Teenage pregnancy and congenital anomalies: which system is vulnerable?

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.