Objective: To examine the relationships among parity, preterm delivery, fetal growth retardation, and prenatal care utilization in first and second adolescent pregnancies.
Design: A longitudinal, retrospective study in which obstetric, behavioral, and sociodemographic data were used to examine birth outcomes of 737 low-income black (80%) and white (20%) teenagers delivering first and second singleton infants at 20 or more weeks' gestation.
Setting: Public health clinics in Jefferson County, Alabama, between January 1983 and February 1990.
Main outcome measures: Mean birth weight, preterm delivery, fetal growth retardation, Apgar scores, and perinatal mortality.
Main results: In their second pregnancies, adolescents presented 2.8 weeks later for care (P = .0001) and made fewer total clinic visits. Mean infant birth weight increased by 91 g (P = .0005). This increase was significantly associated with an increase in maternal prepregnancy body mass index. The rate of fetal growth retardation decreased (P = .0001) and the rate of preterm delivery increased (P < .02) in the second pregnancy. The rate of recurrence of fetal growth retardation was 13% and the rate of preterm delivery was 46%.
Conclusions: Poorer utilization of prenatal care and high risk for recurrence of adverse outcomes are characteristic of adolescents' second pregnancies and should be considered in teenage pregnancy intervention programs.