Public Health/Global Health
Poster Session 1
Michael Richley, MD
Department of OB/GYN
University of Washington
Seattle, WA, United States
Christina S. Han, MD (she/her/hers)
Associate Clinical Professor
David Geffen School of Medicine at UCLA
Los Angeles, CA, United States
Lauren E. Wisk, PhD
Assistant Professor Division of General Internal Medicine & Health Services Research
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States
Tannaz Moin, MBA, MD
Associate Professor, Division of Endocrinology, Diabetes, and Metabolism
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States
Timothy Copeland, PhD
Fielding School of Public Health at UCLA
Los Angeles, CA, United States
Estelle Everett, MD
Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States
Adolescent pregnancies (AP) pose significant psychosocial, economic and intergenerational burdens on the health system and society. While teens tend to be healthier at baseline, adverse pregnancy outcomes (APO) are a known risk. Trends, risk factors, and rates of these APO have not been quantified in the last decade. Given the increasing restrictions in reproductive options for pregnant individuals, we sought to evaluate modern trends in AP rates and associated APO.
Study Design: We performed a retrospective cohort study using the Kids’ Inpatient Database (KID) to identify pediatric admissions (9-20 years old) with ICD-9 and -10 codes pertaining to Labor and Delivery in years 2006, 2009, 2012, 2016, 2019 in the United States. We used descriptive statistics and Pearson’s correlation to measure the association between each year analyzed and APO.
Results:
1,840,913 AP were reported over the study period. AP disproportionately affects the South (44.5%), urban populations (80.4%), Caucasian and Hispanic (35.6% and 27.1%, respectively), lowest quartile of median household income (41.2%), public insurance (72.4%). AP rates have decreased over time (p=< 0.001), but mortality rates remained stable (p=0.04; Figure). Increasing trends (all p=< 0.0001) were noted for obesity (from 1% to 9.3%), type 2 diabetes (from 1.4% to 1.9%), hypertensive disorders (from 8% to 15%), multiple gestations (from 0.3% to 0.8%), length of stay (from 2.54 to 2.70 days), and severity of illness. Cesarean rates decreased from 19.5% to 16.8% (p=< 0.0001) Overall rates of gestational hypertension, preeclampsia, and eclampsia are 5.8%, 6.4%, and 0.14% respectively.
Conclusion: Despite decreasing rates, AP continues to disproportionately affect the South and lower income individuals and yield high rates of APO. These trends highlight the need to focus on preventative health, sex education, access to contraceptive and reproductive options, and prenatal care for this high-risk teen population.