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Hum. Reprod. Advance Access originally published online on March 19, 2007
Human Reproduction 2007 22(6):1730-1735; doi:10.1093/humrep/dem043
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Teenage pregnancy and congenital anomalies: which system is vulnerable?

Xi-Kuan Chen1,2, Shi Wu Wen1,2,3,5, Nathalie Fleming4, Qiuying Yang1,2 and Mark C. Walker1,2,3

1 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6 2 Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada K1H 8L6 3 Department of Epidemiology and Community Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada K1H 8L6 4 Pediatric Adolescent Gynecology, Children's Hospital of East Ontario, University of Ottawa, Ontario, Canada K1H 8L1

5 Correspondence address. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Rd, Box 241, Ottawa, Canada K1H 8L6. Tel: +613-737-8899 ext 73912; Fax: +613-739-6266; E-mail: swwen{at}ohri.ca

BACKGROUND: Teenage pregnancy may be associated with some forms of congenital anomalies. The objective of this study was to identify the types of congenital anomalies associated with teenage pregnancy.

METHODS: We carried out a retrospective cohort study of 5 542 861 nulliparous pregnant women younger than 35 years of age with a live singleton birth between 1995 and 2000 in the USA.

RESULTS: Compared with adult pregnancy (20–34 years old), and after adjustment for confounding variables, teenage pregnancy (13–19 years old) was associated with increased risk of central nervous system anomalies [odds ratio (OR) 1.08; 95% confidence interval (CI): 1.01, 1.16], gastrointestinal anomalies (OR: 1.39; 95% CI: 1.31, 1.49) and musculoskeletal/integumental anomalies (OR: 1.06; 95% CI: 1.03, 1.10). The teenage pregnancy associated increase in risk for central nervous system anomalies was mainly attributable to anomalies other than anencephalus, spina bifida/meningocele and hydrocephalus and microcephalus; for gastrointestinal anomalies the risk was mainly attributable to omphalocele/gastroschisis; and for musculoskeletal/integumental anomalies the risk was mainly attributable to cleft lip/palate and polydactyly/syndactyly/adactyly. No increased risk was found for circulatory/respiratory anomalies, urogenital anomalies, or Down's syndrome.

CONCLUSIONS: Teenage pregnancy increases the risks of congenital anomalies in central nervous, gastrointestinal and musculoskeletal/integumental systems.

Key words: teenage/pregnancy/maternal age/congenital anomalies

Submitted on December 6, 2006; resubmitted on January 22, 2007; accepted on January 31, 2007.


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