Pregnant adolescents admitted to the intensive care unit have better outcomes than pregnant adult women: A retrospective cohort study in Brazil.

ABSTRACT

OBJECTIVE: To compare the outcomes of adolescent versus adult women during pregnancy and puerperium admitted to a dedicated intensive care unit (ICU) in Manaus, Amazonas, Brazil. METHODS: In a retrospective cohort study, we retrieved data from the medical charts of 557 adolescent (<20 years) and adult (≥20 years) women. The association between demographic and clinical variables and the outcomes were compared in univariate and multivariate analyses. RESULTS: The maternal severity index (MSI) of adult women was significantly higher than in adolescents. In univariate log-binomial regression analysis, pneumothorax and circulatory dysfunction were positively associated with the composite primary outcome of death or transfer (for more complex care), whereas eclampsia was negatively associated. Being an adolescent was not associated with this outcome, not even when adjusting for potential confounders. Conversely, being an adolescent was associated with fewer complications (secondary outcome) even after adjusting for potential confounders (type of admission, eclampsia, pre-eclampsia, surgical site infection, abdominal hemorrhage, drug abuse, metabolic syndrome, malnutrition, pneumothorax, or circulatory dysfunction). CONCLUSION: In Manaus, Amazonas, Brazil, adult women admitted to the ICU because of gestational or birth complications had worse outcomes compared with adolescents.