Pediatric Rheumatology Online Journal → August 2003 → Rheumatic Fever → Abstract #155

ASPECTS OF THE PREGNANCY AND POST DELIVERY OF ADOLESCENTS WITH RHEUMATIC FEVER

A. M. Sallum,¹ A. J. Moraes,¹ P. M. Soares,¹ M. M. Leal,² A. P. Lotito,¹ C. A. Silva.¹

¹Department of Pediatric - Pediatric Rheumatology Unit, Instituto da Crianca - Hospital das Clinicas, Sao Paulo, SP, Brazil; ²Department of Pediatric - Adolescent Unit, Instituto da Crianca - Hospital das Clinicas, Sao Paulo, SP, Brazil

Introduction: Nowadays, pediatric rheumatology clinics are having to work with an ever increasing population of adolescents and therefore must take into consideration aspects of adolescence, including the development of sexuality, the more and more precocious beginning of sexual activity and it's possible consequences, such as sexually transmitted disease and pregnancy. Objective: To evaluate the incidence of pregnancy among adolescents with RF attended at the our service.
Patients and methods: A retrospective evaluation was undertaken of the records of 510 patients with a diagnosis of RF, according to the modified Jones criteria, from 1983 to 2001. Out of the total 267 female patients, 123 (43%) were adolescents. Sixteen (13%) patients became pregnant during this period, with a total of 19 gestations (one presented two gestations and another three); 14 realized the prenatal appropriately.
Results: Age at onset of the disease varied from six to 12 years (mean 9.5 years). Age of the first gestation varied from 14 to 19 years (mean 16.7 years). While age at the beginning of sexual activity varied from 13 to 18 years (mean 15.2 years). Intercurrent disease during the prenatal was observed in two patients: in one there was recurrence of RF with chorea and in the other HIV infection. Delivery was normal in 10 adolescents and cesarean in four: of which one with HIV, one with premature twins pregnancy and two with prolonged labor. Thirteen newborn were adequate for gestational age and only the twins were premature. In the postpartum, one patient presented infection in the surgical incision and another mammary abscess. No patient reactivated RF in childbirth or postpartum.
Conclusion: Precocious sexual activity and greater incidence of pregnancy among adolescents are realities in the clinics of pediatric rheumatology; Consequently there is a need for improved orientation in relation to sexuality and use of birth-control methods in the routine of such services.