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庄文明，张丽，张婧，等 . 青少年初产妇妊娠结局及影响因素研究［J］. 中国全科医学，2022，25（20）：2474-
2481. ［www.chinagp.net］
ZHUANG W M，ZHANG L，ZHANG J，et al. Adverse pregnancy outcomes and associated factors in adolescent
primiparous women［J］. Chinese General Practice，2022，25（20）：2474-2481.

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Adverse Pregnancy Outcomes and Associated Factors in Adolescent Primiparous Women ZHUANG Wenming ，ZHANG
Li，ZHANG Jing，HU Rongmin
Department of Obstetrics and Gynecology，Ningbo Women and Children's Hospital，Ningbo 315012，China
*
Corresponding author：ZHUANG Wenming，Associate chief physician；E-mail：44618508@qq.com
【Abstract】 Background Stubbornly high pregnancy prevalence in adolescent females worldwide，results
in numerous adverse pregnancy outcomes，causing wide public concern. Thereby，it is pressing to study the pregnancy
characteristics，adverse pregnancy outcomes and associated factors in adolescent primiparous females. Objective To examine
adverse pregnancy outcomes and related factors in adolescent primiparous females via comparing pregnancy outcomes of them
with those of emerging and early adult females. Methods Primiparous females（n=12 222，<35 year old） with ≥ 28 weeks of
gestation were recruited from Ningbo Women and Children's Hospital during 2019—2020，including 210 aged 13-19 （adolescent
group），1 729 aged 20-24（adult group 1），and 10 283 aged 25-34（adult group 2）. Data were collected for maternal
demographics，pregnancy complications，comorbidities，delivery course and adverse fetal outcomes. The associations of age，
marital status，education background，rural or urban living，income，body mass index （BMI） with adverse maternal and fetal
outcomes were analyzed. Results Adolescent primiparas had higher proportions of individuals with unmarried status，junior high
school or lower education level，rural living，and an unstable income，as well as less mean prenatal care visits than the other
two groups（P<0.05）. Moreover，adolescent primiparas also had higher rates of placental abruption，maternal anemia，vaginal
delivery，perineal laceration，premature labor，（very） low-birth-weight infant，and stillbirth （P<0.05）. Multivariate
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Logistic regression analysis demonstrated that in adolescent primiparas，13-24 years，unmarried and BMI<18.5 kg/m were
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associated with lower risk of gestational diabetes（P<0.05）；gravida ≥ 3 and BMI ≥ 28 kg/m were risk factors for gestational
2
diabetes（P<0.05）；13-24 years，unmarried，unstable income and BMI ≥ 28 kg/m were risk factors for vaginitis（P<0.05）；
13-19 year-old，unmarried，junior high school or lower education level and unstable income were risk factors for placental
abruption（P<0.05）；gravida ≥ 3 was the risk factor for placenta previa（P<0.05）；13-24 years，unmarried，junior high
school or lower education level，rural living and unstable income were risk factors for maternal anemia（P<0.05）；BMI ≥ 28.0
2
kg/m was associated with lower risk of maternal anemia（P<0.05）. Further analysis showed that 13-24 years，unmarried，
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junior high school or lower education level，rural living and BMI<18.5 kg/m ，were associated with higher possibility of having
vaginal delivery（P<0.05），whereas gravida ≥ 3 was associated with higher possibility of having cesarean section（P<0.05）.
Aged 13-19 years，unmarried，junior high school or lower education level，unstable income，gravida ≥ 3，and BMI<18.5
2
2
kg/m or ≥ 28.0 kg/m were risk factors for premature labor（P<0.05）. Aged 13-19 year-old，unmarried，junior high school
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or lower education level，rural living，unstable income，gravida ≥ 3，and BMI<18.5 kg/m were risk factors for （very） low-
birth-weight infants（P<0.05）. 20-24 year-old was associated with lower risk of fetal distress（P<0.05）. 13-19 year-old and
unmarried were risk factors for stillbirth（P<0.05）. 13-24 years，junior high school or lower education level，rural living，
unstable income，and gravida ≥ 3 were risk factors for neonatal asphyxia（P<0.05）. Conclusion Adolescent primiparous
females were featured by high rates of having unmarried status，rural living，an unstable income，low education level，fewer
prenatal care visits，and adverse pregnancy outcomes. Younger age，unmarried，poor socioeconomic status，higher number of
pregnancies，and excessive low or high BMI were risk factors for adverse pregnancy outcomes in this group. Healthcare specialists
should schedule prenatal examinations for these people based on the high risk factors accordingly. And government at all levels
and affiliated adolescent institutions should offer appropriate social and economic support for teenage mothers to reduce adverse
pregnancy outcomes.
【Key words】 Pregnancy in adolescence；Primipara；Maternal health；Pregnancy outcome；Root cause analysis

世界卫生组织将青少年妊娠定义为 10~19 岁阶段的 良妊娠结局发生的影响因素和发生机制仍然不明确，有
妊娠 ［1］ 。青少年妊娠是全球性问题，可引发较多健康、 必要对相关影响因素进行调查分析，从而通过对影响因
教育、社会和经济不良后果 ［2-3］ 。青少年妊娠期各种不 素提早干预以减少不良妊娠结局的发生。本研究利用电