OBJECTIVE: To determine and compare the use of prenatal care, incidence of pregnancy complications, and selected pregnancy outcomes (i.e., incidence of prematurity, low birth weight, and survival) in adolescent mothers with that of older mothers in a military population with access to a tertiary care center. METHODS: We reviewed data from the neonatal data base of a military tertiary care center, for the time period 1990-1994. All singleton births ≥ 20 weeks estimated gestational age (EGA) or ≥ 500 grams were included. All maternal transfers were excluded. Mothers were divided by age into four groups: 1) 13-17 years, 2) 18-19 years, 3) 20-29 years, and 4) ≥ 30 years. Use of prenatal care was assessed by the Kessner index. Data was analyzed by chisquare, t-test, Mann-Whitney U, logistical regression techniques, and One-way ANOVA with Bonferroni correction.RESULTS: There were 7017 infants included in the study (240 in Group 1; 629 in Group 2; 4474 in Group 3; 1674 in Group 4). Utilization of prenatal care was significantly improved as maternal age increased for each successive age group. Hispanic mothers utilized prenatal care less adequately than black and white mothers. Of the nine pregnancy complications reviewed, the only difference noted was a higher incidence of diabetes in Group 4 when compared to the other three groups. There was no difference between Group 1 and each of the other three groups in the incidence of prematurity, low birth weight infants, or infant survival. However, Group 2 had a significantly greater risk of preterm birth at < 33 weeks EGA than Group 3, and Group 4 had a significantly greater risk of preterm birth at < 37 weeks than Group 3. Additionally, rates for birthweight < 2500 grams were significantly greater in Group 2 when compared to Groups 3 and 4. Admission rates to higher level of neonatal care were no different between groups.

CONCLUSIONS: Although young teenagers presented later in gestation and utilized prenatal care less than older mothers, rates for pregnancy complications were similar, there was no greater rate of admission of infants to Level II or III neonatal care, and there were no differences in the incidence of prematurity, low birth weight, or neonatal survival among this group of patients cared for in a military tertiary health care center. However, 18-19 year old mothers had an increased risk of prematurity and low birth weight (< 2500g) when compared to other groups.