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J Adolesc Health. 1993 Jun;14(4):340-2.

Factors associated with preterm delivery among pregnant adolescents.

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Division of Adolescent Medicine, University of Colorado Health Science Center, Denver 80218.


The purpose was to identify characteristics of pregnant adolescents associated with preterm delivery. We studied 126 poor, black, 12 through 18-year-old pregnant adolescents and compared the prevalence of potentially high-risk maternal characteristics and obstetric complications in those who bore preterm and term infants. Of the adolescents studied, 12 (9.5%) delivered prematurely. Five maternal characteristics--conception within 3 years of menarche, a low body mass index, a past history of physical or sexual abuse, a socially deviant father of the baby, and vaginal bleeding during the first 8 weeks of gestation--were associated with preterm delivery. A theoretical model is proposed and the therapeutic implication of the study findings.


In order to identify the characteristics of pregnant adolescents which are associated with preterm delivery of their babies, data collected from the Rochester Study of Adolescent Pregnancy, a 3-year prospective study of the relationship between maternal age, weight gain, and infant outcome in 195 consecutively enrolled, poor, Black, 12-30 year old women, were used to develop a cohort of 126 pregnant adolescents who were less than 19-years-old at conception. Gestational age was calculated from the date of the last menstrual period and verified by ultrasound and Dubowitz examinations. Infants born prior to the 37th week of gestation were considered preterm. 12 of the study mothers had preterm infants (born at an average of 33+or-4 weeks compared with 39+or-1 week for term infants). Univariate analysis revealed that preterm delivery was significantly associated (por=0.05) with 5 maternal characteristics: 1) conception within 3 years of menarche, when menarche occurred after the population mean of 12 years; 2) a body mass index blow the population mean of 23kg/sq. m; 3) a history of abuse; 4) a sexual partner (the baby's father) involved in socially deviant behaviors; and 5) vaginal bleeding during the first 8 weeks of gestation. These maternal characteristics fit a theoretical framework which suggests that during the first trimester, pregnancy hormonal deficiencies associated with physical immaturity, the additional nutritional requirements of a thin body habitus, and stress-related physiologic changes can adversely affect adaptation to the physiologic demands of pregnancy and compromise the growth of the utero-placental vascular bed. This would predispose a women to early first trimester vaginal bleeding and/or preterm delivery. To test this hypothesis, more research is needed in the area of early maternal physiologic adjustment to pregnancy in larger, more diverse populations. Such research would provide a scientific basis for the allocation of scarce adolescent prenatal services.

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