Search

Objective: To compare pregnancy characteristics and outcomes between Aboriginal and non-Aboriginal teenagers. DESIGN, SETTING AND POPULATION: A retrospective cohort study using the perinatal data collection for South Australian births in 1995-1999: 449 Aboriginal and 4,625 non-Aboriginal teenagers., Methods: Comparison of socio-demographic and clinical characteristics, using relative risks., Main Outcome Measures: Rates of pregnancy, smoking during pregnancy, induction, delivery method, preterm and small-for-gestational-age births and perinatal mortality, Results: Aboriginal teenagers have a pregnancy rate more than twice as high as non-Aboriginal, but a smaller proportion of pregnancies are terminated. They have pregnancies earlier, are more likely to be single, to smoke during pregnancy, to have few antenatal visits, to give birth in a country hospital and to have infections and anaemia. They have lower induction and analgesia rates, but a higher caesarean section rate. Their babies are more likely to be small-for-gestational-age and preterm, to have a congenital abnormality, to require special and intensive nursery care and stay longer in hospital. While their perinatal mortality rate has halved since a decade ago, their neonatal death rate is still twice that of non-Aboriginal births., Conclusions: Aboriginal teenagers need special attention. Support in particular is needed for Aboriginal health workers in preconceptional counselling and health promotion programs that build the capacity of the community, eg concerning proper nutrition during pregnancy, smoking cessation, breastfeeding, SIDS prevention, support for early and regular attendance for antenatal care in friendly and culturally appropriate environments. Outreach services and sexual health services for young Aboriginal people also need expansion.

Objectives: To describe trends in teenage pregnancy rates in South Australia and Australia in 1970-2000, and the socio-demographic and clinical characteristics and outcomes of teenage women who gave birth in South Australia in 1995-99., Methods: A descriptive study using population-based legislated South Australian perinatal and abortion data, Australian Medicare and hospital morbidity data on abortions, and birth registration rates from the Australian Bureau of Statistics., Results: The teenage pregnancy rate in South Australia fell in the 1970s and 1980s, increased in the 1990s, but is declining at the turn of the century. Teenage abortions exceeded livebirths annually from 1994, and in 2000 the teenage abortion, birth and pregnancy rates were 22.4,18.3 and 40.8 per 1,000 respectively. The Australian rates, which are an underestimate, follow the South Australian trends and are declining but still much higher than in many western European countries. High socio-economic areas in South Australia have the lowest teenage pregnancy rates but the highest proportion of teenage pregnancies terminated. Teenagers who gave birth were more likely than older women to be Australian-born, Aboriginal, smokers during pregnancy (47% vs. 23%), to attend few antenatal visits, and to have preterm, small-for-gestational-age and low birthweight babies and neonatal deaths. Perinatal mortality has halved among teenagers under 17 years in the past decade., Conclusions and Implications: Births to South Australian teenage women are associated with social disadvantage and relatively poor perinatal outcomes, although these have improved. Current strategies are aimed at reducing the incidence of unplanned teenage pregnancy and improving support for pregnant teenagers.

The objective of this study was to determine whether women who have experienced an unexplained stillbirth have a higher risk of adverse perinatal outcomes in subsequent births. We compared 316 subsequent births to women with a previous unexplained stillbirth, with 3160 births to women with no previous history of stillbirth, matched by year of birth, in the period 1987-1997, from the South Australian perinatal database, using logistic regression analysis. There was no increase in the rate of stillbirth and no statistically significant increase in the rate of perinatal death (OR 1.62 [95%CI 0.63-4.20]) or neonatal death, although larger studies are needed to confirm this. However, after adjusting for age, parity, and hospital category of birth, women who had a previous stillbirth had increased incidences in subsequent births of abnormal glucose tolerance or gestational diabetes (a fourfold increase); induction of labour and elective Caesarean section; fetal distress and postpartum haemorrhage; and forceps and emergency Caesarean delivery and preterm birth, which were independent of induction of labour. Gestational age at birth and birthweight were also significantly reduced, suggesting a need for close monitoring of their future pregnancies.