hemorrhage, sepsis, pregnancy-induced hypertension including preeclampsia and eclampsia, obstructed labor caused by cephalopelvic disproportion, iron-deficiency anemia.
These risks are higher for young women not only because of their age but also because births to younger women often are first births, which are riskier than second, third, or fourth births. Socioeconomic factors, including poverty, malnutrition, lack of education, and lack of access to prenatal care or emergency obstetrical care can further increase a young woman's risk of pregnancy-related complications.
Untreated pregnancy-induced hypertension can cause heart failure or stroke and result in the death of both the mother and infant. Hypertension occurs most often among women having their first child and accounts for a large proportion of maternal deaths in women under age 20 .
Cephalopelvic disproportionmeaning that the woman's pelvic opening is too small to allow the infant's head to pass through during deliverycan slow or prevent vaginal delivery. In some cases, if cesarean section cannot be performed, the woman's uterus ruptures, and both mother and infant die. Cephalopelvic disproportion is common in very young women whose pelvic growth is not complete and women of any age who are of small stature because childhood malnutrition stunted their growth . The prolonged labor associated with cephalopelvic disproportion increases the risk of fistulaa tear between the vagina and the urinary tract or rectum, which allows urine or feces to leak out through the vagina. In many african countries fistula injuries occur most commonly in women under age 20, and obstructed labor causes most of these injuries . Fistula is reparable through surgery. For women who cannot get proper care, however, it often leads to lifelong disability and ostracism.
In many regions iron-deficiency anemia is a factor in almost all maternal deaths. An anemic woman is five times more likely to die of pregnancy-related causes than a woman who is not anemic. Anemic women are less able to resist infection and less able to survive hemorrhage or other complications of labor and delivery. Anemia also contributes to premature delivery and low birth weight .
Iron-deficiency anemia is particularly common among pregnant women, and young pregnant women are more likely than older women to be anemic, even in developed countries. For example, an analysis of eight us clinical studies found that pregnant women under age 20 were twice as likely to be anemic as older women . A us study of pregnant teenagers attending a prenatal clinic found that 70% lacked enough iron . Normal menstrual bleeding, a diet lacking absorbable iron, and malaria cause most anemia in pregnant women.