Background (1) In 1999, the UK DOH Teenage Pregnancy Strategy Plan pledged to reduce the pregnancy rate by 50% in < 18 yrs old by 2010. (2) In 2009, the UK teenage pregnancy rate was 38.3 per 1,000 compared to 54.3 per 1,000 in Barking & Dagenham (high-risk area served by the hospital)

Aim This retrospective cohort study reviewed all viable teenage pregnancies from Jan 1, 2010–Dec 31, 2010.

Method Data were obtained from the Labour Ward, Birth Notification and Operating Theatre Registries.

Results There were 257 teenagers with 260 viable babies > 28 weeks gestation. This included primigravida (230/257) = 89.49% and multiparous (27/257) = 10.51%. The ages ranges from 14–19 yrs (mean = 18.29 yrs). Ten (10/257) 3.89% were < 16 yrs old. There were Instrumental deliveries (29/257) = 11.28%, Caesarean section (36/257) = 14.01%, and Vaginal deliveries (192/257) = 74.71%. The mean fetal birth weights were – Instrumental 3.389 kg +/- SD 0.468 kg, Caesarean 3.106 kg +/- SD 0.752 kg; and Vaginal Delivery 3.117 kg +/- SD 0.501 kg.

Maternal Morbidity Third degree tear (n = 3), Pre-eclampsia (n = 12) & PPH > 1 litre (n = 4)

Fetal Morbidity SCBU admission (n = 7), Stillbirth (n = 3) & Shoulder dystocia (n = 2)

Discussion During 1999–2009 the teenage pregnancy rate fell by only 13.3% in spite of the DOH Teenage Pregnancy Strategy Plan.

1. In this cohort the caesarean rate was lower 14.01% vs 24%, the vaginal delivery higher 74.71% vs 65% but the instrumental was similar 11.28% vs 10% compared to the UK average (Caesarean Section Sentinel Audit).

2. There was a dedicated Teenage Pregnancy Midwifery Team providing continuity of care

3. There were 10.51% (27/257) multiparous teenagers thus contraceptive advice remains crucial, as UK has the highest teenage pregnancy rate in Europe