Adolescent pregnancy in Romania: A retrospective hospital-based study complemented by a literature review on socio-medical determinants

Abstract

Background and objectives. Adolescent pregnancy remains a global public health concern with significant clinical and socio-economic implications. Romania reports one of the highest adolescent birth rates in the European Union, with marked regional disparities. This study aimed to assess the socio-demographic profile, obstetric outcomes, and immediate neonatal status of adolescent mothers delivering at Vaslui County Emergency Hospital in 2023, and to contextualize these findings through a narrative literature review on socio-medical determinants of adolescent pregnancy. Materials and methods. A retrospective observational study was conducted for all deliveries from January to December 2023 in mothers aged 14–17 years. Variables included maternal age, education, residence, parity, gestational age, birth weight, Apgar scores, and postnatal discharge destination. Descriptive and comparative statistics were applied (p < 0.05). A narrative literature review (PubMed, Scopus, Google Scholar, 2007–2024) identified 28 peer-reviewed studies on socio-medical determinants of adolescent pregnancy. Results. Among 1,073 deliveries, 65 (6.0%) involved adolescent mothers, predominantly from rural areas (80.0%) and with low educational attainment (63.0%). Preterm birth occurred in 14.0% of cases, strongly associated with low education (p < 0.001). Older adolescents were more likely to have had prior pregnancies (p = 0.0068). Most deliveries were at term (86.0%) with favorable neonatal outcomes: 88.0% birth weight >2,700 g; all Apgar ≥9 at 5 minutes. The literature review confirmed education, rural residence, and socioeconomic disadvantage as the main determinants. Conclusions. Adolescent pregnancy in Vaslui County predominantly affects socioeconomically disadvantaged rural populations. Targeted interventions in education, reproductive health access, and social support are essential to reduce incidence and adverse outcomes.