Morris - adolescent outcomes

For maternal and fetal outcomes for adolescent pregnancies, they can be very good. If you look at the outcomes for adolescents aged 15 to 19, they’re the same as the 20 to 24 group. If you look at the outcomes for the 12 to 14 age group we do see higher incidences of problems for both the mom and the baby. But once you get over 15, the outcomes don’t look very different in terms of maternal and fetal morbidity and mortality. And this has actually been born out in very large data base studies in the United States so we would regard an adolescent that’s 15 or over as pretty much expecting her to do well as long as we can control for all of the other risks in an adolescent’s life. The 12 to 14 age group do have a higher risk of preterm labour.  They have a higher risk of babies born with abnormalities and much higher social risks attached to it, so they are a special group in the sense that they really need to; you need to target them and access them early and provide the best care possible. The older adolescents tend to do very well.

One feature that’s unique to the adolescent pregnancy as well is there is a much higher risk of a sexually transmitted infection. We do have a prenatal clinic for teens 17 and under at the Women’s Hospital. Every time we’ve done an audit of our practice, the rate of being infected with an STI such as gonorrhea and chlamydia is about 25% over a background population rate of 1 to 3%. So it’s like you’ve taken the cream of the high risk for getting infections and they’re pregnant and have infections so a good part of our care has to focus on identifying and treating infections in that population. But otherwise their maternal and fetal outcomes can be very good in the 15+ age group.