in The review paper, Managment of Teenage Pregnancy, carried out by Dr Kenny and clinical research fellow Richard Horgan, has been published in The Obstetrician & Gynaecologist Journal in Britain.

While much of the reseach took place in Britain, Dr Kenny points out that the risk factors and the recommendations of the review also apply to Ireland. The current rate of teenage births in Ireland is 1.6 per 1,000 females aged 15-19 years of age, while the UK has the highest teenage pregnancy rate in Europe at 41.3 births per 1,000 15 to 17 year-old females. Associated risks in teenage pregnancy include high rates of sexually transmitted infections, alcohol and substance misuse, smoking and poor diet, according to the review. It shows that higher rates of teenage pregnancy tend to be concentrated inner cities and are linked to poverty.

Dr Kenny said: "What is certain is that the risk factors for teenage pregnancy are the same in the UK and Ireland and the risks to the babies are the same, ie babies are much more likely to be small and there is a higher rate of mortality." She cited the need to prevent teenage pregnancy through a multidisciplinary approach by policymakers and healthcare providers and said the risk of adverse outcomes in the pregnant teen must be reduced.

The review show sthe death rate for babies and very young children of teenage mothers in the UK is 60 per cent higher than that for children of older women, and young single women are three times more likely than older women to experience post-natal depression than older women.

"The high risk of adverse pregnancy outcome in the adolescent has been attributed to gynaecological immaturity and the growth and nutritional status of the mother," Dr Kenny said. "Gynaecological immaturity undoubtedly predisposes adolescent girls to poor pregnancy outcome in that the rates of spontaneous miscarriage and of very pre-term birth (32 weeks of gestation) are highest in girls aged 13-15 years.

"However, maternal growth and nutritional status during pregnancy also appear to play a potentially modifiable role. Many adolescent girls retain the potential to grow while pregnant." While there is no evidence, to date, of medical interventions that can specifically improve pregnancy outcome, the authors of the review recommend that teenage mothers receive supportive care and are directed towards the social support they need.