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Am J Perinatol 2017; 34(02): 123-129
DOI: 10.1055/s-0036-1584580
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adolescent Pregnancies in the United States: How Obstetric and Sociodemographic Factors Influence Risk of Cesarean Delivery

Christina A. Penfield
1   Department of Obstetrics and Gynecology, Irvine Medical Center, University of California, Berkeley, California
2   University of California, Berkeley, School of Public Health, Berkeley, California
,
Maureen Lahiff
2   University of California, Berkeley, School of Public Health, Berkeley, California
,
Cheri Pies
2   University of California, Berkeley, School of Public Health, Berkeley, California
,
Aaron B. Caughey
3   Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
› Author Affiliations
Further Information

Publication History

07 April 2016

23 May 2016

Publication Date:
20 June 2016 (online)

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Abstract

Objective To determine how an adolescent's risk of cesarean varies by maternal age and race/ethnicity, and evaluate the contribution of obstetric and sociodemographic factors to mode of delivery.

Study Design This is a retrospective cohort study of 604,287 births to women aged 13 to 23 years. Regression techniques were used to determine maternal ages at lowest risk of primary cesarean in each major racial/ethnic group before and after adjustment for various cesarean risk factors.

Results Adolescent age was associated with lower risk of cesarean compared with young adults (17.2% at age 13 years vs 24.8% at age 23 years, p < 0.05). After stratification by race/ethnicity, Non-Hispanic Black women had the highest probability of cesarean, while Asian/Pacific Islanders had the lowest probability across all ages. When compared with young adults of the same race/ethnicity, young adolescents continued to have a lower risk of cesarean, decreased by at least 30% until age 18 years (White) and 17 years (other racial/ethnic groups). These associations persisted after adjustment for obstetric and sociodemographic risk factors.

Conclusion Young maternal age is protective against cesarean delivery in all racial/ethnic groups. Adolescents also experience racial/ethnic disparities in mode of delivery similar to those observed in adults, which were unexplained by either obstetric or sociodemographic factors.

Keywords

adolescent pregnancy - cesarean delivery - racial/ethnic disparities - perinatal epidemiology

Note

The findings of this study were presented at the Academy Health Annual Research Meeting in San Diego, CA, June 8–10, 2014.


 

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