Teenage antenatal clinics may reduce the rate of preterm birth: a prospective study.

Abstract

To examine whether teenage antenatal clinics reduce the incidence of preterm birth. A multicentre prospective study was performed. Three Australian hospitals with maternity services. Consecutive teenage patients (N= 731) were approached at their first or second antenatal visit. Cases were women attending multidisciplinary teenage antenatal clinics and controls attended general hospital-based antenatal clinics. Teenage antenatal clinics involved multidisciplinary care and included guidelines to screen and treat all patients for infectious and social pathology. General antenatal clinic care was in accordance with Australian standards. Preterm birth, newborn biometry adjusted for gestational age, breastfeeding and contraception plans at discharge. Consent was obtained from 651 (89%) patients. Teenage pregnancy clinic patients were significantly less likely to present with threatened preterm labour (OR 0.45; 95% CI 0.29-0.68), preterm, prelabour, prolonged rupture of membranes (OR 0.34; 95% CI 0.18-0.63) or deliver preterm (OR 0.40; 95% CI 0.25-0.62) compared with those from general clinics. However, there was no independent effect of clinic care upon newborn biometry outcomes. Clinic care did not significantly alter rates of initiation of breastfeeding in hospital. However, significantly more of the teenage antenatal clinic mothers were discharged on contraception (OR 1.58; 95% CI 1.07-2.25). Teenage-specific antenatal clinics may reduce the rate of preterm birth.