Prenatal Care and Maternal and Infant Health Outcomes
Adolescent pregnancies are more likely to result in a poor outcome for both mother and baby than pregnancies in adult women. Adolescent mothers are at increased risk for mortality and pregnancy-induced hypertension, and their babies are at increased risk for prematurity, low birthweight, and mortality in the first year of life ( Brown, Fan, & Gonsoulin, 1991; Friede et al., 1987; Hayes, 1987; McAnarney et al., 1978). It is unclear whether the adverse outcomes are a result of biological or environmental factors -- an issue that is currently a topic of controversy in the teen pregnancy literature ( Fraser, Brockert, & Ward, 1995; Goldenberg & Klerman, 1995; Hughes & Simpson, 1995).
Biologically, several factors have been theorized to explain poor pregnancy outcome in adolescents, including a low gynecological age (conception within 2 years of menarche; Erkan, Rimer, & Stine, 1971; Zlatnik & Burmeister, 1977), incomplete growth in height ( Scholl, Hediger, Ances, & Cronk, 1988), and low prepregnancy weight and poor weight gain ( Haiek & Lederman, 1989). But only low prepregnancy weight and poor weight gain have been consistently associated with low birthweight infants ( Goldenberg & Klerman, 1995). Many environmental factors have been associated with poor birth outcomes including poverty, unmarried status, low educational levels, and inadequate prenatal care ( Ahmad, 1990; Ketterlinus, Henderson, & Lamb, 1990); pregnant adolescents are more likely to be poor, single, uneducated ( Trussell, 1988) and are less likely to receive early prenatal care ( Kinsman & Slap, 1992). Perhaps in adolescents it is a combination of both biological and social factors that lead to poor outcomes.
In this chapter, we present outcome data for both mothers and babies with attention to both biological and environmental factors. For example, we examine a number of prenatal maternal characteristics, such as the incidence of specific pregnancy complications, pregnancy weight gain, prenatal drug use, and quality