Análisis de las diferencias en la complejidad y /o complicaciones obstétricas en relación al parto adolescente

Abstract

The importance of understanding the incidence from unwanted pregnancies, especially in teenagers, led us to make the present study. Objectives: 1) To study demographic data from patients of teenage births considering the rest of population. 2) To know the obstetric characteristics, development and teenage birth aim regarding the rest of population. 3) To break down risk factors and pregnancy, birth and puerperium complications from both groups. 4) To recognize if it exists any risk of domestic violence situation, mental health processes, secual assault and narcotics use in both groups. 5) To asses the educative/social/occupational situation of the teenage girls in the study. 6) To analyze the breastfeeding factor of the teenage girls in our study. Materials and methods: case study (teenagers) and controls (adults) that are completed with personal and telephonic interviews for a bio-psycho-social-ocuppational study and breastfeeding factors; teenage births assisted in the Hospital General Universitario Rafael Méndez from 1/01/2013 to 1/12/2017, in the Area III of the Servicio Murciano de Salud. There were 53 variables analyzed, according to aspects such as pregnancy/birth/puerperium. Results: 28.1% of teenagers are multi-gestation vs. 64.9% adults (p<0.05). 19% have abortion background in both groups (p>0.05).10.56% teenagers experienced premature deliveries vs. 5.08% adults (p<0.05). 83.17% opt for vaginal delivery vs. 73,83% adults (p<0.05). The teens group have more episiotomies (p<0.05) and tears (p<0.05) in 35,31% y 19,8 % respectively contrasted with a 12,5% y 12,4 % in adults. Teenagers have more premature deliveries and with weight below the threshold vs. adults (p<0.05); please note that teens have more risk factors and added pathologies in 40,26% y 28,38% respectively vs. 21,48% y 22,27% in adults, ceteris paribus. Atony occurs more frequently in adolescents than in adults, 4.29% versus 0% (p<0.05). Anemia is the most frequent complication experienced by teens (p<0.05). Conclusions: There is evidence that Gestions, delivery and puerperium among teens, Spanish national mostly, is associated with high complexity and higher number of issues in spite of satisfactory / adequate and thorough pregnancy controls. Most of teen patients are first timers in both gestation and delivery; Comparing vs. control group, they start delivery process spontaneously with: vaginal delivery (eutocic/instrumental), more episotomy and vaginal tearing. In contrast vs. control group, teenagers, experience higher risk during pregnancy with higher number of added pathologies (mostly hipothyroidism), complications during puerpuerium (Anemia mainly), deliver mostly pre-mature / low weight babies, do not opt for breastfeeding exclusively. Most of teen patients have suffered gropu sexual assult and domestic violence. Teen pregnancies exist in condition of financial / family dependance, school desertion, where 73,5% of them not using any contraceptive method previous to a pregnancy. Key words: teenage, complications, risk pregnancy, unwanted pregnancy, bio-psycho-social-ocuppational situation, gender violence, breastfeeding.