JAMA found that the youngest pregnant girls had the highest risk of adverse outcomes

It has long been known that pregnant teens in the United States face increasing health risks and pregnancy complications, but a new study finds for the first time that pregnant girls 13 and younger are at greater risk
.
These very young girls were significantly more likely to experience preterm birth, caesarean section, and intensive care unit (ICU)
admission than older pregnant teenage girls.
Researchers from the University of Maryland School of Medicine (UMSOM) and the Perelman School of Medicine at the University of Pennsylvania led the study, which was published today in the Journal of
the American Medical Association (JAMA).

The researchers examined more than 90,000 birth records of pregnant teens, adolescents and young women between the ages of 10 and 19, the first study
to compare the differences between the youngest pregnant girls and girls pregnant in mid-puberty and girls with adult pregnancies.

"Our study found that when it comes to childbirth, a pregnant child or very young teen is more than just a 'little' teenager," said corresponding study author Kathleen E.
Goodman, Ph.
D.
, assistant professor of
epidemiology and public health at Missouri State University.
"We found that children aged 10 to 13 had a 56% higher risk of preterm birth and a 32%
higher risk of caesarean section compared to children aged 14 to 17 years.
"

The findings are based on all pregnant women aged 10-19 who gave birth in hospitals in the First Health Care Database, a national resource that includes about a quarter of U.
S
.
hospital discharges between January 2019 and May 2021.
Anthony D.
Harris, MD, M.
S.
, professor of epidemiology and public health at Massachusetts State University, is also a co-author
of the study.

Among pregnant adolescents aged 10 to 13 years, the incidence of preterm birth was 18.
5%; 14 ~ 17 years old accounted for 11.
6%; There were also 10.
5% of young women
aged 18-19.
In the youngest age group, about 22 percent were given birth by caesarean section, compared to 16.
4 percent among adolescents between 14 and 17 years old and 20.
1 percent
among young women between 18 and 19 years old.

The researchers considered factors that could contribute to higher mortality rates in the youngest groups, such as race and ethnicity, insurance type, and obesity status
.
They still found that the youngest girls had a significantly increased
risk of breast cancer compared to adolescents ages 14 to 17.
In terms of the total number, the vast majority of pregnancies (almost 68,000) occur between
the ages of 18 and 19.
The total number of pregnancies among adolescents aged 14 to 17 is close to 23,000, while the total number of pregnancies among adolescents aged 10 to 13 is only 206
.
In the youngest age group, more than two-thirds consider black or Hispanic
.

The team believes the ICU admission data they examined is preliminary and says the findings need to be confirmed
in future studies.
However, they still found it remarkable that ICU admissions were three times
higher among adolescents aged 10 to 13 than among adolescents aged 14 to 19.

"These complex birth outcomes are important
.
They can have lifelong effects on both mother and child," Dr.
Goodman said
.
"Mothers born preterm are more likely to have high blood pressure and mental health problems, including postpartum depression and post-traumatic stress disorder
.
Premature babies are at greater
risk of neurodevelopmental and respiratory problems.
”

The findings are particularly relevant
as states decide whether to cut reproductive health services based on the Supreme Court's June decision overturning Roe v.
Wade.

Beth L.
Pineles, MD, assistant professor in the Division of Maternal and Child Medicine, Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Pennsylvania, Perelman School of Medicine, and first author of the study, said, "The findings suggest that it is important to emphasize pregnancy prevention and proper care when it occurs — and if pregnancy is not desirable, all options
including abortion are available.
" "We were surprised at the magnitude of the impact, but it makes sense because the findings are biologically credible and that improved fertility outcomes in low- and middle-income countries have been able to reduce child pregnancies
.
"

Mark T.
Gladwin, M.
D.
, vice chancellor for medical affairs at the University of Maryland, Baltimore, and John Z.
and Akiko K.
Bowers Distinguished Professor and Dean of the University of Maryland School of Medicine, said, "Thankfully, pregnancy in very young girls is still rare in the United States, but even one pregnancy before teenage is too much
.
" "Racial and ethnic disparities remain stark, demonstrating the urgent health needs we as a nation must address to close the health inequality gap
.
"