Comparison of Obstetric and Neonatal Outcomes in Adolescent, Reproductive and Old Age Pregnancies Delivery in a Tertiary Center

Yıl 2017, Cilt: 48 Sayı: 3, 89 - 93, 08.09.2017

Sibel Sak , Adnan İncebıyık , Hacer Uyanıkoğlu Ahmet Berkız Turp Neşe Gül Hilali , Muhammet Erdal Sak

https://doi.org/10.16948/zktipb.300736

Cited By: 1

Öz

Objective:
In this study, we aimed to evulate obstetric neonatal outcomes of adolescent
and old  age pregnants who gave birth in
our center.

Material
and Methods: A total of 126 pregnant women which
were consist of adolascent (14-18), reproductive(19-38) and advanced(39-50)  maternal age pregnancies and gave birth in
Harran University of Medicine Faculty of Obstetric and Gynecology Department
were compared retrospectively. Maternal demographic  datas, obstetric complications(preterm
delivery, abnormalities of presantation, intrauterin growth restriction (IUGR),
preeclampsia, gestational diabetes mellitus (GDM), abnormalities  of placentia, duration of hospitalization,
oligohidramnios, type of delivery, fetal outcomes(birth weights of infants, apgar
scores, macrosomia, congenital malformations, ıumf) were evulated.

Results:
Although the rates of birth weight infant, preterm labour, IUGR, amnion fluid
abnormalities, GDM ,macrosomia and preeclampsia were found  similiar in adolescents of whom majority are
nulliparous  and reproductıve,
advanced  maternal age women, the rates
of gestational week at birth were found to be lower and frequency of congenital
anomalies and abnormalities of presantation 
was found to be higher than the other both groups. The rate of sectio, placenta
previa totalis and percreata, duration of hospitalization were higher  significantly in advanced age maternal women.
The normal spontaneous vaginal deliveries rate was significantly higher in
reproductive group than the other groups.

Conclusion:
This study has shown that the adolescent and advanced maternal age women
have  some kind of charecteristıc high
risks in respect  to their age groups. For
having the best  maternal and neonatal
outcumes in both groups,these women should be informed about maternal and fetal
risks and provided regular perinatal follow ups and treatment. Also social
support is needed

Anahtar Kelimeler

Adolescent, advanced age, obstetric, neonatal

Tersiyer Bir Merkezde Doğum Yapan Adolesan, Reprodüktif ve İleri Yaş Gebelerde Obstetrik ve Neonatal Sonuçların Karşılaştırılması

Öz

Amaç:
Tersiyer bir merkezde doğum yapan  adolesan,
reprodüktif ve ileri yaş gebelerde obstetrik ve neonatal sonuçların
karşılaştırılması

Gereç
ve Yöntemler:  Harran
Üniversitesi Tıp Fakültesi Kadın Doğum Bölümünde  01.08.2015 -01.08.2016 yılları arasında  doğum yapmış olan adolesan yaş(14-18), reprodüktif
yaş(19-38) ve ileri yaş(39-50) gebelerden 
toplam 126 hastanın dosyası retrospektif olarak incelendi. Maternal
demografik veriler , gebelik komplikasyonları (Preterm doğum, prezentasyon
anomalisi, intrauterin büyüme kısıtlılığı(IUGR), preeklampsi, GDM(gestasyonel
diabet), plesantal anomali, hospitalizasyon süresi, oligohidramnios, doğum
şekli ve fetal sonuçlar (doğum ağırlığı, apgar skorları, makrozomi konjenital
malformasyonlar, IUMF(inutero mort fetüs) değerlendirildi.

Bulgular:
Büyük çoğunluğu nulliparlardan oluşan adolasanlarda preterm eylem ,doğum
ağırlığı, IUGR ,amniyon sıvı anomalisi(oligo), gestasyonel diabet ve
preeklampsi oranı reprodüktif ve ileri yaş gebelerle  benzer çıkarken doğumdaki gestasyonel hafta
anlamlı olarak küçük, fetal anomali sıklığı anlamlı olarak yüksek bulundu. İleri
yaş gebelerde ise sezaryen oranları ,plasenta previa totalis ve plesanta
percreata  görülme sıklığı ve
hospitalizasyon süresi anlamlı yüksek saptandı. Reprodüktif grupta ise normal
spontan doğum oranları her iki gruba göre anlamlı yüksek bulundu.

Sonuç:
Bu çalışmada adolesan ve ileri yaş annelerin 
kendi yaş grublarına özgün çesitli risklerin bulunduğu gösterilmiştir. Bu
yaş grubu gebelerde maternal ve neonatal olası en iyi sonuca varabilmek için
öncelikle bu gebelerin maternal ve fetal riskler ile ilgili bilgilendirilmesi,
düzenli prenatal  takip ve tedavi
olmalarının sağlanması ve sosyal destek gerekmektedir.

Anahtar Kelimeler

Adolesan, ileri yaş, obstetrik, neonatal

Kaynakça

• 1. World Health Organization (WHO): WHO guidelines on preventing early pregnancy and poor reproductive outcome among adolescents in developing countries. Geneva, WHO; 2011
• 2. Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J Obstet Gynaecol 2013;33:346–50
• 3. Kaplanoglu M, Kaplanoglu D, Usman MG. Postpartum contraception in adoles-cents: data from a single tertiary clinic in southeast of Turkey. Glob J Health Sci 2014;7:80
• 4. Allen J, Gamble J, Stapleton H, Kildea S. Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature. Women Birth 2012;25:54–63
• 5. Lao T, Ho L. Obstetric outcome of teenage pregnancies. Hum Reprod. 1998;13:3228-3232
• 6. Heino A, Gissler M. The statistics on assisted fertility treatments. Helsinki:THL 2012 (The National Institute for Health andWelfare)
• 7. Bertram H, Bujard M, Rösler W. Rush-hour des Lebens: Geburtenaufschub, Einkommensverläufe und familienpolitische Perspektiven. Journal für Reproduktionsmedizin und Endokrinologie 2011; 8: 91–99
• 8. Hoekelman RA. Teenage pregnancy--one of our nation's most challenging dilemmas. Pediatr Ann. 1993;22(2):81-2.
• 9. Amini SB, Catalano PM, Dierker LJ, Mann LI. Births to teenagers: trends and obstetric outcomes. Obstet Gynecol. 1996;87(5 Pt1):668-74
• 10. Miller FC. Impact of adolescent pregnancy as we approach the new millennium. J Pediatr Adolesc Gynecol. 2000;13(1):5-8
• 11. Yoder BA, Young MK. Neonatal outcomes of teenage pregnancy in a military population. Obstet Gynecol. 1997 ;90:500-6
• 12. English PB, Kharrazi M, Guendelman S. Pregnancy outcomes and risk factors in Mexican Americans: the effect of language use and mother's birthplace. Ethn Dis. 1997;7(3):229-40
• 13. Williams RL, Binkin NJ, Clingman EJ. Pregnancy outcomes among Spanish-surname women in California. Am J Public Health. 1986;76(4):387-91
• 14. Yıldırım Y, Inal MM, Tinar S. Reproductive and obstetric characteristics of adolescen pregnancies in Turkish women. J Pediatr Adolesc Gynecol 2005;18:249-253
• 15. Melekoğlu R, Evrüke C, Kafadar T, Mısırlıoğlu S, Büyükkurt S, Özgünen FT. Perinatal Outcomes of Adolescent Pregnancy Türk Jinekoloji ve Obstetrik Derneği Dergisi 2013;10:213- 9
• 16. Azevedo WF, Diniz MB, Fonseca ES, Azevedo LM, Evangelista CB. Complications in adolescent pregnancy: systematic review of the literature. Einstein (Sao Paulo). 2015;9:0
• 17. Jeha D, Usta I, Ghulmiyyah L, Nassar A. A review of the risks and consequences of adolescent pregnancy. J Neonatal Perinatal Med. 2015;12
• 18. Guimarães AM, Bettiol H, SouzaLd, Gurgel RQ, Almeida ML, Ribeiro ER, Goldaniv MZ, Barbieri MA. Is adolescent pregnancy a risk factor for low birth weight? Rev Saude Publica. 2013;47:11-9
• 19. Scholl TO, Hediger ML, Huang J, Johnson FE, Smith W, Ances IG. Young maternal age and parity. Influences on pregnancy outcome. Ann Epidemiol 1992;2:565-75
• 20. Raatikainen K, Heiskanen N, Verkasalo P, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health. 2006;16:157-161
• 21. Zeteroğlu S, Şahin I, Gol K. Cesarean delivery rates in adolescent pregnancy. Eur J Contracept Reprod Health Care. 2005;10:119-22
• 22. Chandra PC, Schiavello HJ, Ravi B et al. Pregnancy outcomes in urban teenagers. Int J Gynaecol Obstet 2002;79(2):117-22
• 23. Khwaja SS, Al-Sibai MH, Al-Suleiman SA et al. Obs¬tetric implications of pregnancy in adolescence. Acta Obstet Gynecol Scand 1986;65(1):57-61
• 24. Dietl A, Cupisti S,. Beckmann M. W , Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes inWomen Over 40 Years of Age Geburtsh Frauenheilk 2015; 75: 827–832
• Yogev Y, Melamed N, Bardin R et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 2010; 203: 558.e1–558. e7
• 27. Salihu HM, Shumpert MN, Slay M et al. Childbearing beyond maternal age 50 and fetal outcomes in the United States. Obstet Gynecol 2003; 102 (5 Pt 1): 1006–1014
• 28. Callaway LK, Lust K, McIntyre HD. Pregnancy outcomes in women of very advanced maternal age. Aust N Z J Obstet Gynaecol 2005; 45: 12
• 29. Stevens-Simon C, McAnarney ER. Adolescent pregnancy. Gestational weight gain and maternal and infant outcomes. Am J Dis Child. 1992 Nov;146(11):1359-64
• 30. İmır GA, Çetin M, Balta Ö, Büyükayhan D, Çetin A. Perinatal Outcomes of Adolescent Pregnancies at a University Hospital inTurkey. Journal of the Turkish-German Gynecological Association 2008;9:70-73
• 31. Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol 2005;105(5 Pt 1): 983-90
• 32. Panicha Chantrapanichkul, Saifon Chawanpaiboon Adverse pregnancy outcomes in cases involving extremely young maternal age International Journal of Gynecology and Obstetrics 120 (2013) 160–164
• 33. Seçkin KD, Yücel B, Karslı MF, Özdemir Ç. Adölesan Doğumların Demografik Özellikleri ve Maternal-Fetal Sonuçları: İstanbul’da Referans Bir Hastanede Gerçekleştirilen Olgu-Kontrol Çalışması, Okmeydanı Tıp Dergisi 2016; 32(1):14-18