Response to the article: Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns

The study by González-Andrade and collaborators shows that the rate of early pregnancy in Latin America and the Caribbean remains the second-highest in the world, estimated at 66.5 births per 1000 girls between the ages of 15 and 19.1González-Andrade F. Saeteros-Cordero X. Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns.Pediatr Neonatol. 2019; 61: 216-223Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Therefore, teenage pregnancy is an international health problem, and efforts should not be spared to generate norms, regulations, and strategies for intervention in primary healthcare that would gradually decrease these rates. The article showed that higher gestational ages and APGAR scores from 8 to 9 were associated with higher rates of neonatal morbidity in young mothers. This may be related to inadequate prenatal examination or treatment of the newborn.1González-Andrade F. Saeteros-Cordero X. Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns.Pediatr Neonatol. 2019; 61: 216-223Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Thus, the hospital-based study conducted in Brazil in 2015 is right in stating that early initiation of prenatal care allows access to diagnostic and therapeutic methods for various pathologies, provides a more accurate estimate of the gestational age, improves fetal growth monitoring, and improves the basis for decisions related to possible termination of the pregnancy.2Domingues R.M. Viellas E.F. Dias M.A. Torres J.A. Theme-Filha M.M. Gama S.G. et al.Adequacy of prenatal care according to maternal characteristics in Brazil.Rev Panam Salud Publica. 2015; 37 ([Article in Portuguese]): 140-147PubMed Google Scholar A study of adolescent pregnant women in Southwestern Ontario (SWO) in 2019 efficiently reported that young mothers living in disadvantaged socioeconomic neighborhoods were more predisposed to depression during pregnancy.3Wong S.P.W. Twynstra J. Gilliland J.A. Cook J.L. Seabrook J.A. Risk factors and birth outcomes associated with teenage pregnancy: a Canadian sample.J Pediatr Adolesc Gynecol. 2019; 33: 153-159Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar In the same social bias, this study reported that pregnant women aged 20–34 with more than five prenatal exams and living in rural areas had the highest percentage of prenatal pathological antecedents. This fact is related to the unequal distribution of healthcare resources that proves the lack of identification of these antecedents by health professionals.1González-Andrade F. Saeteros-Cordero X. Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns.Pediatr Neonatol. 2019; 61: 216-223Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Adolescent pregnancy is associated with increased frequency of neonatal complications such as respiratory diseases, premature delivery, and infant mortality.1González-Andrade F. Saeteros-Cordero X. Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns.Pediatr Neonatol. 2019; 61: 216-223Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar These issues are in line with the study on neonatal sepsis in the macroregion of Southern Santa Catarina that shows higher rates of neonatal mortality from sepsis found in mothers aged 10–14 years.4Benincá V.M. Milioli D.P. Madeira K. Simon C.S. Pires M.M. Rosa M.I. et al.Epidemiological profile of neonatal sepsis deaths in the Southern Santa Catarina health macro-region in the period 1996 to 2009.Arq Catarin de Med. 2013; 42: 20-26Google Scholar This may be because the adolescent is still in the process of physiological, anatomical and psychological development, which, associated with a lack of family support, impairs the attendance of prenatal consultations.1González-Andrade F. Saeteros-Cordero X. Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns.Pediatr Neonatol. 2019; 61: 216-223Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Therefore, it is perceived that the maturation of the maternal body is essential for the quality of pregnancy.4Benincá V.M. Milioli D.P. Madeira K. Simon C.S. Pires M.M. Rosa M.I. et al.Epidemiological profile of neonatal sepsis deaths in the Southern Santa Catarina health macro-region in the period 1996 to 2009.Arq Catarin de Med. 2013; 42: 20-26Google Scholar Based on the above-mentioned studies, we can conclude that adolescent mothers experience a higher percentage of neonatal morbidity in deliveries, which represents negative outcomes for dyad. Therefore, attention should be paid to contraception in adolescents, both in educational networks and primary healthcare units. Associated with the correct referral of primary care of young mothers, pre and postpartum, to specialist doctors. Thus, the importance of this article in setting improvement goals not only for Ecuador but for all countries is highlighted. The authors declare they have no conflict of interest.

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