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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e247-e252
DOI: 10.1055/s-0040-1715164
Original Article

Driving Factors of Preterm Birth Risk in Adolescents

Marta J. Perez
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Jen J. Chang
2   Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
,
Lorene A. Temming
3   Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Atrium Health Women's Institute, Carolinas Medical Center, Charlotte, North Carolina
,
Ebony B. Carter
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Julia D. López 
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Methodius G. Tuuli
4   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
,
George A. Macones
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Molly J. Stout
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations Funding M.J.S. has support from NIH/NICHD Women's Reproductive Health Research Career Development Program at Washington University in St. Louis (5K12HD063086-05), and The March of Dimes Prematurity Research Center at Washington University in Saint Louis. E.B.C. has support from the Robert Wood Johnson Foundation (74250). M.G.T. had support from NIH/NICHD Women's Reproductive Health Research Career Development Program at Washington University in St. Louis (5K12HD063086-05). The above funding sources had no role in the study design, collection/analysis/interpretation of data, or manuscript preparation. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of the foundation or federal support entities.
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Abstract

Objective We examined rates of spontaneous and indicated preterm births (S-PTB and I-PTB, respectively) and clinical risk factors for PTB in adolescents.

Study Design This is a population-based, retrospective cohort using 2012 U.S. natality data of nulliparous women who delivered a nonanomalous singleton birth between 20 and 42 weeks' gestation. Maternal age included <16, 16 to 19.9, and ≥20 years. Rates of total, S-PTB, and I-PTB were compared across age groups. Multinomial logistic regression tested clinical risk factors for S-PTB.

Results In 1,342,776 pregnancies, adolescents were at higher risk for PTB than adults. The rate of total PTB was highest in young adolescents at 10.6%, decreased to 8.3% in older adolescents, and 7.8% in adults. The proportion of S-PTB was highest in the youngest adolescents and decreased toward adulthood; the proportion of I-PTB remained stable across age groups. Risk factors for S-PTB in adolescents included Asian race, underweight body mass index (BMI), and poor gestational weight gain (GWG). In all age groups, carrying a male fetus showed a significant increased S-PTB, and Women, Infants, and Children's (WIC) participation was associated with a significantly decreased risk.

Conclusion The higher risk for PTB in adolescents is driven by an increased risk for S-PTB. Low BMI and poor GWG may be potentially modifiable risk factors.

Condensation Adolescents have a higher risk for spontaneous PTB than adult women, and risk factors for spontaneous PTB may differ in adolescents.

Keywords

spontaneous preterm birth - indicated preterm birth - adolescents - risk factors

Poster Presentation Information

This data was presented at the 37th Annual Society for Maternal Fetal Medicine Meeting, January 2017, Las Vegas, Nevada.




Publication History

Received: 27 September 2019

Accepted: 06 April 2020

Article published online:
27 August 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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