Obstetrics and Gynecology International (age and habits). Interactions were also considered during regression model construction. A P value of <.05 was considered as statistically signiﬁcant. 3. Results During the study period, there were a total of 1,138 live singleton deliveries. Of these, 151 were nulliparous adoles- cents (13.3%). 151 nulliparous controls were selected for all cases giving a total of 302 gravid women who were surveyed. General demographic data of studied women are shown on Table 1. Adolescents had a nonmarried status and were studying in a higher rate than their counterparts. Partner age and grandmother’s age at ﬁrst child were signiﬁcantly lower among adolescents. Gestational age at ﬁrst antenatal visit was signiﬁcantly higher among adolescents. Cesarean section rate among teenagers was signiﬁcantly lower than controls (34.4% versus 47.7%, P = .01). Women displaying depressed mood (n = 171/302) had more cesarean section (41.1% versus 36.6%, P = .44). When depressed women were stratiﬁed as adolescents and adults, adolescents pre- sented a similar cesarean rate (35.4% versus 33.3%) whereas adults a higher one (52.2% versus 40.7%) as compared to nondepressed ones; however, these comparison, were not found to be statistically signiﬁcant. No other diﬀerences in maternal and neonatal data were observed among studied cases and controls (Table 2). Total CESD-10 and RS scores found among studied women are depicted on Table 3. A 56.6% of all studied women presented CESD-10 total scores of 10 or more indicating depressed mood. Mean total CESD-10 scores and depressed mood rate did not diﬀer among studied groups. Contrary to this, adolescents displayed lower RS total scores (indicating less resilience) and a higher rate of scores below the calculated median (P < .05). Logistic regression analysis (even after included several interactions) could not establish any risk factor for depressed mood among studied subjects; however, having an adolescent partner (OR, 2.0 CI 95% 1.06–4.0, P = .03) and a preterm delivery (OR, 3.0 CI 95% 1.43–6.55, P = .004) related to a higher risk for lower resilience. 4. Discussion Adolescent pregnancies are increasing worldwide in relation to several biological, social, and personal factors. They are unintended in the majority of cases and create negative feelings both in adolescents (mother and progenitor) and their families. Although pregnant teenagers have similar obstetrical issues as older gravids, additional risks may appear when socioeconomical factors are taken into account [3, 16]. Sociodemographical characteristics of pregnant women (teenagers and non teens) of this series reﬂect those of the low income population of the Ecuadorian coast which are cared for at the Sotomayor Hospital. There were no signiﬁcant diﬀerences between pregnant adolescents and young adult women in parameters such as lifestyle habits, rural residency, and prenatal care. Despite this, it is 3 worthy to mention that women in the control group (also nulliparous) were in fact also young (mean 23 years). This maybe due to the fact that low income women cared for at Sotomayor initiate parity young, hence by 30 women already have 2 o 3 siblings. Both groups currently lived together with their partner in a similar rate, yet teenagers had a nonmarried status in a higher rate than adults. Although a signiﬁcant higher proportion of adolescents were studying at the moment of the survey, this rate may be seen as low, moreover if the rest were working, doing nothing, or working and studying. General fertility rate in Ecuador is among the highest of Latin America and has increased from 84 to 100 per 1,000 in 2004. A 20% of women get pregnant before age 20 and 43% of illiterate adolescents have been pregnant as compared to 11% of those with higher education [17]. Although the number of prenatal visits was similar in studied groups, adolescents of the present series initiated some 2-3 weeks later as compared to young adults. These data could be considered as expectable in adolescents and related to the “surprise” of being pregnant and the diﬃculties of assuming pregnancy and obtaining appropriate care. The risk of pregnancy among adolescents is related to family structure, education, and care. Risk increases with a previous teen pregnancy, lower partner age, and having mothers who were also pregnants adolescents. Partner and grandmother’s age at ﬁrst child was signiﬁcantly lower among adolescents of our series, which is in correlation with other reports [18]. Perinatal outcome among adolescents of this study was similar to adults in terms of preterm birth rate, small- for-gestational-age (%), Apgar scores, and neonatal weight. These results support those of others [3, 19]. Reports indicate that adolescents have both shorter ﬁrst and second stages of labor as compared to the general obstetrical population [20]. There is no clear explanation for this ﬁnding; however, it could be related to the way women experience the onset of their labor. A large proportion of these experiences bear no resemblance to the classical diagnosis of labor and most are unrelated to labor duration [21]. Although progression of labor was not speciﬁcally analyzed in this series, vaginal delivery rate was higher among adolescents supporting the ﬁndings of others [20]. Progression of labor may depend on factors such as maternal and fetal weight, ethnics, and the type of used analgesia. Overall cesarean section rate was high in our series as compared to results from other latitudes [22, 23]. Explanation to this may rely on the fact that Sotomayor hospital is a major referral obstetrical institution for low income women of a vast population of the Ecuadorian coast with high rates of inadequate prenatal care and medical/obstetrical complications. A lower cesarean section rate was found among our adolescents which correlates with other reports [3, 16, 22]. Depressive episodes may aﬀect adolescents in up to 15% of cases, being more frequent among women with negative cognitions, interpersonal conﬂicts, low social support, and stressful life events [24]. Pregnant adolescents suﬀer depres- sion, anxiety, frustration, and aggression in a higher rate than gravid adults [25]. Depression prevalence is much higher among pregnant teens than in adults, with rates varying