Background: Adolescent pregnancy remains a major global public health issue, often linked to socioeconomic and educational disparities rather than biological immaturity. This study aimed to identify sociodemographic factors associated with adolescent pregnancies and to evaluate their impact on maternal and neonatal outcomes in a tertiary hospital in Northeastern Romania. Methods: A retrospective analysis was conducted at the “Cuza Vodă” Obstetrics-Gynecology Clinic Hospital, Iași, over two periods: 2013–2017 and January–October 2025. Records of 637 mothers aged <20 years were reviewed. Variables included age, education, prenatal monitoring, gestational age, delivery mode, neonatal outcomes, and obstetric complications. Statistical analyses were performed using SPSS v26, employing ANOVA, Welch ANOVA, and post hoc tests (p < 0.05). Ethical approval was obtained from the institutional ethics committee. Results: The mean maternal age was 17.26 ± 1.5 years, with 82.6% from rural areas. Most had only primary or lower secondary education. Fully monitored pregnancies were associated with significantly higher birth weights (mean = 3249 g) compared with unmonitored pregnancies (mean = 3009 g; p < 0.001). Infants of mothers with low education had the lowest mean birth weights (2963 g; p = 0.002). Preterm births represented 14.3% of cases, and cesarean deliveries accounted for 34.5%. A slight but significant increase in maternal age was observed between 2013–2017 and 2025 (p < 0.001), suggesting delayed adolescent childbearing. Conclusions: Low educational attainment and inadequate prenatal monitoring remain major determinants of adverse neonatal outcomes among adolescent mothers. Comprehensive sexual education, improved prenatal care accessibility, and social support programs are essential to reduce adolescent pregnancy rates and improve reproductive health in Romania.

Latency antibiotic therapy is an established component of expectant management after preterm prelabour rupture of membranes (PPROMs). Pooled randomised evidence from 22 trials involving 6872 women and infants shows that antibiotics prolong pregnancy, reduce chorioamnionitis (risk ratio 0.66) and reduce neonatal infection (risk ratio 0.67), without a significant reduction in perinatal mortality. The evidence supporting the therapeutic principle is stronger than the evidence defining how the therapy should be configured. This narrative review examines the three decisions an obstetrician makes at the bedside, namely, which agent, at which dose and route, and for how long, and the comparative evidence behind each. Contemporary practice descends from two protocols: the ampicillin–erythromycin regimen of the NICHD Maternal–Fetal Medicine Units Network trial and the erythromycin arm of ORACLE I. Neither was designed to identify an optimal regimen. Substitution of azithromycin for erythromycin rests predominantly on observational cohorts together with one small open-label randomised comparison that pre-specified no non-inferiority margin and is therefore pragmatic and guideline-permitted rather than confirmed by an adequately powered randomised trial. No randomised dose comparison using clinical endpoints has been performed in PPROM, although randomised pharmacokinetic data exist for azithromycin. The seven-day course derives from a trial protocol rather than from a duration-ranging study, and the two randomised duration comparisons published since 2023 point in opposite directions. Guideline agreement reflects shared historical ancestry rather than independent confirmation of optimality. Adequately powered pragmatic trials, stratified by gestational age, remain the principal unmet need.