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1.
Clin Immunol ; : 110335, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39098705

RESUMO

More frequent among adults, phenocopies may be caused by somatic mutations or anti-cytokine autoantibodies, mimicking the phenotypes of primary immunodeficiencies. A fourteen-year-old girl was referred for a two-year history of weight loss and multiple recurrent abscesses, complicated recurrent pneumonia, pyelonephritis, osteomyelitis, and septic shock, without fever. She had started with nausea, hyporexia, and weight loss, then with abscesses in her hands, knee, ankle, and spleen. She also developed a rib fracture and left thoracic herpes zoster. The patient was cachectic, with normal vital signs, bilateral crackles on chest auscultation, tumefaction of the knee joint, and poorly healed wounds in hands and chest, oozing a yellowish fluid. Chest computed tomography revealed multiple bilateral bronchiectases. Laboratory workup reported chronic anemia, leukocytosis, neutrophilia, mild lymphopenia, thrombocytosis, pan-hypergammaglobulinemia, and elevated acute serum reactants. Lymphocyte subsets were low but present. Mycobacterium tuberculosis was detected via polymerase chain reaction in a bone biopsy specimen from ankle osteomyelitis. Whole-exome sequencing failed to identify a monogenic defect. Interleukin-12 was found markedly elevated in the serum of the patient. Phosphorylation of STAT4, induced by increasing doses of IL-12, was neutralized by patient serum, confirming the presence of anti-IL12 autoantibodies. IL-12 and IL-23 are crucial cytokines in the defense against intracellular microorganisms, the induction of interferon-gamma production by lymphocytes, and other inflammatory functions. Patients who develop neutralizing serum autoantibodies against IL12 manifest late in life with weight loss, multiple recurrent abscesses, poor wound healing, and fistulae. Treatment with anti-CD20 monoclonal antibodies was effective.

2.
Health Econ ; 33(7): 1528-1545, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38483024

RESUMO

I examine the effect of city-level juvenile curfews on teenage birth rates using the National Center for Health Statistics birth data from 1982 to 2002. I compare differences in birth rates between younger and older age groups in cities with and without curfew ordinances. Before curfew adoption, the age differential in birth rates trended similarly for cities that did and did not adopt a curfew. There were significant decreases in the age differential birth rates in cities that adopted a curfew relative to cities that did not. Curfews reduced birth rates by approximately 3 births per 1000 women ages 15-17. I find a decrease in birth rates among white women. The main results are corroborated using a variety of robustness checks and specifications.


Assuntos
Coeficiente de Natalidade , Gravidez na Adolescência , Humanos , Adolescente , Feminino , Gravidez na Adolescência/estatística & dados numéricos , Coeficiente de Natalidade/tendências , Gravidez , Estados Unidos , Adulto Jovem , Fatores Etários
3.
Health Econ ; 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39020467

RESUMO

We study the impact of vertical identification card laws, which changed the orientation of driver's licenses and state identification cards from horizontal to vertical for those under 21 years, on teenage tobacco and alcohol use. We study this question using four national datasets (pooled national and state Youth Risk Behavior Surveillance System, National Youth Tobacco Survey, Current Population Survey to Tobacco Use Supplements, and Behavioral Risk Factor Surveillance System). We improve previous databases of vertical ID law implementation by using original archival research to identify the exact date of the law change. We estimate models using standard two-way fixed effects and stacked difference-in-differences that avoid bias from dynamic and heterogeneous treatment effects. Using data through 2021, we do not find evidence of reductions in teenage tobacco and alcohol use. While these laws reduce retail-based purchasing, they also increase social sourcing, thus leading to no net impact on use.

4.
Artigo em Inglês | MEDLINE | ID: mdl-38937966

RESUMO

INTRODUCTION: The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents. MATERIAL AND METHODS: The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174 653 Norwegian women born 1989-1990, 1994-1995, and 1999-2000. We examined use of hormonal contraceptives through dispensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi-squared test, survival analysis, and Joinpoint regression analysis with p-values < 0.05. RESULTS: By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen-only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long-acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19 years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002. CONCLUSIONS: Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long-term first-time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long-term first-time hormonal contraceptive users.

5.
BMC Womens Health ; 24(1): 335, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851734

RESUMO

BACKGROUND: Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. METHODS: This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20-24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20-24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05. RESULTS: Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors. CONCLUSION: This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results.


Assuntos
Gravidez na Adolescência , Humanos , Feminino , Gravidez na Adolescência/estatística & dados numéricos , Malaui , Gravidez , Estudos de Casos e Controles , Adolescente , Adulto Jovem , Comportamento Contraceptivo/estatística & dados numéricos , Casamento/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Risco , Escolaridade , Anticoncepção/estatística & dados numéricos , Modelos Logísticos
6.
BMC Womens Health ; 24(1): 236, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38614989

RESUMO

BACKGROUND: Globally, teenage pregnancy is among the most social problems, affecting 21 million adolescents aged 15-19. Due to the increased responsibility of prenatal and postnatal care for their infants without support, pregnant and parenting teenagers, tend to experience mental health problems. Factors contributing to these problems among pregnant and parenting teenagers in rural African settings have hardly received scholarly attention and, therefore, are less understood. The purpose of the study was to explore mental health and challenges among pregnant and parenting teenagers,. METHOD(S): The study adopted a qualitative descriptive, exploratory, and phenomenological design. Purposive sampling was used to select 22 pregnant and parenting teenagers 18 years or older. Data were collected in ten selected clinics within the Demographic Surveillance Systems (HDSS) of DIMAMO and analysed using qualitative content analysis. RESULTS: The findings reveal that pregnant and parenting teenagers in rural areas experience various mental challenges such as depression. These challenges are caused by social problems such as stigmatisation, lack of support from families and friends, as well as parenting demands that contribute to poor progress at school or dropouts. Pregnant teens expressed concerns about the lack of spousal support resulting from abandoning their partners. CONCLUSIONS: Stress and depression were self-reported as mental problems among participants with various psychosocial implications, such as school dropout and miscarriage. There are various contributing factors to the mental health problems identified among pregnant and parenting teenagers, including inadequate family and spousal support. Access to integrated reproductive, psychosocial, and mental health services could be essential for these pregnant and parenting teenagers, to improve their mental well-being and improve the support system.


Assuntos
Aborto Espontâneo , Saúde Mental , Adolescente , Feminino , Humanos , Lactente , Gravidez , População Negra , Poder Familiar , África do Sul/epidemiologia , Adulto Jovem
7.
BMC Womens Health ; 24(1): 342, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38877516

RESUMO

BACKGROUND: Teenage childbearing is a common issue for young people's sexual and reproductive health in the world, particularly in low-income countries, and affects teenagers between the ages of 13 and 19. According to several academics, adolescent pregnancy accounts for the majority of Ethiopia's population increase, and there has been little effort to address this threat. This study aimed to determine the prevalence and associated factors of the time to teenage childbearing in Ethiopia. METHOD: This paper compares the results of the semi-parametric proportional hazard (PH), parametric PH, and accelerated failure time (AFT) models to find the model that best fits the data. The Akaike Information Criterion (AIC) was used to evaluate the performance of models examined in this investigation. Time to teenage childbearing was the study's outcome variable, while the analysis considered various independent variables. We analyze data from the 2016 National Demographic Health Survey to assess the influence of different risk factors on teenage pregnancy among Ethiopian women. RESULTS: Out of the 10,274 teenagers (aged between 13 and 19) who participated in the 2016 survey, 6,430 (62.59%) were parents. The study findings revealed that these teenage parents were influenced by various time-related factors before becoming parents. The log-normal AFT model has the lowest AIC value and hence it is the best fit for this data. Results from this model indicated that significant factors influencing the time to teenage childbearing include the age of the household head, current age of the respondents, region, religion, educational attainment, wealth status, intention to use contraception, and recent sexual activity. CONCLUSION: This study reveals that 62.59% of surveyed teenagers aged 13 to 19 were parents. Various factors at both the individual and community levels: including the age of the household head, regional differences, religious affiliation, educational level, economic status, contraceptive intentions, and recent sexual activity, determine the time to teenage childbearing. Targeted interventions addressing these factors are essential for reducing teenage pregnancies and supporting adolescent parents effectively.


Assuntos
Gravidez na Adolescência , Humanos , Feminino , Etiópia/epidemiologia , Adolescente , Gravidez na Adolescência/estatística & dados numéricos , Gravidez , Prevalência , Adulto Jovem , Modelos de Riscos Proporcionais , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos
8.
Birth ; 51(1): 218-228, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37849418

RESUMO

OBJECTIVES: This study aimed to estimate the prevalence of diagnosed postpartum depression (PPD) and the likelihood of PPD among primiparous women. We also evaluated differences in the influence of various maternal factors associated with PPD in adolescent versus adult mothers. METHODS: We conducted a retrospective cohort study using electronic health records linked to birth certificates to evaluate the associations between maternal factors and PPD diagnosis. The study population was stratified into adults and adolescents based on age at delivery. We evaluated socioeconomic, demographic, psychological, and clinical factors associated with PPD in each of the age-defined maternal cohorts using multivariable logistic regression analyses. RESULTS: A total of 61,226 primiparous women, including 6435 (11%) mothers younger than 20 years old, were included in the study. The overall PPD rate was 4.0%, with the age-specific PPD rate measuring 1.6 times higher in adolescents than in adult women (6.1% vs. 3.8%). Compared with adults, adolescents were less likely to obtain firsttrimester prenatal care (33% vs. 16%), more likely to have recent tobacco use (11% vs. 6%), and more likely to have had an infection during pregnancy (5% vs. 1%). In adjusted models, significant factors for PPD in both groups included a history of depression or anxiety, tobacco use, and long-acting reversible contraception use. CONCLUSIONS: In this cohort of first-time mothers, adolescents had higher rates of PPD diagnosis as well as PPD-associated maternal factors than adults. Increased awareness of PPD risk in adolescents and early intervention, including integrating mental healthcare into prenatal care, may help benefit adolescents and reduce the risk and severity of PPD.


Assuntos
Depressão Pós-Parto , Gravidez , Adulto , Feminino , Adolescente , Humanos , Adulto Jovem , Depressão Pós-Parto/psicologia , Estudos Retrospectivos , Fatores de Risco , Mães/psicologia , Cuidado Pré-Natal , Período Pós-Parto/psicologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-38831170

RESUMO

BACKGROUND: Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to determine the indirect effects of neighbourhood socioeconomic status (NSES) on the risk of spontaneous PTB. METHODS: We carried out a retrospective case-control study including sociodemographic and obstetric data of multigravid women who gave birth at a maternity hospital in Tucumán, Argentina, between 2005 and 2010: 949 women without previous PTB nor pregnancy loss who delivered at term and 552 who had spontaneous PTB. NSES was estimated from the Unsatisfied Basic Needs index of census data. Variables selected through penalised regressions were used to create a data-driven Bayesian network; then, pathways were identified and mediation analyses performed. RESULTS: Maternal age less than 20 years mediated part of the protective effect of high NSES on spontaneous PTB [natural indirect effect (NIE) -0.0125, 95% confidence interval (CI) (-0.0208, -0.0041)] and on few prenatal visits (< 5) [NIE - 0.0095, 95% CI (-0.0166, -0.0025)]. These pathways showed greater sensitivity to unobserved confounders that affect the variables mediator-outcome in the same direction, and exposure-mediator in the opposite direction. They did not show sensitivity to observed potential confounders, nor to the parameterization used to define NSES. Meanwhile, urinary tract infections showed a trend in mediating the effect of low NSES on spontaneous PTB [NIE 0.0044, 95% CI (-0.0006, 0.0093), P 0.0834]. CONCLUSIONS: High NSES has protective indirect effects on spontaneous PTB risk, mainly associated with a lower frequency of teenage pregnancy.

10.
Cult Health Sex ; : 1-16, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38315580

RESUMO

Using a feminist narrative approach, this article explores how unintended pregnancy can rupture young lives, and how young people respond to and navigate these ruptures. We analyse qualitative data from a longitudinal cohort study in Luwero, Uganda, focusing on narratives of a girl and a boy about their recent experiences of unintended and unwanted pregnancy during COVID-19 school closures. We argue that laws, policies and norms relating to education, sexual and reproductive health, and the family in Uganda position young people in complex and contradictory ways, that create the conditions for unintended pregnancies, and restrict the choices open to them. The analysis traces how pregnancy ruptures their everyday lives, their identities, and relationships. Their narratives reveal gendered ways in which they enact identities to manage the ruptures. Families are sites of contestation, where gender and sexuality are regulated, but are also mobilised by young people to support their efforts to repair the ruptures. Our analysis underscores the importance of working with young people to understand their positionalities, resource environments and social networks as they make and navigate decisions about pregnancy, and of addressing the structural forces that underpin the rupturing effects of pregnancy on teenage lives.

11.
Cult Health Sex ; 26(4): 563-574, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37052126

RESUMO

Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.


Assuntos
Violência de Gênero , Gravidez na Adolescência , Gravidez , Adolescente , Feminino , Humanos , Peru , Violência , Indonésia
12.
Cult Health Sex ; 26(1): 30-45, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37105132

RESUMO

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.


Assuntos
Gravidez na Adolescência , Gravidez , Adolescente , Feminino , Humanos , Masculino , Papel de Gênero , Colômbia/epidemiologia , Estudos Transversais , Estudos Retrospectivos
13.
Cult Health Sex ; : 1-15, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365220

RESUMO

Adolescents' sexual and reproductive health challenges are of global public health concern and good quality sexual and reproductive health (SRH) education has an important role to play in addressing these negative sexual health outcomes. Yet in most Sub-Saharan African countries including Ghana, there is limited implementation of SRH education. Several environmental factors hinder the implementation of SRH education with the attitudes expressed by religious leaders having a major impact. We conducted semi-structured interviews with 15 Christian leaders in Bolgatanga, Ghana, to explore the factors influencing their decision to adopt and implement SRH education. Findings show that although Christian leaders were aware of (unsafe) sexual practices among adolescents, they held a conservative position on SRH education. While leaders were open to educating adolescents about sexual health, most held the opinion that SRH education for adolescents should be limited to abstinence-only and not acknowledge sexual activity or promote contraceptive use. Beliefs related to sexual morality, the perceived cause(s) of teenage pregnancy, and perceived responsibility for SRH education influenced Christian leaders' thinking about SRH education. Implementing SRH education programmes to address young people's sexual behaviour will require intervention programmes to change Christian leaders' beliefs and attitudes towards SRH education.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38789834

RESUMO

BACKGROUND: The risks of sexually transmitted infections (STIs) and teenage pregnancy in the offspring of parents with schizophrenia remain unknown. METHODS: From the Taiwan National Health Insurance Research Database, 5,850 individuals born between 1980 and 1999 having any parent with schizophrenia and 58,500 age-, sex-, income- and residence-matched controls without parents with severe mental disorders were enrolled in 1996 or on their birthdate and followed up to the end of 2011. Those who contracted any STI or became pregnant in adolescence during the follow-up period were identified. RESULTS: Cox regression analyses demonstrated that offspring of parents with schizophrenia (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 1.02-1.44), especially daughters (HR: 1.30, 95% CI: 1.06-1.58), were more likely to contract any STI later in life than the control comparisons. In addition, daughters of parents with schizophrenia had an elevated risk of being pregnant in their adolescence (HR: 1.47, 95% CI: 1.29-1.67) compared with those having no parents with severe mental disorders. DISCUSSION: The positive relationship between parental schizophrenia and offspring STIs and teenage pregnancy necessitates clinicians and public health officers to closely monitor the sexual health in the offspring of parents with schizophrenia so that optimal and prompt preventive measures can be taken in the at-risk group.

15.
J Pediatr ; 253: 135-143.e6, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36179892

RESUMO

OBJECTIVES: To study sexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior. STUDY DESIGN: Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother's first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure. RESULTS: A linear dose-response relationship existed between gestational age and STCT and teenage pregnancy; adjusted hazard for STCT decreased by 1.6% (95% CI, 0.7%-2.6%), and for teenage pregnancy by 3.3% (95% CI, 1.9%-4.8%) per each week decrease in gestational age. Those born extremely preterm (23-27 completed weeks) had a 51% (95% CI, 31%-83%) lower risk for criminal offending than their full-term born counterparts, and those born very preterm (range, 28-31 weeks) had a 28% (95% CI, 7%-53%) higher hazard for payment defaults than those born at full term. Gestational age was not associated with substance abuse. CONCLUSIONS: The lower risk-taking that characterizes people born preterm seems to generalize to sexual and to some extent criminal behavior. Those born very preterm are, however, more likely to experience payment defaults.


Assuntos
Gravidez na Adolescência , Nascimento Prematuro , Transtornos Relacionados ao Uso de Substâncias , Recém-Nascido , Criança , Gravidez , Feminino , Humanos , Adulto Jovem , Adolescente , Adulto , Estudos de Coortes , Idade Gestacional , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Assunção de Riscos , Nascimento Prematuro/epidemiologia
16.
J Child Psychol Psychiatry ; 64(2): 299-310, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36440655

RESUMO

BACKGROUND: Causal explanations for the association of young motherhood with increased risk for child attention-deficit hyperactivity disorder (ADHD) remain unclear. METHODS: The ABCD Study recruited 11,878 youth from 22 sites across the United States between June 1, 2016 and October 15, 2018. This cross-sectional analysis of 8,514 children aged 8-11 years excluded 2,260 twins/triplets, 265 adopted children, and 839 younger siblings. We examined associations of maternal age with ADHD clinical range diagnoses based on the Child Behavior Checklist and NIH Toolbox Flanker Attention Scores using mixed logistic and linear regression models, respectively. We conducted confounding and causal mediation analyses using genotype array, demographic, socioeconomic, and prenatal environment data to investigate which genetic and environmental variables may explain the association between young maternal age and child ADHD. RESULTS: In crude models, each 10-year increase in maternal age was associated with 32% decreased odds of ADHD clinical range diagnosis (OR = 0.68; 95% CI [0.59, 0.78]) and 1.09-points increased NIH Flanker Attention Scores (ß = 1.09; 95% CI [0.76, 1.41]), indicating better child visual selective attention. However, adjustment for confounders weakened these associations. The strongest confounders were family income, caregiver education, and ADHD polygenic risk score for ADHD clinical range diagnoses, and family income, caregiver education, and race/ethnicity for NIH Flanker Attention Scores. Breastfeeding duration, prenatal alcohol exposure, and prenatal tobacco exposure were responsible for up to 18%, 6%, and 4% mediation, respectively. CONCLUSIONS: Socioeconomic disadvantages were likely the primary explanation for the association of young maternal age with child ADHD, although genetics and modifiable environmental factors also played a role. Public policies aimed at reducing the burden of ADHD associated with young motherhood should target socioeconomic inequalities and support young pregnant women by advocating for reduced prenatal tobacco exposure and healthy breastfeeding practices after childbirth.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Efeitos Tardios da Exposição Pré-Natal , Recém-Nascido , Adolescente , Criança , Humanos , Gravidez , Feminino , Idade Materna , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Estudos Transversais , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Parto
17.
Health Econ ; 32(12): 2679-2693, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37528619

RESUMO

Teenage fertility is a social problem because of its private and public costs in countries of different development levels. Reductions in adolescent birth rates do not necessarily follow drops in overall fertility due to the demographic transition model. This paper analyses the impact of a subdermal contraceptive program on repeat teenage motherhood. Using a regression discontinuity design, we find that the intervention reduced mothers' likelihood of having another child in the next 48 months by 10 percentage points. This reduction is not random, and we also identify small positive selection in subsequent births.


Assuntos
Gravidez na Adolescência , Adolescente , Feminino , Humanos , Gravidez , Anticoncepcionais , Fertilidade , Maternidades , Gravidez na Adolescência/prevenção & controle , Uruguai
18.
BMC Pregnancy Childbirth ; 23(1): 371, 2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37217921

RESUMO

BACKGROUND: Adolescent pregnancy is an important issue in terms of reproductive health. Adolescent mothers have to overcome two crises at the same time: motherhood and maturity. Childbirth experience and posttraumatic stress disorder may influence the mother's perception of her infant and postpartum care behaviors. METHODS: This cross-sectional study was conducted on 202 adolescent mothers referring to health centers in Tabriz and its suburbs between May and December, 2022. Data were collected by PTSD Symptom Scale, Childbirth Experience Questionnaire 2.0, and Barkin Index of Maternal Functioning. The association between childbirth experience, posttraumatic stress disorder and maternal functioning was assessed by multivariate analysis. RESULTS: After adjusting the effect of socio-demographic and obstetric characteristics, the score of maternal functioning among mothers without posttraumatic stress disorder was statistically significantly higher than mothers with posttraumatic stress disorder diagnosis [ß (95% CI) = 2.30 (0.39 to 4.20); p = 0.031]. The score of maternal functioning increased with the increase in the childbirth experience score [ß (95% CI) = 7.34 (3.87 to 10.81); p < 0.001]. The score of maternal functioning among mothers with wanted sex of baby was statistically significantly higher than unwanted sex of baby [ß (95% CI) = 2.70 (0.37 to 5.02); p = 0.023]. CONCLUSION: Healthcare professionals should pay special attention to improving maternal functioning among adolescent mothers. One of the important actions can be to create a positive experience of childbirth for avoiding of posttraumatic stress disorder following birth and counseling with mothers who stated sex of fetus is undesired.


Assuntos
Mães , Transtornos de Estresse Pós-Traumáticos , Adolescente , Feminino , Humanos , Lactente , Gravidez , Mães Adolescentes , Estudos Transversais , Parto Obstétrico/psicologia , Mães/psicologia , Parto/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
19.
BMC Pregnancy Childbirth ; 23(1): 861, 2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-38097996

RESUMO

BACKGROUND: An estimated 21 million adolescent girls become pregnant with nearly half of these pregnancies being unintended, and more than half end in unsafe abortion in low and middle-income countries every year. Teenage pregnancy causes serious health, social, and economic consequences around the globe. Despite it is a common problem in the whole community it is more devastating when this occurs in a refugee setup. This study assessed the magnitude of teenage pregnancy in the Kule refugee camp, in Ethiopia. METHODS: A community-based mixed cross-sectional study was done among 422 adolescent girls. Participants were selected using a systematic sampling technique. A structured, pre-tested, and interviewer-administered questionnaire was used to collect the data. Binary and multivariable logistic regression was used to identify associated factors. Adjusted odds ratio with 95% CI was used to show the strength and direction of the association. For the qualitative part, four focused group discussion sessions were done, and participants were selected purposely. Thematic analysis was used to analyze, and the finding was triangulated with quantitative findings. RESULT: A total of 146 adolescents (34.6%, 95% CI: (29.9, 38.9)) have experienced pregnancy at least one time. Age (≤ 16) [AOR = 0.48, 95% CI: (0.27, 0.85)], not attending school [AOR = 3.59, 95% CI: (1.2, 10.8)], having a mother with no history of teenage pregnancy [AOR = 0.45, 95% CI: (0.21, 0.98)], being unmarried [AOR = 0.21, 95% CI: (0.12, 0.36)], and having a sister/s with a history of teenage pregnancy [AOR = 2.22, 95% CI: (1.33, 3.7)] were significantly associated factors. CONCLUSION: More than one-third of adolescents experience teenage pregnancy. The magnitude of teenage pregnancy was high which may lead to serious health consequences for both the mother and their fetus. Addressing cultural barriers and strengthening adolescent reproductive health education to decrease intergenerational transmission of teenage pregnancy through community awareness and strengthening reproductive parent-adolescent Sexual and Reproductive Health communication are important measures to tackle the problem.


Assuntos
Comunicação em Saúde , Gravidez na Adolescência , Refugiados , Gravidez , Feminino , Adolescente , Humanos , Etiópia/epidemiologia , Campos de Refugiados , Estudos Transversais
20.
Demography ; 60(3): 707-729, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37226980

RESUMO

Teen mothers experience disadvantage across a wide range of outcomes. However, previous research is equivocal with respect to possible long-term mental health consequences of teen motherhood and has not adequately considered the possibility that effects on mental health may be heterogeneous. Drawing on data from the 1970 British Birth Cohort Study, this article applies a novel statistical machine-learning approach-Bayesian Additive Regression Trees-to estimate the effects of teen motherhood on mental health outcomes at ages 30, 34, and 42. We extend previous work by estimating not only sample-average effects but also individual-specific estimates. Our results show that sample-average mental health effects of teen motherhood are substantively small at all time points, apart from age 30 comparisons to women who first became mothers at age 25‒30. Moreover, we find that these effects are largely homogeneous for all women in the sample-indicating that there are no subgroups in the data who experience important detrimental mental health consequences. We conclude that there are likely no mental health benefits to policy and interventions that aim to prevent teen motherhood.


Assuntos
Saúde Mental , Mães , Gravidez na Adolescência , Adolescente , Adulto , Feminino , Humanos , Gravidez , Teorema de Bayes , Estudos de Coortes , Mães/psicologia , Gravidez na Adolescência/psicologia , Reino Unido/epidemiologia
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