{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:52:14Z","timestamp":1791265934242,"version":"4.1.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This retrospective cohort study followed pregnant adolescents (aged 10\u201317 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10\u201313 years were compared to those of adolescents aged 14\u201315 years and 16\u201317 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7\u201311.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10\u201313 age group, 8.7% for the 14\u201315 age group and 12.1% for the 16\u201317 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10\u201313, 14\u201315, and 16\u201317 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups (<jats:italic>p<\/jats:italic> &amp;gt; 0.05). The infants born to mothers aged 10\u201313 years presented significantly (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) lower Apgar scores than other age groups, but the scores were within the normal range.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.<\/jats:p>","DOI":"10.3389\/fpubh.2021.536342","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T04:47:39Z","timestamp":1617943659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Risks of Adverse Neonatal Outcomes in Early Adolescent Pregnancy Using Group Prenatal Care as a Strategy for Public Health Policies: A Retrospective Cohort Study in Brazil"],"prefix":"10.3389","volume":"9","author":[{"given":"Danylo Jos\u00e9 Palma","family":"Honorato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela","family":"Fulone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Tolentino","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciane Cruz","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"B1","unstructured":"Adolescent Pregnancy2016"},{"key":"B2","first-page":"881","article-title":"Multiple challenges of teenage pregnancy and maternity","volume":"126","author":"Halonen","year":"2010","journal-title":"Duodecim."},{"key":"B3","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1590\/S0100-72032004000800007","article-title":"Indicadores sociais de gr\u00e1vidas adolescentes: estudo caso-controle","volume":"26","author":"Michelazzo","year":"2004","journal-title":"Rev Bras Ginecol Obstetr."},{"key":"B4","unstructured":"Adding It Up: Costs and Benefits of Meeting the Contraceptive Needs of Adolescents\n            DarrochJE\n            WoogV\n            BankoleA\n            AshfordLS\n          2016"},{"key":"B5","unstructured":"Gravidez na Adolesc\u00eancia, s\u00e3o 400 Mil Casos por Ano No Brasil2019"},{"key":"B6","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1590\/S0100-72032011001100006","article-title":"Associa\u00e7\u00e3o de gravidez na adolesc\u00eancia e prematuridade","volume":"33","author":"Martins","year":"2011","journal-title":"Rev Bras Ginecol Obstet."},{"key":"B7","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.jpag.2011.12.070","article-title":"Modifying effect of prenatal care on the association between young maternal age and adverse birth outcomes","volume":"25","author":"Vieira","year":"2012","journal-title":"J Pediatr Adolesc Gynecol."},{"key":"B8","unstructured":"Maternal and neonatal outcome in teenage pregnancy in Tehran Valiasr Hospital\n            NiliF\n            RahmatiMR\n            SharifiSM\n          Acta Med Iran.2002"},{"key":"B9","unstructured":"Tend\u00eancia secular da gravidez na adolesc\u00eancia216Pediatria.262004"},{"key":"B10","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/1471-2458-5-79","article-title":"Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?","volume":"5","author":"Markovitz","year":"2005","journal-title":"BMC Public Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1590\/S0103-05822011000400004","article-title":"Gravidez na adolesc\u00eancia e baixo peso ao nascer: existe associa\u00e7\u00e3o?","volume":"29","author":"Neves Filho","year":"2011","journal-title":"Rev Paul Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1590\/S0100-72032006000900005","article-title":"Prematuridade e baixo peso entre rec\u00e9m-nascidos de adolescentes prim\u00edparas","volume":"28","author":"Rocha","year":"2006","journal-title":"Rev Bras Ginecol Obstet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1590\/S1679-45082015RW3127","article-title":"Complications in adolescent pregnancy: systematic review of the literature","volume":"13","author":"Azevedo","year":"2015","journal-title":"Einstein (S\u00e3o Paulo)."},{"key":"B14","doi-asserted-by":"publisher","first-page":"CD010994","DOI":"10.1002\/14651858.CD010994.pub2","article-title":"Health system and community level interventions for improving antenatal care coverage and health outcomes","volume":"12","author":"Mbuagbaw","year":"2015","journal-title":"Cochrane Database Syst Rev."},{"key":"B15","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1590\/1414-462X201600020171","article-title":"Qualidade da assist\u00eancia pr\u00e9-natal no Brasil: revis\u00e3o de artigos publicados de 2005 a 2015","volume":"24","author":"Nunes","year":"2016","journal-title":"Cad Sa\u00fade Coletiva."},{"key":"B16","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1186\/s12884-017-1522-2","article-title":"A systematic overview of the literature regarding group prenatal care for high-risk pregnant women","volume":"17","author":"Byerley","year":"2017","journal-title":"BMC Pregnancy Childbirth."},{"key":"B17","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1111\/j.1552-6909.2006.00040.x","article-title":"Centering pregnancy group prenatal care: promoting relationship-centered care","volume":"35","author":"Massey","year":"2006","journal-title":"J Obstet Gynecol Neonatal Nurs."},{"key":"B18","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12884-017-1327-3","article-title":"Expect With Me: development and evaluation design for an innovative model of group prenatal care to improve perinatal outcomes","volume":"17","author":"Cunningham","year":"2017","journal-title":"BMC Pregnancy Childbirth."},{"key":"B19","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/S1701-2163(16)35182-9","article-title":"Group prenatal care versus individual prenatal care: a systematic review and meta-analyses","volume":"34","author":"Ruiz-Mirazo","year":"2012","journal-title":"J Obstet Gynaecol Can."},{"key":"B20","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00737-015-0564-6","article-title":"The comparative effects of group prenatal care on psychosocial outcomes","volume":"19","author":"Heberlein","year":"2016","journal-title":"Arch Womens Ment Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12978-018-0476-9","article-title":"Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis","volume":"15","author":"Sharma","year":"2018","journal-title":"Reprod Health."},{"key":"B22","unstructured":"Censos Demogr\u00e1ficos 20102010"},{"key":"B23","unstructured":"Humaniza\u00e7\u00e3o do Parto. Humaniza\u00e7\u00e3o no Pr\u00e9-natal e Nascimento2015"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1016\/j.clinthera.2014.06.026","article-title":"Effect of low birth weight on women's health","volume":"36","author":"Alexander","year":"2014","journal-title":"Clin Ther."},{"key":"B25","doi-asserted-by":"publisher","first-page":"CD011558","DOI":"10.1002\/14651858.CD011558.pub2","article-title":"Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis","volume":"11","author":"Munabi-Babigumira","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"B26","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1590\/S0100-72032009000700002","article-title":"Impacto da idade materna sobre os resultados perinatais e via de parto","volume":"31","author":"Santos","year":"2009","journal-title":"Rev Bras Ginecol Obstetr."},{"key":"B27","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511974175","article-title":"Multivariable Analysis","author":"Katz","year":"2011"},{"key":"B28","unstructured":"Organiza\u00e7\u00e3o Pan-Americana de Sa\u00fade2020"},{"key":"B29","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/S1701-2163(15)30995-6","article-title":"Adolescent pregnancy outcomes in the province of Ontario: a cohort study","volume":"35","author":"Fleming","year":"2013","journal-title":"J Obstet Gynaecol Can."},{"key":"B30","first-page":"2149","article-title":"Birthing experience of adolescents at the Ottawa General Hospital Perinatal Centre","volume":"148","author":"Lena","year":"1993","journal-title":"CMAJ."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e1001373","DOI":"10.1371\/journal.pmed.1001373","article-title":"Why do women not use antenatal services in low- and middle-income countries? A meta-synthesis of qualitative studies","volume":"10","author":"Finlayson","year":"2013","journal-title":"PLoS Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e016258","DOI":"10.1136\/bmjopen-2017-016258","article-title":"Impact of adolescent age on maternal and neonatal outcomes in the Born in Bradford cohort","volume":"8","author":"Marvin-Dowle","year":"2018","journal-title":"BMJ Open."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e0218259","DOI":"10.1371\/journal.pone.0218259","article-title":"Adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia","volume":"14","author":"Kassa","year":"2019","journal-title":"PLoS One."},{"key":"B34","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1111\/j.1467-842X.2002.tb00904.x","article-title":"Teenage pregnancy: trends, characteristics and outcomes in South Australia and Australia","volume":"26","author":"Van der Klis","year":"2002","journal-title":"Aust N Z J Public Health"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3124847","article-title":"Teenage pregnancy and its adverse obstetric and perinatal outcomes at Lemlem Karl Hospital, Tigray, Ethiopia","author":"Abebe","year":"","journal-title":"Biomed Res Int"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-0070(86)80006-7","article-title":"Pregnancy outcomes among adolescent and older women receiving comprehensive prenatal care","author":"Leppert","year":"1986","journal-title":"J Adolesc Health Care."},{"key":"B37","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1080\/07399331003646323","article-title":"Comparison of maternal and neonatal outcomes of group versus individual prenatal care: a new experience in Iran","volume":"31","author":"Jafari","year":"2010","journal-title":"Health Care Women Int."},{"key":"B38","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.whi.2015.09.011","article-title":"Exploring Group Composition among Young, Urban Women of Color in Prenatal Care: implications for satisfaction, engagement, and group attendance","volume":"26","author":"Earnshaw","year":"2016","journal-title":"Womens Health Issues."},{"key":"B39","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1590\/S0034-89102003000500003","article-title":"Caracter\u00edsticas da gravidez na adolesc\u00eancia em S\u00e3o Lu\u00eds, Maranh\u00e3o","volume":"37","author":"Sim\u00f5es","year":"2003","journal-title":"Rev Sa\u00fade P\u00fabl."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1590\/S0102-311X2005000400010","article-title":"Gravidez na adolesc\u00eancia, pr\u00e9-natal e resultados perinatais em Montes Claros, Minas Gerais, Brasil","volume":"21","author":"Goldenberg","year":"2005","journal-title":"Cadernos Sa\u00fade P\u00fabl."},{"key":"B41","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1590\/S0102-311X2007000100019","article-title":"Gravidez na adolesc\u00eancia: perfil s\u00f3cio-demogr\u00e1fico e comportamental de uma popula\u00e7\u00e3o da periferia de S\u00e3o Paulo, Brasil","volume":"23","author":"Chalem","year":"2007","journal-title":"Cadernos Sa\u00fade P\u00fabl."},{"key":"B42","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1590\/S1519-38292006000400009","article-title":"Caracter\u00edsticas das m\u00e3es adolescentes e de seus rec\u00e9m-nascidos e fatores de risco para a gravidez na adolesc\u00eancia em Campinas, SP, Brasil","volume":"6","author":"Carniel","year":"2006","journal-title":"Rev Bras Sa\u00fade Materno Infantil."},{"key":"B43","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S0029-7844(97)00009-4","article-title":"Determinants of poor pregnancy outcomes among teenagers in Sweden","volume":"89","author":"Olausson","year":"1997","journal-title":"Obstet Gynecol."},{"key":"B44","unstructured":"Caracter\u00edsticas de seguimento pr\u00e9-natal, do parto e do rec\u00e9m-nascido de adolescentes gr\u00e1vidas, munic\u00edpio de Joinville, Estado de Santa Catarina, Brasil, 19951239\n            GalloPR\n            ReisAOA\n            LeoneC\n          Pediatria (S\u00e3o Paulo).222000"},{"key":"B45","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jpag.2011.09.004","article-title":"Pregnancies in young adolescent mothers: a population-based study on 37 million births","volume":"25","author":"Malabarey","year":"2012","journal-title":"J Pediatr Adolesc Gynecol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ajog.2015.04.024","article-title":"Labor and delivery outcomes among young adolescents","volume":"213","author":"Torvie","year":"2015","journal-title":"Am J Obstet Gynecol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1590\/S0034-89102001000100011","article-title":"Gravidez na adolesc\u00eancia como fator de risco para baixo peso ao nascer no Munic\u00edpio do Rio de Janeiro, 1996 a 1998","volume":"35","author":"Gama","year":"2001","journal-title":"Rev Sa\u00fade P\u00fabl."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.4067\/S0034-98872003001000010","article-title":"Prevalencia al nacimiento de malformaciones cong\u00e9nitas y de menor peso de nacimiento en hijos de madres adolescentes","volume":"131","author":"Pardo","year":"2003","journal-title":"Rev M\u00e9d Chile."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1095\/biolreprod.104.030965","article-title":"Nutritionally mediated placental growth restriction in the growing adolescent: consequences for the fetus","volume":"71","author":"Wallace","year":"2004","journal-title":"Biol Reprod."},{"key":"B50","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1067\/mob.2002.123986","article-title":"Risk of adverse pregnancy outcomes in young adolescent parturients in an inner-city hospital","volume":"186","author":"Eure","year":"2002","journal-title":"Am J Obstet Gynecol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"44","DOI":"10.31729\/jnma.395","article-title":"Outcome of newborns with birth asphyxia","volume":"44","author":"Shah","year":"2005","journal-title":"JNMA J Nepal Med Assoc."},{"key":"B52","doi-asserted-by":"publisher","first-page":"185","DOI":"10.5123\/S1679-49742007000300005","article-title":"Fatores de risco para mortalidade neonatal em coorte hospitalar de nascidos vivos","volume":"16","author":"Carvalho","year":"2007","journal-title":"Epidemiol Serv Sa\u00fade."},{"key":"B53","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.ejogrb.2009.08.006","article-title":"Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: a cohort study","volume":"147","author":"De Vienne","year":"2009","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B54","unstructured":"Organiza\u00e7\u00e3o Mundial da Sa\u00fade.2016"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.536342\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T04:47:48Z","timestamp":1617943668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.536342\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,9]]},"references-count":54,"alternative-id":["10.3389\/fpubh.2021.536342"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.536342","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,9]]},"article-number":"536342"}}