Driving Factors of Preterm Birth Risk in Adolescents

Marta J. Perez; Jen J. Chang; Lorene A. Temming; Ebony B. Carter; Julia D. López; Methodius G. Tuuli; George A. Macones; Molly J. Stout

doi:10.1055/s-0040-1715164

American Journal of Perinatology Reports, Table of Contents

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

¹Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

,

Jen J. Chang

²Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri

,

Lorene A. Temming

³Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Atrium Health Women's Institute, Carolinas Medical Center, Charlotte, North Carolina

,

Ebony B. Carter

¹Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

,

Julia D. López

¹Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

,

Methodius G. Tuuli

⁴Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana

,

George A. Macones

¹Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

,

Molly J. Stout

¹Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

› Author Affiliations

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

Full Text

References

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