Background and objective: For most teenagers, pregnancy brings insecurity, problems, fear and many questions. The main objective of this research is to determine the outlined profile of the pregnant teenager and the medical implications associated with pregnancy in mothers under 18 years of age.
Materials and methods
A cross-sectional questionnaire-based study was carried out in 2019 and 2020 in Ploiesti, Romania. A total of 200 childbearing women who gave birth at the Hospital of Obstetrics and Gynaecology with ages between 13- 42 years participated voluntarily in this study with given informed consent. Out of them 100 were under 18 years of age (group A). The group B (control group) consisted of 100 childbearing women with ages over 18 years. The questionnaire was composed of 29 closed questions, administered by the same investigator in a face-to-face interview, contained general data of childbearing women, (age, marital status, place of residence, number of children, occupation, level of education, ability to understand medical terms – health literacy- by applying the Sahl test) and aspects related to the family environment, (parental education, parental occupation , characteristics of the dwelling, number of siblings). Beside the questionnaire, data about the obstetrical profile of the childbearing woman, data about the birth and the new-born baby were collected. The resulting data were centralized in a database, gathering all the data from the questionnaire and as well as from the observation sheets.
Results
Teenager childbearing women (mothers under 18 years of age) from group A had an average age of 16.56 ± 1.65. The highest frequency of births was at 17 years of age. The percentage of births in very young girls (13-15 years old) accounts for 28% (N=28). The analysis of the two groups showed that only 40 mothers under 18 years of age came from families whose parents have a registered marriage (P= 0.011 as compared to the control group). We found that in 65 teenagers the beginning of sexual life took place at an earlier age (under 14 years). Regarding pregnancy monitoring, expressed by the number of medical checkouts and examinations, there are significant differences between the studied groups (P<0.001). The lack of health education and knowledge of medical terms is evident in the group of teenage childbearing women. The application of the Sahl test to both groups showed a low level of health literacy in the group of teenager childbearing women, 84 cases vs. 35 cases in the control group.
When studying the number of medical investigations performed during pregnancy, we found significant differences (P<0.001): only 116 childbearing women from both groups performed medical investigations during pregnancy and only 42 were teenagers from these 116. Of 95 childbearing women from both groups who had hospitalizations during pregnancy, 56 were from the group of teenager mothers compared to 39 from the control group (p = 0.016). Teenager childbearing women gave birth to children with low weight for their gestational age (P<0.001 compared with the control group): in group A there were 14% and in group B only 4%. Regarding the gestational age, in the case of teenage mothers we had an average of 37.88 ± 2.13 weeks of gestation with a median of 38 weeks, compared to the gestational age in the control group of 38.41 ± 1.57 weeks, median of 39 weeks.
Conclusions
In Romania there are teenagers that became mothers at early ages. A pregnancy at an age between 13-15 years may come with medical implications, both physically and mental, thus medical supervision is important. Sexual and contraceptives' education in school and in the family may help the teenagers to control the possibility of becoming pregnant at such an early age. Therefore such type of educational programs must exist in rural and urban schools and communities. The midwife may play an essential role in the rural communities. A better management and multidisciplinary approach is needed.
