This is a twelve month retrospective cohort study carried out from

1. adolescent Pregnancies in sarawak The unspoken facts GaneshanMuniswaran, SuharjonoHaris, HY Voon ,ET Goh, BohanSuhaila, Ibrahim A Fatin Department of Obstetrics & gynaecology, SARAWAK GENERAL HOSPITAL Conclusions Objectives Adolescent pregnancies is highly prevalent in Sarawak. The current measures undertaken to reduce the incidence are ineffective as teenage marriages is culturally acceptable. However, 47% of the cohort in Sarawak are single which is of significant concern. Although majority had good outcomes, the physical risk is significantly increased for those aged below sixteen. Better understanding of the social, nutritional and psychological implications are essential to optimize management. This is best done via setting a national registry. It still remains a major health and social concernin Malaysia and there is an urgent need for a more aggressive multidisciplinary holistic approach in our quest to improve reproductive health as we progress towards achieving our Millennium Development Goals. Adolescent pregnancies is a major public health concern. It is a period of profound biological, social and physical change. It is also a time of vulnerability. The implications on the young mother, the unborn child and the society are enormous. Despite the various problems, it remains culturally acceptable in certain parts of the world, including Malaysia. Unfortunately, as we endeavor towards achieving the Millennium Development Goals, adolescent pregnancy rates in Sarawak remains exceptionally high. Thus, the novel aim of this study is to highlight the significance of adolescent pregnancies in Sarawak. This will be followed by a multicentre prospective study involvingall the major hospital in Sarawak which is currently in progress. References Methods • Teenage pregnancy and reproductive health summary review: June 2007 . RCOG. • Consensus views arising from the 52nd Study Group: Teenage Pregnancy and Reproductive Health • Relationship between maternal growth, infant birth weight and nutrient partitioning in teenage pregnancies. RL Jones1, HMS Cederberg1, SJ Wheeler2, L Poston2, CJ Hutchinson2, PT Seed2, RL Oliver3, PN Baker1. BJOG. Volume 117, Issue 2, pages 200–211, January 2010 • Teenage pregnancy : strategies for prevention . Aisling S Baird, Charlotte C Porter. Obstetrics, Gynaecologyand Reproductive Medicine 21:6.2011. • Wellings K, Hutchinson C, Guthrie K, Baker PN, eds. ‘Teenage pregnancy’. London: RCOG Press, 2007. • Wellings K, Nanchahal K, Macdowall W, et al. Sexual behavior in Britain: early heterosexual experience. Lancet 2001; 358: 1843e50. • Healthy lives, healthy people. white paper, Department of Health, London. • Review management of teenage pregnancy. The Obstetrician & Gynaecologist. Richard P Horgan, Louise C Kenny. 2007;9:153–158. • National Collaborating Centre for Women’s and Children’s Health. Antenatal Care: Routine Care for the Healthy Pregnant Woman. Clinical Guideline. NCCWCH: RCOG Press; 2003. • Ehiri JE, Meremikwu A, Meremikwu M. Interventions for preventing unintended pregnancies among adolescents. (Protocol) Cochrane Database of Systematic Reviews 2005, Issue 2. • National Institute for Health and Clinical Excellence. Preventing Sexually Transmitted Infections and Reducing Under 18 Conceptions: Guidance. Public Health Intervention Guidance 3. London: NICE; 2007 • Department of Health. Best practice guidance for doctors and other health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health. London. • Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit. Contraceptive choices for young women, March 2010. • Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit. Postnatal sexual and reproductive health, September 2009. This is a twelve month retrospective cohort study carried out from 1stSeptember 2010 till 31st August 2011. Seven hundred forty four adolescent pregnancies were studied. The cases were identified from the admission registry and the case notes were retrieved. A standardized profoma was used for data extraction and the parameters analyzed included socio-demographic factors, antenatal, intra-partum, post partum complications and fetal outcomes. The results were analyzed using SPSS 17. Results Adolescent birth rates – 62/1000 Contraceptive prevalence – 12% Antenatal care coverage - 97.3 % Maternal /Perinataldeath – 0 Planned pregnancy – 86% Miscarriage rates – 3.1% Ectopic pregnancy rates - 0.4% Caesarean section rates – 12.5% Episiotomy rates – 43.8 % Preterm deliveries – 16.7% Low birth weight– 33 %