Prenatal care utilization and perinatal outcomes among pregnant adolescents in Mexico, 2008–2019

Objective: To describe utilization of prenatal care and outcomes of low birth weight and preterm birth among adolescent births in Mexico. Methods: We used birth certificate data and included live births to individuals 10–24 years, 2008–2019. Our outcomes were binary measures of adequate prenatal care, low birth weight, and preterm birth. We compared adolescents (10–14 years, 15–16, and 17–19) to those 20–24 years. We included individual-, clinical-, and municipality-level variables, used multivariable logistic regression, and calculated adjusted predicted probabilities. We also tested whether receipt of prenatal care moderated the relationship of age with preterm birth and low birth weight. Results: We included a total of 12 106 710 births to women 10–24 years. The adjusted predicted probability of adequate prenatal care increased with age: 56.07% (95% CI 55.82–56.31%) adjusted probability among adolescents 10–14 years compared with 65.51% (95% CI 65.48%–65.55%) among individuals 20–24 years. Receipt of adequate prenatal care in part mitigated disparities in preterm birth and low birthweight across all age groups: 7.30% (95% CI 7.17%–7.43%) adjusted probability of delivering a preterm infant among those 10–14 years who received adequate prenatal care compared with 9.37% (95% CI 9.20%–9.53%) among those 10–14 years without adequate prenatal care. Conclusion: In Mexico, adolescent pregnancies are associated with inadequate prenatal care as well as higher odds of preterm delivery and low birth weight. Youngest adolescents (10–14 years) have the highest probability of adverse outcomes. Adequate prenatal care may help partially mitigate disparities in poor perinatal outcomes.