OBJECTIVES: To describe the maternal and neonatal outcomes of a large cohort of adolescent pregnancies in a tertiary care hospital at Reunion Island. METHODS: Retrospective study of all primiparous singleton pregnancies over 10.5 years. Adolescent (\textless18 years) were compared to 18-29 years pregnancies. The maternal outcomes were obstetric illness, labor complications, and way of delivery. Neonatal outcomes were preterm birth, low birth weight (LBW), small for gestational age, birth asphyxia, need for mechanical ventilation, and mortality. RESULTS: We analyzed 1839 adolescent pregnancies and 11,445 controls. Adolescents had worse prenatal care than older mothers, (4.4 vs. 1.4%; p \textless 0.0001), higher rates of smoking and alcohol assumption (13 vs. 11% and 0.7 vs. 0.4%, both p \textless 0.05). They showed less pregnancy-related illness and labor complications and higher rates of normal vaginal delivery (80 vs. 69%; p \textless 0.0001), without increased risk of episiotomy or postpartum hemorrhage. Offspring mortality, preterm birth, and LBW were higher in adolescent pregnancies (3.3 vs. 2.2%; p = 0.001, 14 vs. 12%; p = 0.0008; 17 vs. 14%; p = 0.002). CONCLUSIONS: In this population, adolescents had an obstetrical outcome better than controls, but their offspring short-term outcomes were unfavorable. Furthers studies are needed to better elucidate the link between adolescent pregnancy and impaired neonatal outcome.