Molar Pregnancy in Adolescents

dc.contributorUniversidade Estadual Paulista (UNESP)
dc.creatorBraga, Antonio
dc.creatorGrowdon, Whitfield B.
dc.creatorBernstein, Marilyn
dc.creatorMaestá, Izildinha
dc.creatorRudge, Marilza Vieira Cunha
dc.creatorGoldstein, Donald P.
dc.creatorBerkowitz, Ross S.
dc.date2014-05-20T13:35:25Z
dc.date2016-10-25T16:52:49Z
dc.date2014-05-20T13:35:25Z
dc.date2016-10-25T16:52:49Z
dc.date2012-05-01
dc.date.accessioned2017-04-05T20:28:37Z
dc.date.available2017-04-05T20:28:37Z
dc.identifierJournal of Reproductive Medicine. St Louis: Sci Printers & Publ Inc, v. 57, n. 5-6, p. 225-230, 2012.
dc.identifier0024-7758
dc.identifierhttp://hdl.handle.net/11449/12181
dc.identifierhttp://acervodigital.unesp.br/handle/11449/12181
dc.identifierWOS:000304738800009
dc.identifier0000-0002-9227-832X
dc.identifierhttp://www.reproductivemedicine.com/toc/auto_abstract.php?id=23967
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/859831
dc.descriptionOBJECTIVE: To describe the clinical presentation of hydatidiform molar pregnancy in women under the age of 20 years. In addition, we sought to understand if this adolescent population manifests differences in clinical factors compared to an adult population that may affect outcome.STUDY DESIGN: We used a database from the New England Trophoblastic Disease Center to analyze clinical data from all women followed for molar pregnancy between 1970 and 2009 with complete follow-up information. This population was stratified by age and clinical parameters including presenting signs, molar histology and development of gestational trophoblastic neoplasia (GTN). Univariable and multivariable logistic regression was employed to discern clinical factors that associated with adolescent age. The Partners Human Research Committee approved this study.RESULTS: We identified 1,494 women diagnosed with hydatidiform mole (HM), of which 220 (14.7%) were adolescents defined as age <20 years. The most common presenting clinical signs were vaginal bleeding and an enlarged uterus compared to dates. Median gestational age at diagnosis was 13.4 weeks, not different from that in the adult population. Similarly, no difference in presenting human chorionic gonadotropin was observed between the adult and adolescent populations. Adolescents presented with a significant overrepresentation of complete mole (86% vs. 75%, p < 0.001) compared to adults. Complete mole was associated with a heightened risk of developing GTN (OR 2.6, 95% CI 1.9-3.5), and despite the association of complete mole with young maternal age, univariable analysis showed no difference in the rate of GTN observed between adolescents and adults (24% vs. 30%, p = 0.08). Multivariable analysis controlling for molar histology demonstrated that adolescent age was associated with a decreased risk of GTN (hazard ratio 0.67, 95% CI 0.48 0.93).CONCLUSION: Adolescents account for a substantial proportion of the population with HM. They commonly present with vaginal bleeding. Though this population develops a complete mole with a higher frequency than adults, adolescents appear to have a significantly decreased risk of developing GTN. (J Reprod Med 2012; 57:225-230)
dc.languageeng
dc.publisherSci Printers & Publ Inc
dc.relationJournal of Reproductive Medicine
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectadolescent pregnancy
dc.subjectadolescents
dc.subjectgestational trophoblastic neoplasia
dc.subjecthydatidiform mole
dc.subjectmolar pregnancy
dc.titleMolar Pregnancy in Adolescents
dc.typeOtro


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