Eur J Contracept Reprod Health Care. 2000 Mar;5(1):77-84
Teenage pregnancy and ethnicity in The Netherlands: Frequency and obstetric outcome.
Authors:
Van Enk WJ ,Gorissen WH,
Sorg-Saem, Health Care and Research, Amsterdam, The Netherlands.
Objectives:
To study differences in Frequency and obstetric outcome of teenage pregnancy (not ending in induced abortion) between the main ethnic groups in The Netherlands.
Design:
A retrospective cohort study based on the 1990-93 birth cohort in the National Obstetric Registry.
Subjects:
A total of 10,583 teenagers and 54,501 20-24-year-old women who had a singleton pregnancy and were primiparous. MAIN OBSTETRIC
Outcome Measures:
These were perinatal death occurring between the 16th week of pregnancy and 24 h after birth, preterm birth and operative delivery (vaginal extraction and Cesarean section).
Method:
Results:
A total of 55.2% of pregnant teenagers had non-Dutch ethnicity compared to
13.8% of all pregnant women. Islamic-Mediterranean teenagers constituted the
largest group, one in four of all primiparous Mediterranean women being younger
than 20 years of age, followed by black teenagers. Except for Hindustani
teenagers, perinatal death occurred in all non-Dutch teenage groups more
frequently than in Dutch teenagers, but the differences were only significant
for black teenagers (odds ratios of black compared to Dutch teenagers were 2.89
(95% confidence interval (CI) 1.89-4.4) and 1.53 (95% CI 1.19-1.98),
respectively). Rates for preterm birth were higher in black and Asian than in
Dutch teenagers, but the difference was only significant for black teenagers
(odds ratio 1.53, 95% CI 1.19-1.98). Compared to ethnically related
20-24-year-old women, rates of perinatal death and preterm birth were
significantly higher in Dutch, black and Asian teenagers and, for preterm birth
only, in Mediterranean teenagers. Correction for preterm birth showed that only
part of these differences in perinatal death could be explained by preterm
birth. Vaginal extraction and Cesarean section occurred less frequently in
teenagers than in ethnically related (and in Dutch) 20-24-year-old women.
Mediterranean teenagers had the lowest Cesarean section rate and Blacks the
lowest vaginal extraction rate.
Conclusion::
Teenage pregnancy in The Netherlands is much more common in minority ethnic
groups than in the indigenous population, particularly among Islamic-Mediterraneans
and Blacks. Obstetric outcomes vary considerably, these being best in Hindustani
and poorest in black teenagers, and being worse in teenagers than in
20-24-year-old women. However, teenagers less often had assisted delivery.
Results:
A total of 55.2% of pregnant teenagers had non-Dutch ethnicity compared to 13.8% of all pregnant women. Islamic-Mediterranean teenagers constituted the largest group, one in four of all primiparous Mediterranean women being younger than 20 years of age, followed by black teenagers. Except for Hindustani teenagers, perinatal death occurred in all non-Dutch teenage groups more frequently than in Dutch teenagers, but the differences were only significant for black teenagers (odds ratios of black compared to Dutch teenagers were 2.89 (95% confidence interval (CI) 1.89-4.4) and 1.53 (95% CI 1.19-1.98), respectively). Rates for preterm birth were higher in black and Asian than in Dutch teenagers, but the difference was only significant for black teenagers (odds ratio 1.53, 95% CI 1.19-1.98). Compared to ethnically related 20-24-year-old women, rates of perinatal death and preterm birth were significantly higher in Dutch, black and Asian teenagers and, for preterm birth only, in Mediterranean teenagers. Correction for preterm birth showed that only part of these differences in perinatal death could be explained by preterm birth. Vaginal extraction and Cesarean section occurred less frequently in teenagers than in ethnically related (and in Dutch) 20-24-year-old women. Mediterranean teenagers had the lowest Cesarean section rate and Blacks the lowest vaginal extraction rate.
Conclusion::
Teenage pregnancy in The Netherlands is much more common in minority ethnic groups than in the indigenous population, particularly among Islamic-Mediterraneans and Blacks. Obstetric outcomes vary considerably, these being best in Hindustani and poorest in black teenagers, and being worse in teenagers than in 20-24-year-old women. However, teenagers less often had assisted delivery.
