Maternal Characteristics and Outcomes Associated with Late Enrollment for Care in Teenage Pregnancies

Objective: To identify characteristics associated with late prenatal care in adolescent mothers. Methods: This retrospective cohort study reviews all nulliparous adolescent deliveries at the authors' institution during 2000-2004. Subjects were divided into three trimester groups using American College of Obstetricians and Gynecologists standard definitions. First trimester enrollees served as controls. Second and third trimester registrants served as exposure groups. Frequencies and odds ratios were calculated for adverse outcomes. Results: During the study period, 484 adolescents met the inclusion criteria (11-18 years old). Very young adolescents (age < 16 years) enrolled for care significantly later than their older counterparts (19.7 vs 16.2 weeks). Second trimester enrollment was not associated with any adverse outcomes. Third trimester registrants had significantly lower prepregnancy body mass index (23.2 vs 25.0 kg/m2) and weight gain (27.6 vs 32.6 lbs); and a higher rate of Medicaid use (77 vs 59%) and low birth weight infants (adjusted OR, 2.15; 95% CI, 1.04-4.43) when compared to controls. Conclusion: Third trimester enrollment for prenatal care in adolescents is associated with higher rates of adverse perinatal outcomes. Interventions to improve prenatal care enrollment among adolescents should be sought.