Maternal mortality among adolescents in the Russian Federation
Guseva E.V., Filippov O.S., Klimov V.A., Kan N.E.
Objective: To analyze maternal mortality in adolescents in the Russian Federation.
Materials and methods: This was a retrospective analysis of 112 maternal deaths of adolescents from 2009–2023 compared to women 20–34 years of age. Medical and social parameters and organization of medical care were analyzed.
Results: The maternal mortality rate in adolescents (9.9 per 100,000 live births) is lower than in women aged 20–34 (12.8 per 100,000 live births) (p<0.05). The main causes of death in adolescents were extragenital diseases (44.6%), preeclampsia and eclampsia (17.0%) and sepsis after delivery and abortions (14.3%). Adolescents had a higher risk of maternal death from preeclampsia and sepsis and a lower risk of death from extragenital diseases. There were more adolescents living in rural areas, unmarried and single. Pregnancies were more likely to be unwanted. Adolescents were more frequently registered in prenatal clinics after 12 weeks gestation and were observed in medical organisations of group I. Adolescents had higher rates of anemia and genitourinary diseases, pregnancy-related vomiting, preeclampsia, eclampsia and fetal hypoxia during pregnancy and delivery, and postpartum infection. Most deaths (50.9%) occurred in specialized and high-tech medical facilities.
Conclusion: To prevent maternal mortality among adolescents, it is necessary to take measures to prevent abortions, improve the quality of medical care and introduce modern organizational and medical technologies.
Authors’ contributions: Filippov O.S., Guseva E.V. – developing the concept and design of the study; Guseva E.V., Filippov O.S., Klimov V.A. – collecting and processing the material; Guseva E.V. – statistical processing of the data, writing the text; Filippov O.S., Klimov V.A., Kan N.E. – editing the article.
Conflicts of interest: The authors declare that they have no apparent and potential conflicts of interest related to the publication of this article.
Funding: The study was conducted without sponsorship.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Guseva E.V., Filippov O.S., Klimov V.A., Kan N.E.
Maternal mortality among adolescents in the Russian Federation.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 112-124 (in Russian)
https://dx.doi.org/10.18565/aig.2025.22
Keywords
maternal mortality
pregnancy in adolescence
delivery
pregnancy complications
young women
References
- World Health Organization. Fact Sheet: Adolescent Pregnancy. 2022. Available at: https://www.who.int/en/news-room/fact-sheets/detail/adolescent-pregnancy
- Ganchimeg T., Ota E., Morisaki N., Laopaiboon M., Lumbiganon P., Zhang J. et al.; WHO Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014; 121 Suppl. 1: 40-8. https://dx.doi.org/10.1111/1471-0528.12630.
- Eyeberu A., Getachew T., Sertsu A., Sisay M., Baye Y., Debella A. et al. Teenage pregnancy and its predictors in Africa: A systematic review and meta-analysis. Int. J. Health Sci. (Qassim). 2022; 16(6): 47-60.
- Part K., Moreau C., Donati S., Gissler M., Fronteira I., Karro H.; REPROSTAT group. Teenage pregnancies in the European Union in the context of legislation and youth sexual and reproductive health services. Acta Obstet. Gynecol. Scand. 2013; 92(12): 1395-406. https://dx.doi.org/10.1111/aogs.12253.
- Nove A., Matthews Z., Neal S., Camacho A.V. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. Lancet Glob. Health. 2014; 2(3): e155-64. https://dx.doi.org/10.1016/S2214-109X(13)70179-7.
- Wong 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. 2020; 33(2): 153-9. https://dx.doi.org/10.1016/j.jpag.2019.10.006.
- Amoadu M., Hagan D., Ansah E.W. Adverse obstetric and neonatal outcomes of adolescent pregnancies in Africa: a scoping review. BMC Pregnancy Childbirth. 2022; 22(1): 598. https://dx.doi.org/10.1186/s12884-022-04821-w.
- Todhunter L., Hogan-Roy M., Pressman E.K. Complications of pregnancy in adolescents. Semin. Reprod. Med. 2022; 40(1-02): 98-106. https://dx.doi.org/10.1055/s-0041-1734020.
- Елгина С.И., Кондратова Л.А. Особенности течения беременности, родов и послеродового периода, перинатальные исходы у подростков в Кузбассе. Репродуктивное здоровье детей и подростков. 2021; 17(2): 24-32. [Еlgina S.I., Kondratova L.А. Features of the course of pregnancy, childbirth and the postpartum period, perinatal outcomes in adolescents in Kuzbass. Pediatric and Adolescent Reproductive Health. 2021; 17(2): 24-32. (in Russian)]. https://dx.doi.org/10.33029/1816-2134-2021-17-2-24-32.
- Ursache A., Lozneanu L., Bujor I., Cristofor A., Popescu I., Gireada R. et al. Epidemiology of adverse outcomes in teenage pregnancy-A Northeastern Romanian Tertiary Referral Center. Int. J. Environ. Res. Public Health. 2023; 20(2): 1226. https://dx.doi.org/10.3390/ijerph20021226.
- Karataşlı V., Kanmaz A.G., İnan A.H., Budak A., Beyan E. Maternal and neonatal outcomes of adolescent pregnancy. J. Gynecol. Obstet. Hum. Reprod. 2019; 48(5): 347-50. https://dx.doi.org/10.1016/j.jogoh.2019.02.011.
- Althabe F., Moore J.L., Gibbons L., Berrueta M., Goudar S.S., Chomba E. et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study. Reprod. Health. 2015; 12 Suppl. 2(Suppl. 2): S8. https://dx.doi.org/10.1186/1742-4755-12-S2-S8.
- Zhang T., Wang H., Wang X., Yang Y., Zhang Y., Tang Z. et al. The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China. BMC Pregnancy Childbirth. 2020; 20(1): 339. https://dx.doi.org/10.1186/s12884-020-03022-7.
- van Enk W.J., Gorissen W.H., van Enk A. Teenage pregnancy and ethnicity in the Netherlands: frequency and obstetric outcome. Eur. J. Contracept. Reprod. Health Care. 2000; 5(1): 77-84. https://dx.doi.org/10.1080/13625180008500379.
- Nyongesa P., Ekhaguere O.A., Marete I., Tenge C., Kemoi M., Bann C.M. et al. Maternal age extremes and adverse pregnancy outcomes in low-resourced settings. Front. Glob. Womens Health. 2023; 4: 1201037. https://dx.doi.org/10.3389/fgwh.2023.1201037.
- Lastinger J., Enengl S., Neururer S., Leitner H., Oppelt P., Stelzl P. Teenage pregnancies in Austria - an epidemiological study on prevalence and perinatal outcome. Geburtshilfe Frauenheilkd. 2022; 83(2): 212-9. https://dx.doi.org/10.1055/a-1911-1996.
- Blanc A.K., Winfrey W., Ross J. New findings for maternal mortality age patterns: aggregated results for 38 countries. PLoS One. 2013; 8(4): e59864. https://dx.doi.org/10.1371/journal.pone.0059864.
- GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1775-812. https://dx.doi.org/10.1016/S0140-6736(16)31470-2.
- Knight M., Bunch K., Patel R., Shakespeare J., Kotnis R., Kenyon S., Kurinczuk J.J. (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care Core Report - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018-20. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2022.
- Diguisto C., Saucedo M., Kallianidis A., Bloemenkamp K., Bødker B., Buoncristiano M. et al. Maternal mortality in eight European countries with enhanced surveillance systems: descriptive population based study. BMJ. 2022; 379: e070621. https://dx.doi.org/10.1136/bmj-2022-070621.
- Boutin A., Cherian A., Liauw J., Dzakpasu S., Scott H., Van den Hof M. et al.; Canadian Perinatal Surveillance System (Public Health Agency of Canada). Database Autopsy: an efficient and effective confidential enquiry into maternal deaths in Canada. J. Obstet. Gynaecol. Can. 2021; 43(1): 58-66.e4. https://dx.doi.org/10.1016/j.jogc.2020.06.026.
- Leal L.F., Malta D.C., Souza M.F.M., Vasconcelos A.M.N., Teixeira R.A., Veloso G.A. et al. Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019. Rev. Soc. Bras. Med. Trop. 2022; 55(suppl. 1): e0279. https://dx.doi.org/10.1590/0037-8682-0279-2021.
- Li C.L., Jiang M., Huang K.C., Li J., Xu L.G. The trends of maternal mortality ratios and cause pattern in 34 Chinese provinces, 1990-2017. BMC Public Health. 2022; 22(1): 1369. https://dx.doi.org/10.1186/s12889-022-13770-0.
- Kallianidis A.F., Schutte J.M., Schuringa L.E.M., Beenakkers I.C.M., Bloemenkamp K.W.M., Braams-Lisman B.A.M. et al. Confidential enquiry into maternal deaths in the Netherlands, 2006-2018. Acta Obstet. Gynecol. Scand. 2022; 101(4): 441-9. https://dx.doi.org/10.1111/aogs.14312.
- de Wet N. Pregnancy and death: An examination of pregnancy-related deaths among adolescents in South Africa. SAJCH. 2016; 10(3): 151-5.
- Neal S., Mahendra S., Bose K., Camacho A.V., Mathai M., Nove A. et al. The causes of maternal mortality in adolescents in low and middle income countries: a systematic review of the literature. BMC Pregnancy Childbirth. 2016; 16(1): 352. https://dx.doi.org/10.1186/s12884-016-1120-8.
- Say L., Chou D., Gemmill A., Tunçalp Ö., Moller A.B., Daniels J. et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob. Health. 2014; 2(6): e323-33. https://dx.doi.org/10.1016/S2214-109X(14)70227-X.
- Филиппов О.С., Гусева Е.В. Материнская смертность в Российской Федерации в 2019 г. Проблемы репродукции. 2020; 26(6-2): 8-26. [Filippov O.S., Guseva E.V. Maternal mortality in the Russian Federation in 2019. Russian Journal of Human Reproduction. 2020; 26(6-2): 8-26. (in Russian)]. https://dx.doi.org/10.17116/repro2020260628.
- Bodenlos K., Brandt J.S., Graham H.L., Schuster M., Ananth C.V. Trends in cardiovascular disease-related maternal mortality in the United States, 1999-2018. Am. J. Obstet. Gynecol. 2022; 226(3): 432-4. https://dx.doi.org/10.1016/j.ajog.2021.10.012.
- Brosens I., Muter J., Ewington L., Puttemans P., Petraglia F., Brosens J.J. et al. Adolescent preeclampsia: pathological drivers and clinical prevention. Reprod. Sci. 2019; 26(2): 159-71. https://dx.doi.org/10.1177/1933719118804412.
Received 04.02.2025
Accepted 28.03.2025
About the Authors
Elena V. Guseva, PhD, Associate Professor, Deputy Director for Development of the National Medical Research Center for Anesthesiology and Resuscitation for Pregnant Women, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Heath of Russia, 117997, Russia, Moscow,Ac. Oparin str., 4, el_guseva@oparina4.ru, https://orcid.org/0000-0002-7480-9625
Oleg S. Filippov, Dr. Med. Sci., Professor, Deputy Director, Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency of Russia, 1150409, Russia, Moscow, Moskvorechye str., 20; Russian University of Medicine, Ministry of Health of Russia, 127006, Russia, Moscow, Dolgorukovskaya str., 4, +7(926)354-17-61, Filippovolsem@yandex.ru, https://orcid.org/0000-0003-2654-1334
Vladimir A. Klimov, PhD, Head of the Service for Organization of Medical Care and Information Service, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Heath of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(977)937-67-27, va_klimov@oparina4.ru,
https://orcid.org/0000-0002-4699-7614
Natalia E. Kan, Professor, Dr. Med. Sci., Honored Scientist of the Russian Federation, Deputy Director for Research – Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4,
kan-med@mail.ru, Researcher ID: B-2370-2015, SPIN: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Corresponding author: Elena V. Guseva, el_guseva@oparina4.ru
Similar Articles
