Adolescent pregnancy remains a significant public health concern due to its potential impact on maternal and neonatal outcomes. However, evidence comparing outcomes between primigravid adolescents and low-risk adult mothers in tertiary care settings in the Philippines remains limited. This study aimed to compare the prevalence and types of maternal and neonatal outcomes during delivery between primigravid adolescent mothers (10–19 years) and low-risk primigravid adult mothers (20–34 years) admitted from January 1, 2022 to December 31, 2024. A retrospective cohort study was conducted among 2,628 primigravid mothers. Participants were classified as adolescents or low-risk adults. Descriptive statistics summarized baseline characteristics. Group differences were analyzed using Chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U test for continuous variables. Effect sizes were reported as crude odds ratios (cOR) with 95% confidence intervals, with p<0.05 considered significant. Adolescents comprised 41.93% of the cohort. Compared to adults, adolescents were more likely to have normal spontaneous delivery (85.12% vs 70.30%; cOR 2.42, 95% CI: 1.99–2.96) and less likely to undergo cesarean section (cOR 0.41, 95% CI: 0.33–0.50; p<0.001). They had lower odds of gestational hypertension, preeclampsia, gestational diabetes, and PROM, but higher odds of infections (cOR 3.46, 95% CI: 2.55–4.71). Neonates of adolescents had lower mean birthweight (−80.71 g, p<0.001) and higher low birthweight rates (19.42% vs 15.53%; cOR 1.31, 95% CI: 1.07–1.61). APGAR scores, preterm birth, and major complications were comparable. Adolescents showed higher rates of no adverse outcomes and lower fetal distress, with no neonatal deaths.

A fourth-year Obstetrics and Gynecology resident at Bataan General Hospital and Medical Center, she is an advocate of adolescent and maternal health. A certified Women and Children Protection Unit specialist and Family Planning trainer, she promotes compassionate, evidence-based care, empowering women and adolescents through clinical excellence, education, and community-centered reproductive health initiatives.