How do pregnancy outcomes differ in teenage mothers? A Western Australian study

Lucy N Lewis, Martha Hickey, Dorota A Doherty and S Rachel Skinner
Med J Aust 2009; 190 (10): 537-541.


Objectives: To determine whether teenage pregnancy and Indigenous status are associated with increased risk of adverse pregnancy outcomes.

Design, setting and participants: A cross-sectional descriptive analysis of nulliparous women with singleton pregnancies who delivered at the sole tertiary obstetric hospital in Western Australia between June 2004 and September 2006, using data obtained from computerised midwifery records.

Main outcome measures: Maternal risk factors, pregnancy characteristics, and obstetric and perinatal outcomes for teenage and adult pregnancies.

Results: Of the 4896 births reviewed, 560 (11%) were to teenage mothers. Teenagers were more likely to be Indigenous and to experience maternal risk factors such as anaemia and smoking. Indigenous women were more likely than non-Indigenous women to be smokers, with young Indigenous teenagers (aged 12–16 years) being most likely to smoke (odds ratio [OR], 6.29; 95% CI, 3.99–9.92). Perinatal outcomes for teenage and adult births were similar, while adjustment for smoking and Indigenous status changed the observed association for the Indigenous population of preterm delivery < 37 weeks’ gestation (OR, 1.31; 95% CI, 1.01–1.71), admission to special care nursery (OR, 1.41; 95% CI, 1.10–1.81) and low birthweight (OR, 1.43; 95% CI, 1.10–1.87). However, older teenagers (aged 17–18 years) were the group at highest risk of stillbirth (OR, 1.99; 95% CI, 1.03–3.76).

Conclusions: These results improve our understanding of the obstetric and medical issues associated with teenage pregnancy and birth in WA and how we might tailor our approach to care. Indigenous teenagers need special attention, and there is significant scope for public health interventions around anaemia and smoking in this population.

  • Lucy N Lewis1,2
  • Martha Hickey2
  • Dorota A Doherty2
  • S Rachel Skinner3

  • 1 School of Paediatrics and Child Health, University of Western Australia, Perth, WA.
  • 2 School of Women’s and Infants’ Health, University of Western Australia, Perth, WA.
  • 3 Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW.



This study was supported by a Princess Margaret Hospital for Children Clinical Research Scholarship and the Women and Infants Research Foundation, Western Australia. We would like to thank Maureen Hutchinson and the midwives and other health care workers at KEMH for the perinatal data supplied by the Obstetric and Gynaecology Clinical Care Unit. We are grateful for the biostatistical support provided by James Humphreys and Angela Jacques.

Competing interests:

None identified.

  • 1. Australian Bureau of Statistics. Births, Australia, 2006. Canberra: ABS, 2007. (ABS Cat. No. 3301.0.) (accessed Jul 2008).
  • 2. UNICEF. A league table of teenage births in rich nations. Innocenti Report Card No. 3. Florence: UNICEF Innocenti Research Centre, Jul 2001.
  • 3. Shaw M, Lawlor DA, Najman JM. Teenage children of teenage mothers: psychological, behavioural and health outcomes from an Australian prospective longitudinal study. Soc Sci Med 2006; 62: 2526-2539.
  • 4. Fraser AM, Brockert JE, Ward RH. Association of young maternal age with adverse reproductive outcomes. N Engl J Med 1995; 332: 1113-1117.
  • 5. Robson S, Cameron CA, Roberts CL. Birth outcomes for teenage women in New South Wales, 1998–2003. Aust N Z J Obstet Gynaecol 2006; 46: 305-310.
  • 6. Coory M. Trends in birth rates for teenagers in Queensland, 1988 to 1997: an analysis by economic disadvantage and geographic remoteness. Aust N Z J Public Health 2000; 24: 316-319.
  • 7. van der Klis KA, Westenberg L, Chan A, et al. Teenage pregnancy: trends, characteristics and outcomes in South Australia and Australia. Aust N Z J Public Health 2002; 26: 125-131.
  • 8. Westenberg L, van der Klis KA, Chan A, et al. Aboriginal teenage pregnancies compared with non-Aboriginal in South Australia 1995–1999. Aust N Z J Obstet Gynaecol 2002; 42: 187-192.
  • 9. O’Leary CM, Bower C, Knuiman M, Stanley FJ. Changing risks of stillbirth and neonatal mortality associated with maternal age in Western Australia 1984–2003. Paediatr Perinat Epidemiol 2007; 21: 541-549.
  • 10. Skinner SR, Hickey M. Current priorities for adolescent sexual and reproductive health in Australia. Med J Aust 2003; 179: 158-161. <MJA full text>
  • 11. Chen XK, Wen SW, Fleming N, et al. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol 2007; 36: 368-373.
  • 12. Smith GC, Pell JP. Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: population based retrospective cohort study. BMJ 2001; 323: 476-479.
  • 13. Raatikainen K, Heiskanen N, Verkasalo P, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health 2006; 16: 157-161.
  • 14. Chan DL, Sullivan EA. Teenage smoking in pregnancy and birthweight: a population study, 2001–2004. Med J Aust 2008; 188: 392-396. <MJA full text>
  • 15. Dewan N, Brabin B, Wood L, et al. The effects of smoking on birthweight-for-gestational-age curves in teenage and adult primigravidae. Public Health 2003; 117: 31-35.
  • 16. Australian Bureau of Statistics. Information paper: an introduction to Socio-Economic Indexes for Areas (SEIFA), 2006. Canberra: ABS, 2008. (ABS Cat. No. 2039.0.) ain%20Features22006?opendocument (accessed Jul 2008).
  • 17. Lumley J, Oliver SS, Chamberlain C, Oakley L. Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev 2004; (4): CD001055. DOI: 10.1002/14651858.CD00 1055.pub2.
  • 18. Mohsin M, Bauman AE. Socio-demographic factors associated with smoking and smoking cessation among 426,344 pregnant women in New South Wales, Australia. BMC Public Health 2005; 5: 138. (accessed Aug 2008).
  • 19. Australian Bureau of Statistics. National Aboriginal and Torres Strait Islander Health Survey, 2004–05. Canberra: ABS, 2006. (ABS Cat. No. 4715.0.) (accessed Jul 2008).
  • 20. Gupta N, Kiran U, Bhal K. Teenage pregnancies: obstetric characteristics and outcome. Eur J Obstet Gynecol Reprod Biol 2008; 137: 165-171.
  • 21. Levy A, Fraser D, Katz M, et al. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol 2005; 122: 182-186.
  • 22. Reveiz L, Gyte GM, Cuervo LG. Treatments for iron-deficiency anaemia in pregnancy. Cochrane Database Syst Rev 2007; (2): CD003094. DOI: 10.1002/14651858.CD003 094.pub2.
  • 23. Pena-Rosas J, Viteri FE. Effects of routine oral iron supplementation with or without folic acid for women during pregnancy. Cochrane Database Syst Rev 2006; (3): CD004736. DOI: 10.1002/14651858.CD004736.pub2.
  • 24. Chen XK, Wen SW, Fleming N, et al. Increased risks of neonatal and postneonatal mortality associated with teenage pregnancy had different explanations. J Clin Epidemiol 2008; 61: 688-694.
  • 25. Leeds K, Gourley M, Laws P, et al. Indigenous mothers and their babies, Australia 2001–2004. Canberra: Australian Institute of Health and Welfare, 2007. (AIHW Cat. No. PER 38. Perinatal statistics series no. 19.) (accessed Jul 2008).


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