Engin YURTÇU, Sibel MUTLU, Ayşe ÇİTİL, Vehbi Yavuz TOKGÖZ

Adolesan ve Erişkin Gebelikler Arasındaki Perinatal Sonuçların Karşılaştırılması: Retrospektif Kohort Çalışma

Çalışmamızın amacı doğum yapan adolesan yaş grubundaki gebeler ile yetişkin yaş grubu gebeler arasında demografik özellikler ve maternal ve neonatal sonuçlar açısından fark olup olmadığını retrospektif olarak karşılaştırmaktır. Çalışmamız retrospektif olarak kurgulanmış, 2016-2018 yılları arasında Karabük Üniversitesi Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde doğumu gerçekleşmiş 207 adolesan gebe (15-19 yaş) ve kontrol grubu olarak yine aynı yıllar arasında doğum yapmış rastgele seçilen 226 yetişkin gebe kadın (20-35 yaş) dahil edilmiştir. Adolesan grubun yaş ortalaması 18.19±0.93 kontrol grubundaki gebelerin yaş ortalaması 27.09±3.75 idi. Eğitim düzeyi adolesan grubunda düşük saptandı. Sezaryen ile doğum oranı kontrol grubunda daha yüksek (%51.8'e karşın%35.7) epizyotomi ile normal vajinal doğum oranı ise adolesan grubunda yüksek (%93.2'e karşın %70.6) bulundu. Adolesan grubunda intrauterin gelişim geriliği ve oligohidroamnios birlikteliği daha sık saptandı (p=0.019). Kontrol grubunda gestasyonel diabet görülme sıklığı daha fazlaydı (%4 'e karşın %0.5, p=0.015). Adolesan grubunda fetal doğum ağırlığı kontrol grubuna kıyasla daha düşük saptandı (p=0.014). Adolesan grubunda birinci dakika Apgar skorları daha düşük bulundu (p=0.043). Preeklampsi, preterm doğum, erken membran rüptürü görülme sıklığı gruplar arasında benzerdi. Çalışmamızın sonuçlarına göre adolesan gebelikler kötü perinatal sonuçlarla birliktelik göstermektedir. Adolesan gebelikler bu nedenle yüksek riskli gebelikler gibi değerlendirilmelidir. Devlet ve eğitim kurumları adolesan gebelikleri ve onun kötü sonuçlarını önlemek için etkili eylem planları hazırlamalıdır.

Anahtar Kelimeler:

Adolesan, gebelik, yenidoğan, perinatal komplikasyonlar

Comparison of Perinatal Outcomes Between Adolescent and Adult Pregnancies: A Retrospective Study

The aim of this study is to investigate adolescent pregnancies, sociodemographic characteristics of these pregnancies, maternal and neonatal outcomes and complications of adolescent pregnancies. We enrolled 207 adolescent pregnancies between ages of 15-19 years and adult pregnancies (after 19 years old) who were delivered at Karabuk University Hospital between 2016 and 2018. We compared the results within the groups retrospectively. The mean maternal age of the adolescent and control groups were 18.19±0.93 and 27.09±3.75 respectively (p<0.001). The educational status of adolescent group was lower than the control group. While cesarean section rate was higher in control group (51.8% vs 35.7%), vaginal delivery with episiotomy was higher in adolescent group (93.2% vs 70.6%). Intrauterine growth restriction with oligohydramnios was significantly higher in study group (p=0.019). The mean of birth weight and 1. minute APGAR score of adolescent group was significantly lower compared to the control group(p=0.014 and p=0.043 respectively). Gestational diabetes mellitus was significantly higher in control group (4% vs 0.5%, p=0.015). Rate of preeclampsia, preterm labor and premature rupture of membrane were similar the between the groups. In our study, adolescent pregnancies were associated with adverse fetal and maternal outcomes. So, adolescent pregnancies should be evaluated as a high risk pregnancy. Government and educational agencies should make an effective plan and take an action for preventing early pregnancies and poor reproductive outcomes among adolescents.

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