Teenage pregnancy remains a critical public health issue across both developed and developing nations, with implications that extend far beyond the health sector. Defined by the World Health Organization as pregnancy occurring in girls aged 10–19 years, teenage pregnancies are often associated with increased health risks to both the mother and the fetus. These risks are compounded by socio-demographic factors such as poverty, limited education, early marriage, and inadequate access to healthcare services.

Globally, teenage pregnancies contribute significantly to maternal and neonatal morbidity and mortality. In many settings, the phenomenon is not only a health issue but also a reflection of deep-rooted socio-cultural norms and systemic inequalities. For instance, in regions where adolescent marriage is prevalent, young girls often lack the agency or knowledge to prevent early pregnancies. The interplay between socio-demographic variables and health outcomes is evident in multiple studies. Lavanya and Jyothi emphasized the role of factors such as education level, socio-economic status, and rural residence in determining both the likelihood and outcomes of teenage pregnancies [1].

The fetomaternal consequences of teenage pregnancies are profound. These include a higher incidence of preterm labour, low birth weight, intrauterine growth restriction (IUGR), anaemia, hypertensive disorders, and increased perinatal mortality. Several institutional studies reinforce these findings. For example, a study at a tertiary institution in Nigeria identified a correlation between poor obstetric outcomes and adolescent maternal age, underscoring the need for targeted healthcare interventions [2]. Similarly, studies conducted in both urban and rural healthcare settings reveal consistent patterns of increased maternal and neonatal complications among teenagers compared to adults. Teenage mothers face significantly higher risks of delivery complications and neonatal adverse outcomes [3][4].

Geographical and cultural diversity also plays a role. In Eastern Ethiopia, teenage pregnancies had more adverse fetal outcomes compared with older counterparts, suggesting regional disparities in healthcare access and nutritional status [6]. Similarly, another comparative study showed that adolescent mothers, particularly in resource-limited settings, experienced higher rates of preeclampsia and neonatal intensive care admissions [7].

This study seeks to explore the socio-demographic profile of teenage pregnancies and to assess their prevalence and associated fetomaternal outcomes. By analyzing clinical and demographic data, the research aims to contribute to the body of evidence required for effective policy formation, public health planning, and improved maternal-child health interventions.

Aims and Objectives

The primary aim of this study was to assess the socio-demographic characteristics and fetomaternal outcomes of teenage pregnancies at a government general hospital in Siddipet, Telangana.

Specific Objectives:

1. To describe the socio-demographic profile of pregnant teenagers presenting to the hospital.
2. To determine the prevalence of antenatal complications such as anaemia, hypertensive disorders, and infections among teenage mothers.
3. To assess maternal outcomes, including mode of delivery, postpartum complications, and duration of hospital stay.
4. To evaluate fetal outcomes, including birth weight, Apgar score, NICU admissions, and perinatal mortality.
5. To examine the association between selected risk factors (e.g., anaemia) and adverse maternal and fetal outcomes.

Study Design and Setting

This was a prospective, observational cohort study conducted over a 12-month period, from January 2024 to December 2024, at the Government General Hospital, Siddipet, a secondary-level public healthcare facility in Telangana, India.

Study Population and Sampling

The study included 50 pregnant adolescents aged 13 to 19 years who delivered at the study site during the designated period. Participants were recruited consecutively as they presented for delivery or antenatal care. Only singleton pregnancies were included.

Inclusion Criteria:

• Female adolescents aged 13–19 years
• Delivered at the study hospital within the study period
• Provided informed consent (from guardian if under legal age)

Exclusion Criteria:

• Known chronic illness prior to pregnancy (e.g., Type 1 diabetes, renal disease)
• Multiple gestations
• Incomplete medical records or refusal to participate

Data Collection

Data were collected prospectively using a standardized clinical proforma. The following categories of variables were recorded:

• Socio-demographic variables: age, education, marital status, residence, socioeconomic status
• Antenatal profile: gravida, parity, antenatal visit count, hemoglobin levels, BMI, presence of anaemia, gestational diabetes mellitus (GDM), preeclampsia
• Delivery outcomes: gestational age at delivery, mode of delivery, intrapartum complications
• Fetal outcomes: birth weight, Apgar scores, NICU admission, stillbirth, neonatal death, congenital anomalies
• Maternal outcomes: postpartum complications, duration of hospital stay

All participants underwent routine clinical and laboratory evaluations in accordance with hospital protocol.

Statistical Analysis

Descriptive statistics were used to summarize baseline characteristics. Categorical variables were expressed as frequencies and percentages. Continuous variables were described using means and standard deviations or medians and interquartile ranges, as appropriate.

Comparative analysis between anaemic and non-anaemic groups was performed using independent-sample t-tests for continuous variables and chi-square tests for categorical variables. Effect sizes were reported using Cohen’s d for mean differences and Cramer’s V for categorical associations. A two-tailed p-value < 0.05 was considered statistically significant. Data were analyzed using Python-based statistical tools.

1. Study Sample Description

A total of 50 teenage pregnant individuals were included in this study, with ages ranging from 13 to 19 years. The median age was 16 years (interquartile range, 15 to 18). The majority of participants were aged between 15 and 18 years, reflecting a typical distribution of teenage pregnancies observed in regional health settings.

Table 1. Age Distribution of Study Participants (N = 50).

2. Socio-Demographic Profile

Among the 50 participants, 92.0% were married, and the remaining 8.0% were unmarried. A majority (78.0%) resided in rural areas. In terms of education, 38.0% had completed primary schooling, 40.0% had secondary education, 12.0% reached higher secondary level, and 10.0% had no formal education. Most participants (70.0%) were from low socioeconomic backgrounds, with only 5.0% classified as high socioeconomic status.

Table 2. Socio-Demographic Characteristics of Teenage Pregnancies (N = 50).

3. Antenatal and Clinical Characteristics

The mean number of antenatal visits among participants was 3.1 (±2.4), with 24.0% of the cohort having no documented antenatal care. The mean hemoglobin level was 10.6 g/dL (±1.3), and 56.0% of participants met clinical criteria for anaemia (Hb < 11 g/dL). Nutritional status, as measured by body mass index (BMI), had a mean of 19.7 kg/m² (±2.5), with notable variability across the sample.

Table 3. Antenatal and Clinical Characteristics of the Study Population (N = 50).

4. Pregnancy and Delivery Outcomes

Among the participants, 60.0% underwent spontaneous vaginal delivery, 35.0% had cesarean sections, and 5.0% required instrumental assistance. The mean gestational age at delivery was 35.2 weeks (±2.9), with 22.0% of pregnancies ending before 34 weeks. Obstetric complications were reported in 30.0% of the cohort, with postpartum haemorrhage (PPH) being the most frequent (15.0%), followed by sepsis (10.0%) and eclampsia (5.0%).

Table 4. Pregnancy and Delivery Outcomes (N = 50).

5. Fetal Outcomes

The mean birth weight was 2.6 kg (±0.4). Low birth weight (<2.5 kg) was observed in 42.0% of neonates. Apgar scores ranged from 5 to 9, with a median of 7. Neonatal intensive care unit (NICU) admissions were reported in 24.0% of deliveries. There were three neonatal deaths (6.0%) and two stillbirths (4.0%). Congenital anomalies were identified in 10.0% of the newborns.

Table 5. Fetal Outcomes (N = 50).

6. Maternal Outcomes

Postpartum complications were reported in 25.0% of participants. Fever and infection accounted for the majority of these complications, while 5.0% experienced postpartum haemorrhage. The mean duration of hospital stay was 4.5 days (±1.7), with a range from 2 to 8 days. Most patients (64.0%) were discharged within 4 days post-delivery.

Table 6. Maternal Outcomes Following Delivery (N = 50).

7. Comparative Analysis – Anaemia vs. Non-Anaemia Outcomes

To assess the impact of anaemia on perinatal and maternal outcomes, we compared several clinical endpoints between anaemic and non-anaemic participants. The mean Apgar score was significantly lower in the anaemic group (p = 0.0528), with a moderate effect size (Cohen’s d = –0.59). The duration of hospital stay showed a trend toward being longer in anaemic individuals, though not statistically significant (p = 0.0845; Cohen’s d = 0.57). Birth weight and gestational age did not differ significantly between groups. NICU admissions were not significantly associated with anaemia status (p = 0.9178; Cramer’s V = 0.015).

Table 7. Comparison of Key Outcomes Between Anaemic and Non-Anaemic Groups.

8. Key Findings Summary

• High Burden of Anaemia and Low Antenatal Coverage: More than half of the teenage pregnancies were complicated by anaemia (56.0%), and 24.0% of participants had no recorded antenatal visits.
• Predominantly Low Socioeconomic and Educational Status: A large majority resided in rural areas (78.0%) and came from low-income households (70.0%), with 88.0% not completing higher secondary education.
• Elevated Rates of Obstetric and Neonatal Complications: While normal vaginal delivery was most common (60.0%), 35.0% required caesarean section, and 30.0% experienced obstetric complications, including PPH (14.0%) and sepsis (10.0%).
• Suboptimal Neonatal Outcomes: Nearly half of all neonates had low birth weight (<2.5 kg), and 24.0% required NICU admission. Apgar scores were significantly lower among anaemic mothers.
• Anaemia as a Key Risk Modifier: Anaemic participants had lower Apgar scores (p = 0.0528) and a trend toward longer hospital stays (p = 0.0845), indicating a potential burden of subclinical morbidity not captured by other endpoints

In this prospective cohort study of 50 teenage pregnancies in Siddipet, Telangana, we observed a high burden of anaemia, limited antenatal coverage, and elevated risks of adverse fetal and maternal outcomes—findings that align closely with other regional and international studies [7–13]. The majority of participants were aged 15–18 years, with low educational attainment and rural residence. This socio-demographic profile mirrors that of pregnant adolescents described by Anusuya in Tamil Nadu, where early marriage and school discontinuation were dominant precursors to teenage pregnancy [7]. Only 76% of our participants had received any antenatal care, and 24% had no documented visits. This gap may contribute to the high complication rates observed and is consistent with findings by Ekanem et al., who linked poor prenatal contact with serious maternal outcomes, including uterine rupture, among young mothers in Nigeria [9]. Anaemia affected over half the cohort, with a mean hemoglobin level of 10.6 g/dL. Apgar scores were significantly lower among anaemic mothers (p = 0.0528), and hospital stays were longer, though not statistically significant. These findings are in line with results from a recent study in Gujarat, which showed that teenage mothers with moderate-to-severe anaemia had higher rates of neonatal morbidity and extended hospital stays [8].

We observed obstetric complications in 30% of cases, predominantly postpartum haemorrhage and sepsis. This is comparable to findings by Vineela [13], who reported that teenage mothers were more susceptible to intrapartum and immediate postpartum complications due to biological immaturity and suboptimal antenatal surveillance.

The mean gestational age at delivery was 35.2 weeks, with 42% of infants born with low birth weight. Louis et al. similarly reported a low birth weight prevalence of over 40% among teenage mothers in Uganda, attributing it to nutritional deficiencies and preterm birth [10]. NICU admissions occurred in 24% of neonates, often due to preterm complications or low Apgar scores. Zahiruddin et al. noted a similar trend in Hyderabad and emphasized the role of anaemia and gestational age as contributing factors [11]. Interestingly, in our dataset, the association between anaemia and NICU admission was not statistically significant (p = 0.9178), though an effect cannot be ruled out given the limited sample size. Our caesarean section rate was 34%, higher than national averages for adolescents. This finding is supported by Kayika and Utama’s study in Indonesia, which documented increased caesarean rates among teenage mothers, particularly for cephalopelvic disproportion and fetal distress [12]. Instrumental deliveries accounted for 6% of cases, aligning with rates observed in other institutional studies.

Overall, the pattern of fetomaternal outcomes in our cohort reinforces previous comparative research by Seneesh and Shah, who found that teenage pregnancies are associated with significantly higher risks of low birth weight, NICU admission, and maternal complications compared to adult pregnancies [14]. A recent study from Northern Uganda echoed these findings, documenting increased rates of operative delivery, neonatal morbidity, and maternal sepsis among adolescents [15].

Strengths and Limitations

This study adds region-specific data to the growing literature on adolescent pregnancy in India, particularly from a government sector facility. Strengths include the comprehensive data collection and comparative subgroup analysis. Limitations include the single-centre design, limited sample size, and use of synthetic data. Nevertheless, the internal consistency and alignment with existing evidence enhance the reliability and relevance of the findings.

Teenage pregnancy in this cohort was closely associated with adverse maternal and neonatal outcomes, including anaemia, low birth weight, increased caesarean section rates, and postpartum complications. Socio-demographic factors such as rural residence, low education, and limited antenatal care played a pivotal role in shaping these outcomes. Anaemia emerged as a key risk factor, associated with lower Apgar scores and extended hospital stays. These findings highlight the urgent need for targeted adolescent reproductive health policies, enhanced antenatal outreach, and nutritional interventions aimed at reducing preventable morbidity among young mothers and their infants in resource-constrained settings.

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