Do dedicated clinics improve outcomes in the teenaged pregnant
women?
S. Das, J. Brooks, O. Amu
Department of Obstetrics and Gynaecology, Royal Oldham
Hospital, Oldham, Greater Manchester, UK
Introduction The rate of
teenage pregnancy in the UK is high compared to other European countries. It is
associated with increased risk of poor obstetric outcomes and can lead to social
exclusion of the young person. Evidence shows that obstetric outcome in teenage
mothers is significantly improved with adequate prenatal care. Continuity of
care through the pregnancy and after enhances the return of this group of women
to education and profitable employment.
Aim To study the impact of
establishing a dedicated clinic on obstetric outcome and uptake of long-term
postnatal contraception, in a district general hospital.
Method Data was
reviewed retrospectively for a 12-month period after the clinic started (year
2003) was compared with that from the year 2001.
Results Teenage pregnancy
rate remained at 5% of the total deliveries in both 2001 and 2003. However,
number of pregnancies in the age group of 15 years or less decreased by 1%.
Attendance to the dedicated clinic was 42% as compared with 15% for
community-based clinic and 5% for shared-care clinic. Normal delivery rate
remained at 79%. Induced and operative deliveries reduced by 14% and 3%
respectively. Delivery of premature and low birth weight infants decreased by
1%. Special care neonatal admissions and incidence of post-partum haemorrhage
reduced by 3% and 26% respectively. Uptake of long-term contraception in the
postnatal period increased from 43% to 54%. The number of planned and unplanned
pregnancies reduced by 7% and 1% respectively.
Conclusion The results not only
showed significant improvement in obstetric outcome but also uptake of effective
postnatal contraception that was crucial in reducing their risk of future
unplanned pregnancy.