According to the World Health Organization (WHO), teenage pregnancy is pregnancy in a female aged 10-19 years and it is a socio-medical issue worldwide that has significant health and socio-economic impacts [1, 2]. In developing regions, it is estimated that every year about 21 million girls aged 15-19 years become pregnant globally [2]. Although there have been global improvements in maternal health care services, adolescent childbearing is common in South Asia due to the entrenched socio-cultural beliefs and practices, early marriage, low education rates and limited use of contraceptives [3, 4]. In Bangladesh, despite the enactment of legal measures to curb early marriage, it is still prevalent. As a result, a significant number of young women bear children prior to their full biological and anatomical development [5, 6]. The obstetric complications due to biological immaturity of female pelvis and incomplete physiological development include: cephalopelvic disproportion, obstructed labor, pre-eclampsia, maternal anemia etc. [7, 8]. Additionally, physical vulnerabilities are compounded by lack of awareness, insufficient nutrition and poor health care utilization (defined as poor attendance or irregular attendance to ANC clinics) [9, 10]. The literature clearly shows that adolescent mothers are at a higher risk for antepartum and intrapartum complications than adult mothers [11, 12]. Teenage pregnancy is associated with a high prevalence of anaemia, as pregnancy places an additional nutritive demand on maternal nutrition, in addition to that of growth [13]. In addition, pregnant teenagers often develop complications like eclampsia, pregnancy-induced hypertension, and preterm rupture of membranes (PROM), which can lead to pregnant teenage deaths and complications [14, 15]. Perinatal adverse outcomes also are significant. Adolescent mothers are at increased risk for having their babies premature, low birth weight (LBW), intrauterine growth restriction (IUGR), lower APGAR scores, and birth asphyxia [16, 17]. High admission rates to NICU and high rates of perinatal mortality in this group highlight the severity of the situation [18, 19]. Despite the high number of complex pregnancies being managed at tertiary level hospitals in urban areas, there is a need for local empirical evidence on the outcomes of adolescent pregnancy to guide clinical practice and policies. Hence, this study was planned to make an assessment of the maternal clinical complications and the perinatal outcome of teenage mothers admitted in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh.

This retrospective observational study was conducted in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh, from January to December 2023. A total sample size of 150 teenage pregnant women was selected via purposive sampling. Inclusion Criteria 1. Pregnant females aged 14-19 years of age at admission. 2. Capacity to take part and to provide informed written consent (self or legal guardian) Exclusion Criteria 1. Women aged 20 years or older. 2. Women with chronic medical conditions before becoming pregnant (such as pre-existing diabetes mellitus, chronic renal disease, pre-existing hypertension, cardiac disease); 3. Patients unwilling to give consent. Data Collection Procedure Data were collected using a pre-tested structured questionnaire. Detailed socio-demographic information (age, socio-economic status, education, residence), obstetric history (gravidity, ANC visits), intrapartum events, and maternal/neonatal outcomes were documented. Clinical features, laboratory findings (e.g., hemoglobin levels, urine protein), mode of delivery, maternal complications (anemia, pre-eclampsia/eclampsia, PROM, PPH, obstructed labor), and fetal outcomes (gestational age at delivery, birth weight, APGAR score at 1 and 5 minutes, NICU admission) were systematically recorded from clinical examination and medical records. Statistical Analysis Collected data were checked, cleaned, and analyzed using the Statistical Package for Social Sciences (SPSS) software version 26.0. Continuous variables were expressed as mean ± standard deviation (SD), and categorical variables were presented as frequencies and percentages.

Table 1: Socio-demographic and Obstetric Profile of Study Participants (N = 150) Parameter Category Frequency (n) Percentage (%) Age Group (Years) <16 20 13.3% 17–19 130 86.7% Education Status Illiterate / Can sign only 36 24.0% Primary Level 72 48.0% Secondary Level or Higher 42 28.0% Socio-economic Status Low Income 98 65.3% Middle Income 52 34.7% Gravidity Primigravida 132 88.0% Multigravida 18 12.0% Antenatal Visits (ANC) No ANC / Irregular (< 4 visits) 102 68.0% Regular ANC (≥ 4 visits) 48 32.0% Table 2 shows maternal anemia was the most prevalent complication (46.0%), followed by hypertensive disorders of pregnancy (22.0%), including pre-eclampsia (14.0%) and eclampsia (4.0%). Prolonged/obstructed labor occurred in 12.0% of cases, and postpartum hemorrhage (PPH) was observed in 8.0%. Table 2: Maternal Complications and Mode of Delivery (N = 150) Clinical Parameter Frequency (n) Percentage (%) Maternal Complications* Maternal Anemia (Hb < 11 g/dL) 69 46.0% Gestational Hypertension 12 8.0% Pre-eclampsia 21 14.0% Eclampsia 6 4.0% Premature Rupture of Membranes (PROM) 22 14.7% Prolonged / Obstructed Labor 18 12.0% Postpartum Hemorrhage (PPH) 12 8.0% Puerperal Sepsis 5 3.3% Mode of Delivery Spontaneous Vaginal Delivery (SVD) 75 50.0% Instrumental Delivery (Forceps) 9 6.0% Cesarean Section (LSCS) 66 44.0% Table 3 shows out of 150 total deliveries, there were 6 cases of stillbirth/IUFD; therefore, neonatal live-birth denominators for evaluating parameters like Apgar scores are calculated based on 144 live births. Low birth weight (< 2.5 kg) was recorded in 28.0% of neonates. Preterm delivery (< 37 weeks) occurred in 16.0% of cases. Birth asphyxia (APGAR score < 7 at 5 minutes among live births) was observed in 14.6% of neonates, and 16.6% required admission to the Neonatal Intensive Care Unit (NICU). Table 3: Perinatal and Neonatal Outcomes (Total N = 150; Live Births n = 144) Neonatal Parameter Frequency (n) Percentage (%) Gestational Age at Birth (N = 150) Preterm (< 37 completed weeks) 24 16.0% Term (37–42 weeks) 126 84.0% Birth Weight (N = 150) Low Birth Weight (< 2.5 kg) 42 28.0% Normal Birth Weight (≥ 2.5 kg) 108 72.0% APGAR Score at 5 Minutes (Live Births n = 144) Low APGAR (< 7) 21 14.6% Normal APGAR (≥ 7) 123 85.4% Neonatal Morbidity & Mortality (N = 150) Birth Asphyxia 21 14.0% Neonatal Jaundice 27 18.0% NICU Admission 25 16.6% Stillbirth / Intrauterine Fetal Death (IUFD) 6 4.0%

This study evaluated the clinical outcomes and obstetric complications among 150 teenage pregnant women admitted to Shaheed Suhrawardy Medical College & Hospital, Dhaka. The findings confirm that adolescent pregnancy carries heightened clinical risks for both mother and child, consistent with broader literature from low- and middle-income countries [1, 3]. In our cohort, 88.0% of participants were primigravidae, and 68.0% had irregular or no antenatal visits. This pattern reflects persistent socio-demographic challenges in Bangladesh, where early marriage and unplanned early childbearing are compounded by limited utilization of maternal healthcare services [5, 9]. Sultana et al. and Basak et al. similarly observed low rates of regular ANC among teenage mothers in tertiary hospital settings in Bangladesh, linking poor attendance to lack of health awareness and financial barriers [9, 20]. The most common complication was maternal anemia which was experienced by 46.0% of the participants. This is consistent with the national and regional studies [8, 13]. This high prevalence is largely due to nutritional deficiencies, the additional demands of adolescent status on iron requirements and insufficient prenatal supplementation [10]. Hypertensive disorders of pregnancy such as gestational hypertension, pre-eclampsia, and eclampsia were detected in 22.0% of cases. The uterine vasculature is believed to be biologically immature in young primigravidae and maternal adaptation is not yet complete, which may account for their susceptibility to pre-eclampsia [7, 14]. In our study, the rate of cesarean section was 44.0% and the spontaneous vaginal delivery was 50.0%. Performing operative delivery was mostly indicated when the fetus was in distress, failed to progress or when cephalopelvic disproportion (CPD) was present. Cephalopelvic disproportion has been documented as a complication in young adolescents whose pelvic bones have not completely matured [7, 15]. Similar trends in elevated operative delivery rates among teenage mothers have been reported by Thirukumar et al. and Subedi et al. [11, 17]. Neonatal outcomes were also poor. Neonatal complications were mainly low weight (28.0%) and preterm (16.0%). Poor nutritional status, maternal anemia and hypertensive disorders are important risk factors associated with fetal growth restriction and early delivery [12, 16]. Additionally, 14.0% of infants suffered from birth asphyxia, and 16.6% required NICU management. Ergen EB et al. similarly highlighted that teenage mother face significantly higher risks of preterm delivery and neonatal complications compared to adult mothers [12]. Study Limitations There are some limitations of this study. First, it is a single center study performed at a tertiary care referral hospital, which may not be entirely representative in the community on Bangladesh. Second, the study focused predominantly on high-risk or complicated cases. Second, it is not possible to make direct statistical comparisons and quantify the relative risk of the adolescent age group compared to an adult pregnant control group (20–35 years) due to their absence. Third, the small number sample (N = 150) obtained using non-probability purposive sampling might be subject to selection bias. Lastly, there are issues of limitations in information or documentation

Teen pregnancy is linked to a variety of maternal and neonatal complications, such as anemia, pre-eclampsia, premature delivery, low birth weight and operative interventions. The low uptake of antenatal care further contributes to these risks. A supportive legislative framework to combat early marriage, better secondary education of girls, and greater access to antenatal care services that are youth-friendly are crucial measures to limit the impact of adolescent pregnancy in Bangladesh.

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