Adolescents often receive suboptimal prenatal care, which may account for increased adverse outcomes. We determined the distribution of inappropriate prenatal care by maternal age, examined the temporal trend of inappropriate care among adolescents ages 12-15 and their effects on neonatal outcomes.METHODS:
Using the CDC Period Linked Birth/Infant Death File, we conducted a retrospective cohort study of adolescents ages 12-15 who delivered between 2011-2015. Adequacy of care was measured using the R-G INDEX. Linear regression analysis was used to measure adequacy of care and unconditional multivariate logistic regression was used to examine its effects on neonatal outcomes.RESULTS:
We observed decreasing rates of inappropriate care with rising maternal age. Among 63,484 adolescents ages 12-15, 14,845 (23.38%) received inappropriate care with rates rising significantly during the study period. Inappropriate care was most common among mothers ages 12-15 who were of Black (31.74%) or Hispanic ethnicity (26.66%), those with more than one prior birth (two prior births 30.30%), those presenting to their first prenatal visit at >7 months gestation (97.51%), and those with higher BMIs (BMI 25-29.9 28.16%, BMI 35-39.9 29.69%, BMI 40+ 33.78%). Neonates born to adolescents ages 12-15 and who received inappropriate prenatal care were significantly more likely to involve IUGR (7.58%, OR1.40, 95% CI (1.30-1.51)), infant deaths (1.33%, OR 1.35, 95% CI (1.15-1.58)) and NICU admissions (9.84%, OR 1.27, 95% CI (1.19-1.35)).CONCLUSION:
Inappropriate care decreased with rising maternal age. Adolescents ages 12-15 experienced increasing rates of inappropriate care from 2011-2015 and were associated with certain demographics and poorer neonatal outcomes.