Medical complications and psychosocial outcomes of adolescent pregnancy in high-income countries: a scoping review

BACKGROUND: Adolescent pregnancy is highly prevalent in high-income countries. As this complex, multifaceted problem can be linked to multiple consequences, pregnancy in this population poses significant challenges for health and social service professionals. However, there is a lack of integrated knowledge on the topic. Thus, this study aimed to synthesize the literature published over the last decade on the medical complications and psychosocial outcomes of pregnancy, delivery, and postpartum in the 15-19 age group in high-income countries, including fetal complications. METHOD: A scoping review was conducted by searching MEDLINE, CINHAL, and PsycInfo for the period from January 2014 to July 2024. Articles were included if they reported the results of empirical studies on medical complications or psychosocial outcomes of pregnancy, delivery, fetal or postpartum outcomes in adolescents aged 15-19 years conducted in high-income countries. A narrative synthesis was conducted. RESULTS: Most of the 15 included studies were authored by US-based investigators (n = 4) and all were published in English. More than half were conducted after 2017 (n = 9). Twelve studies were quantitative, three were qualitative, and the population-based retrospective cohort study design was the most frequently used (n = 6). Pregnancies in this population regularly led to medical complications as well as psychosocial outcomes. Compared with adults aged 25 to 34, adolescents were almost three times more likely to have hemolysis, elevated liver enzyme levels, and low platelet levels syndrome. Preterm birth was also twice as likely to be associated with adolescence. Neonatal death and stillbirth were twice as common as in 25-34-year-olds. Compared to childless adolescents, motherhood was associated with separation anxiety disorder and social phobia, and more than three times more likely to be associated with specific phobias. Lack of social support, exclusion, discrimination, and peer stigmatization were among the psychosocial outcomes. CONCLUSION: The results of this scoping review highlighted the importance of an interdisciplinary team to ensure optimal care management. To better understand their specific issues and to develop guidelines that promote overall health in this population, further studies should include adolescents younger than 15 years and their babies.