Teenage pregnancy raises risks for pregnant women and fetuses

Pregnancy during adolescence represents a series of risks for both the pregnant woman and the fetus, obstetricians point out. Among the problems, some of them are early birth of the baby, maternal death and gestational diabetes.

“Any teenage pregnancy is considered a high-risk pregnancy,” says Fernanda Faig, a specialist in high-risk obstetrics and fetal and medical medicine at the maternal and child department at Hospital Israelita Albert Einstein.

Teenage pregnancy is a reality in Brazil. According to Marcelo Antonini, obstetrician gynecologist at the State Public Servant Hospital, there are about 400,000 pregnancies among teenagers in the country each year.

The subject came up again in Brazil with the case of an 11-year-old girl who is pregnant for the second time. In January 2021, the girl was raped in a rural area of ​​Piauí, where she lives. So, she became pregnant for the first time and proceeded with the pregnancy.

The mother, a 29-year-old housewife, did not authorize the abortion and said the doctor had said the girl was life-threatening in the procedure. The girl also chose not to have an abortion.

Now, the girl is pregnant for the second time also as a result of sexual violence. According to her mother, the rape was committed by her paternal uncle. Both shared the same room in the girl’s father’s house.

The abortion is again rejected by the girl’s mother. For her, abortion is a crime. On the other hand, the victim’s father says he is in favor of the procedure.

In Brazil, the termination of a pregnancy is allowed in cases of rape, risk of death for the pregnant woman and anencephaly of the fetus.

Obstetrician gynecologist Natalia Grandini Tannous says that a problem in this girl’s case is the proximity between the first period and pregnancy. Tannous explains that a pregnancy up to two years after the first period represents a problem. This is because there is a “dispute for nutrients between the mother and the fetus”, since the pregnant woman is still in the growth phase.

In addition, the obstetrician cites that other risks have already been documented in the medical literature for pregnant adolescents. The main ones are maternal death, high blood pressure, gestational diabetes, eclampsia, greater chances of the baby being born small and greater probability of performing a cesarean section.

“This all seems to get worse if you go before age 15,” says Tannous.

Another problem is prematurity. Antonini explains that the risks of a baby being born prematurely are greater in the case of teenage pregnancy.

The obstetrician also says that teenage pregnancy problems are greater in girls under 15 and up to 1.5m tall. Pregnant girls weighing up to 45 kg are also more likely to experience complications. One of them is cephalopelvic disproportion, which is when the pregnant woman’s pelvis is not wide enough for the baby to pass through.

In such cases, cesarean section is an option, but it continues to pose risks. “During the cesarean section, there is a greater morbidity”, says Faig.

The specialist also cites other complications, such as anemia. “There are nutritional changes. It is a body that is not used to it, so there is a greater risk of developing anemia”, she summarizes.

Faig also draws attention to other problems, such as psychological and social. “We talk a lot about a psychological vulnerability in these teenagers who are not psychologically prepared for a pregnancy.”

The 11-year-old girl is an example of this problem. Since the birth of her first child, she has refused psychological support, dropped out of school and is in conflict with her parents.

Consecutive pregnancies

The girl’s case also alerts to another problem: the proximity between two pregnancies. She gave birth to her first child in September 2021 and is now three months into her second pregnancy.

Antonini says that the period from one pregnancy to another must be at least two years for the woman’s body to fully recover. Without this, problems already mentioned, such as premature births, may be more common.

The orientation is also indicated for adult women. However, in cases of adolescents, complications from one pregnancy followed by another can be worse.

“The interval between births is worse for teenagers, but for older women it also happens”, concludes Antonini.