**2. Definition of adolescence**

The WHO defines adolescence as the period of human growth and development after childhood and before adulthood, between the ages of 10 and 19. It is one of the most important transitional phases in human life, characterized by an accelerated rhythm of growth and changes, only surpassed by those in infants. This growth and development phase is conditioned by several biological processes. The beginning of puberty is the hallmark of passage from childhood to adolescence. From this stage on, the reproductive system's capacity to procreate is potentially latent [1].

## **3. Classification of adolescence**

It is difficult to establish the chronological boundaries of this period, but in accordance with conventionally accepted concepts accepted by the World Health Organization (WHO), adolescence may be divided into two phases:

1.Early (10–14 years).

2.Late (15–19 years).

Likewise, other authors refer that there are three stages:

1.Early adolescence, between the ages of 10 and 13.

2.Mid-adolescence, between the ages of 14 and 17.

3.Late adolescence, between the ages of 17 and 21 [2].

## **4. Impact of pregnancy on an adolescent**

The beginning of sexual activity in adolescents currently occurs at a younger age and carries immediate unwanted consequences such as an increased frequency of sexually transmitted diseases (STD) and unwanted pregnancy that may lead to miscarriage or other complications during pregnancy [3].

From a biological viewpoint, some of the consequences of adolescent pregnancy include hypertensive disease of pregnancy, anemia, gestational diabetes, and complications during childbirth that lead to an increase in maternal and fetal mortality [4]; complications in the newborn include higher rates of low birth weight, premature delivery, respiratory diseases, dystocia, and an increased frequency of neonatal complications and greater infant mortality [5].

Risk factors in adolescent pregnancy include low educational level, beginning sexual activity before the age of 15, absence of the partner, maternal history of pregnancy in adolescence, and the lack of knowledge and access to birth control methods. There is also a high percentage of school dropouts, a lack of plans for the future, low self-esteem, alcohol and drug abuse, ignorance on sexuality, and an inadequate use of birth control [6].

A correlation has been shown between minimal or absent family communication on birth control and sexuality and a higher risk of adolescent pregnancy and infection with sexually transmitted diseases [7].

**127**

**Table 1.**

*VLBW, very low birth weight.*

*Adolescence and Preeclampsia*

provided to these patients.

and 29.

*DOI: http://dx.doi.org/10.5772/intechopen.86147*

Kawakita [37] CS OR = 0.49;

PPH\*

Bostanci et al. [21] Preeclampsia and HELLP Sd

etc. lead to an increase in maternal morbidity and mortality and an estimated twoto threefold increase in infant mortality among patients in the age range between 20

In adolescents, the higher observed compared risk does not appear to be due to special physiologic conditions but to sociocultural variables and the medical care

These pregnancies are frequently unwanted or unplanned events within a weak couple relationship, which leads to an attitude of rejection and concealment because of fear of the family group that, in turn, conditions late or insufficient prenatal care. According to various publications, we must emphasize that 73–93% of cases of pregnant adolescents are women bearing their first child. The first pregnancy carries specific risks resulting from physiological immaturity in the pregnant

CI 95% = 0.42–0.59

CI 95% = 0.47–0.84

CI 95% = 1.07–1.45

PD < 37 weeks OR = 1.36; CI 95% = 1.14–1.62 aOR = 1.16;

OR = 1.46; CI 95% = 1.10–1.95

OR = 1.44; CI 95% = 1.17–1.77 PL OR = 0.82;

> Late adolescent (%)

Preeclampsia 4.8 2.7 5.9 <0.001 PD 37.2 12.8 2.2 <0.001 PPROM 37.2 10.2 8.5 <0.001 IUGR 9 3.3 5.4 <0.001 Postterm 0.7 5.9 8.7 <0.001 Episiotomy 79.3 69.8 70 >0.05 NICU 18 11.7 10 0.009 Neonatal outcome 2.1 1.1 2.1 >0.05 LBW 17.9 13.2 13.1 >0.05 VLBW 4.1 3.4 2.7 >0.05 CS 17.2 25.7 29.6 0.001

Early adolescent (%)

*CS, cesarean section; CA, chorioamnionitis; MA, maternal anemia; PD, preterm delivery; PPH, postpartum hemorrhage; BT, blood transfusion; PL, perineal laceration; PPROM, preterm premature rupture of membranes; IUGR, intrauterine growth restriction; NICU, neonatal intensive care unit admission; LBW, low birth weight;* 

*Comparison of some pregnancy complications and outcome among early and late adolescent.*

CA OR = 0.63;

MA OR = 1.25;

and BT\*\* \*

**<16 years >16 years**

OR = 0.75; CI 95% = 0.71–0.79

OR = 0.83; CI 95% = 0.75–0.91

OR = 1.15; CI 95% = 1.09–1.22

CI 95% = 1.08–1.25

\*\*OR = 1.21; CI 95% = 1.02–1.43

CI 95% = 0.71–0.95

P value

Adult (%)

Medical risks associated with pregnancy in adolescent mothers such as hypertensive pathology, anemia, low birth weight, prematurity, insufficient nutrition,

### *Adolescence and Preeclampsia DOI: http://dx.doi.org/10.5772/intechopen.86147*

*Prediction of Maternal and Fetal Syndrome of Preeclampsia*

The WHO defines adolescence as the period of human growth and development after childhood and before adulthood, between the ages of 10 and 19. It is one of the most important transitional phases in human life, characterized by an accelerated rhythm of growth and changes, only surpassed by those in infants. This growth and development phase is conditioned by several biological processes. The beginning of puberty is the hallmark of passage from childhood to adolescence. From this stage

on, the reproductive system's capacity to procreate is potentially latent [1].

Organization (WHO), adolescence may be divided into two phases:

Likewise, other authors refer that there are three stages:

1.Early adolescence, between the ages of 10 and 13.

2.Mid-adolescence, between the ages of 14 and 17.

**4. Impact of pregnancy on an adolescent**

complications and greater infant mortality [5].

inadequate use of birth control [6].

tion with sexually transmitted diseases [7].

3.Late adolescence, between the ages of 17 and 21 [2].

miscarriage or other complications during pregnancy [3].

It is difficult to establish the chronological boundaries of this period, but in accordance with conventionally accepted concepts accepted by the World Health

The beginning of sexual activity in adolescents currently occurs at a younger age and carries immediate unwanted consequences such as an increased frequency of sexually transmitted diseases (STD) and unwanted pregnancy that may lead to

From a biological viewpoint, some of the consequences of adolescent pregnancy include hypertensive disease of pregnancy, anemia, gestational diabetes, and complications during childbirth that lead to an increase in maternal and fetal mortality [4]; complications in the newborn include higher rates of low birth weight, premature delivery, respiratory diseases, dystocia, and an increased frequency of neonatal

Risk factors in adolescent pregnancy include low educational level, beginning sexual activity before the age of 15, absence of the partner, maternal history of pregnancy in adolescence, and the lack of knowledge and access to birth control methods. There is also a high percentage of school dropouts, a lack of plans for the future, low self-esteem, alcohol and drug abuse, ignorance on sexuality, and an

A correlation has been shown between minimal or absent family communication on birth control and sexuality and a higher risk of adolescent pregnancy and infec-

Medical risks associated with pregnancy in adolescent mothers such as hypertensive pathology, anemia, low birth weight, prematurity, insufficient nutrition,

**2. Definition of adolescence**

**3. Classification of adolescence**

1.Early (10–14 years).

2.Late (15–19 years).

**126**

etc. lead to an increase in maternal morbidity and mortality and an estimated twoto threefold increase in infant mortality among patients in the age range between 20 and 29.

In adolescents, the higher observed compared risk does not appear to be due to special physiologic conditions but to sociocultural variables and the medical care provided to these patients.

These pregnancies are frequently unwanted or unplanned events within a weak couple relationship, which leads to an attitude of rejection and concealment because of fear of the family group that, in turn, conditions late or insufficient prenatal care.

According to various publications, we must emphasize that 73–93% of cases of pregnant adolescents are women bearing their first child. The first pregnancy carries specific risks resulting from physiological immaturity in the pregnant


*CS, cesarean section; CA, chorioamnionitis; MA, maternal anemia; PD, preterm delivery; PPH, postpartum hemorrhage; BT, blood transfusion; PL, perineal laceration; PPROM, preterm premature rupture of membranes; IUGR, intrauterine growth restriction; NICU, neonatal intensive care unit admission; LBW, low birth weight; VLBW, very low birth weight.*

#### **Table 1.**

*Comparison of some pregnancy complications and outcome among early and late adolescent.*

adolescent. For example, preeclampsia or gestation-induced hypertension is more frequent in young pregnant women, from a low socioeconomic level, and specifically, in the first pregnancy, conditions all frequently met by a pregnant adolescent. When developing this clinical entity, a possible failure in the adaptive immune response has been posited, although it normally permits the development of a close interrelation between the maternal organism and its host. Since 50% of the fetal antigenic structure is of paternal origin, it acts like a graft and has been associated to factors such as immaturity of the maternal immune system or a functional abnormality that may be associated to maternal malnutrition, a very common condition in pregnant adolescents. Morbidity may be classified according to the gestational periods, whereby miscarriage, anemia, urinary tract infections, and asymptomatic bacteriuria are more common in the first half. In the second half, there are hypertensive manifestations, hemorrhage associated to placental pathology, scarce weight gain and associated maternal malnutrition, symptoms of premature delivery (abnormal contractility), and premature membrane rupture [8, 9].

Several authors have suggested that there is a relation between hypertensive disorders and pregnancy, which will be further discussed in this chapter. Other complications are summarized in **Table 1**.

A strategy to confront these problems and adolescent pregnancy is to increase the availability of high-quality sexual and reproductive health services for adolescents [10].
