Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad

Objective: Repeat adolescent pregnancy is a hot topic worldwide and imposes a challenge on the health system, especially when faced with limited resources. We aimed to assess maternal and neonatal outcomes in adolescent pregnant women with one prior cesarean section (CS).

Material and methods: Singleton adolescent pregnant women with one prior CS scar were recruited and divided into two groups based on the obstetric decision for delivery and/or mother’s wish, either trial of labor (TL) or elective cesarean section (ECS). If TL failed, an emergency CS was performed.

Results: Out of the total 109 involved women, TL and ECS groups included 78 (71.6%) and 31 (28.4%) women, respectively. Emergency CS was done for 57 (52.3%) women from the TL group, leaving only 21 (19.3%) women with successful TL who had statistically significant (non-recurrent) indications of the prior CS [12 (57.1%)]. Malpresentation (n=24; 77.4%) was the major indication in the ECS group, while fetal distress (n=29; 50.9%) was the main cause of failed TL. Total maternal morbidities in the TL group were significantly higher for adjusted [1.5 (1.1-4.2)] and non-adjusted odds ratios (OR) [2.4 (1.6-5.6)]. Neonatal complications, such as admission to neonatal intensive care unit, were higher in the TL group without reaching significance. However, the adjusted OR [1.9 (1.1-3.3)] for perinatal asphyxia was significantly increased in TL group.

Conclusion: Maternal morbidities and perinatal asphyxia were significantly higher in the TL group of adolescent women compared with the ECS group in this study.