A new paper to be published in The Obstetrician & Gynaecologist ( TOG ) will look at the causes of teenage pregnancy and offers recommendations on tackling this social problem.

Though a decreasing figure since 1998, the UK still has the highest teenage pregnancy rate in Western Europe.

The adverse outcomes associated with teenage pregnancy include miscarriage, premature birth and babies that are born small for gestational age or have low birth weight. Teenage mothers have higher rates of sexually transmitted infections, alcohol or substance abuse, smoking and poor nutrition. Teenage mothers are also found to suffer from higher rates of postnatal depression.

One cited reason for adverse outcomes in teenage pregnancy is the gynaecological immaturity of mothers. Many adolescent girls continue to grow when pregnant. Though weight gain and increased fat stores are often experienced during pregnancy by adolescent mothers, their babies have lower fetal growth rates as a result of the competition for nutrients between the maternal body and the growing baby. During birth, there is also the increased likelihood of obstructed labour for adolescent mothers because of their small, underdeveloped pelvises.

To prevent teenage pregnancies, the authors of the paper recommend better contraception services tailored to the needs of teenagers. Family planning and sexual health clinics should be easily accessible to these women and provide a range of services, including advice on diet, smoking cessation and returning to school after birth. Pregnant teenagers should be encouraged to attend antenatal classes and care should include medical as well as social support. The authors also believe that postnatal management for teenage mothers should be better, providing further counselling and education on essential aspects of motherhood such as breastfeeding and nutrition for babies. As many teenage mothers tend to be single and often feel isolated in bringing up their babies, they require special attention from the health and social services.

Author Louise Kenny, Consultant Obstetrician and Gynaecologist at Cork University Maternity Hospital in Ireland said "The death rate for babies and very young children of teenage mothers is 60% higher than that for children of older women and young single mothers are three times more likely than older women to experience postnatal depression. These are starkly depressing figures."

"More research is urgently needed into the causes of poor pregnancy outcome in the teenage population as it is unclear whether poor outcomes are attributable to the biological challenges presented by young maternal age or whether they are solely the consequence of socio-demographic factors."

"At a practical level, antenatal care should be tailored to the individual needs of pregnant teenagers. There is an important opportunity here to encourage smoking and alcohol cessation, and provide to counsel regarding the risks of sexually transmitted infections and on the use of contraception afterwards."

Professor Neil McClure TOG editor-in-chief said, "Attendance at antenatal clinics for the majority of teenage mothers is generally poor, with many mothers only seeking help late in pregnancy. This means we are unable to provide these mothers with appropriate advice on health care during pregnancy and to monitor the development of their babies."

"All too often, these teenagers slip through the system and we don't find out about them until there is a problem. We need a nationwide strategy to engage more thoroughly with pregnant teenagers so that we can provide the services they need and reduce the incidence of maternal deaths and complications among this group of mothers."

The Obstetrician & Gynaecologist ( TOG ) is published quarterly and is the Royal College of Obstetricans and Gynaecologists' (RCOG) medical journal for continuing professional development. TOG is an editorially independent, peer reviewed journal aimed at providing health professions with updated information about scientific, medical and clinical developments in the specialty of obstetrics and gynaecology.