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  • Title: Teenage pregnancy in Scotland: trends and risks.
    Author: Rosenberg K, McEwan HP.
    Journal: Scott Med J; 1991 Dec; 36(6):172-4. PubMed ID: 1805377.
    Abstract:
    Teenage pregnancy, considered to be associated with social and medical risks, is seen as a growing problem. Population based information from the Registrar General (Scotland) and Notification of Abortion permitted an analysis of the trends in the numbers, rates and outcomes of pregnancies among women aged less than 20 years. In addition, clinical information is available on all deliveries in Scottish hospitals from the standard hospital discharge document permitting analysis of the association of defined complications with age. Contrary to current perceptions, pregnancies and births among teenagers are not more frequent in 1988 when compared to 1975. There has been, however, a large increase in births to single women, a group with particular problems. The obstetric risks when compared to older women, are small and probably socially, not age related. These include a slightly higher rate of pre-term delivery and low birthweight and a later presentation for specialist antenatal care. The proportion of pregnancies affected by neural tube defects which are terminated is lower among women under 20. These medical risks are small, however, compared to the well-documented social and economic problems which will have long term and indirect effects on health. An analysis of trends in numbers, rates, and outcomes of pregnancies in women of 19 years and less was performed using population-based data from the Registrar General of Scotland, of all deliveries in Scottish hospitals from 1975 to 1988. The data were taken from the standard maternity discharge document including live and stillbirths, and from the 1975-87 Notifications of Abortion records. Pregnancies/1000 women ranged from 40 in 1983 to 50 in 1975. Proportionally more pregnancies were terminated in 1987. The number of live births to single women rose from 11.4 to 22.2/1000 over the period. In 1987 there were fewer marriages during pregnancy, and a lower proportion of pregnancies in married women. The total number of live births to women 20 decreased from 8267 in 1975 to 6158 in 1988, while those in single women rose from 2297 to 4558, from 28% to 74%. There were no evident trends in teen pregnancies, but an increase in the termination rate in teens was apparent. Most teen births occurred in mature out-of-school women. While 32% of primiparous women aged 18 booked for prenatal care at 21 weeks or more, there was no increase in anencephaly or spina bifida, which would have been detected by prenatal screening. Hypertension occurred in 14% of women 20 and in 21% of those 20. Operative deliveries were more common in women aged 20-24, and more often resulted in low birth weight. Low birth weight occurred in 8% of women, compared with 7% in those 20 (p0.01). When social factors were controlled, there were no differences in birth weight and gestation length. Indicators of social deprivation are discussed. The longterm implications of loss of education, training, employment, and stable marriages were considered more detrimental to the young mothers than the adverse health effects of early pregnancy.
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