Effect of Digital applications on maternal as well as neonatal outcomes in Young pregnant girls: A Scope Review / Efecto de las aplicaciones digitales en los resultados maternos y neonatales de las jóvenes embarazadas: Una revisión de alcance / Efeito dos aplicativos digitais nos resultados maternos e neonatais de mulheres grávidas jovens: uma revisão de escopo

Objective. To understand the effect of digital applications on maternal and neonatal outcomes in young pregnant girls. Methods. A PubMed, CINAHL and Medline online database search was conducted, and related studies were included the databases were searched in order to carry out a more in detailed search of the available literature utilizing keywords like "digital technology"; "adolescent mothers"; and "infant, newborn", as well as Boolean operators to generate papers pertinent which were correlating with the objective of the study. Results.The findings revealed that the PPPs employed produced both positive and negative effects on mothers and newborns. Some were effective, especially in aspects related to improved mental health, while others did not necessarily support the adolescents in preparing for pregnancy and childbirth, but rather raised their anxiety levels. Similarly, the use of these apps decreased the use of emergency neonatal services by the adolescent mothers and the infants were lower in likelihood of exclusive breastfeeding. Participants appreciated the social media-based instruction, but this exposure did not translate into considerable change in routines and behaviors.

Objetivo. Conocer el efecto de las aplicaciones digitales en los resultados maternos y neonatales en jóvenes embarazadas. Métodos. Se realizó una estrategia de búsqueda en las bases de datos en línea PubMed, CINAHL y Medline utilizando los términos "digital technology"; "adolescent mothers"; y "infant, newborn", y operadores booleanos. Resultados. Los hallazgos revelaron que las APPs empleadas produjeron efectos tanto positivos como negativos sobre las madres y los neonatos. Algunas fueron efectivas, especialmente en los aspectos relacionados con la mejoría en la salud mental, mientras que otras nó ayudaron necesariamente a las adolescentes a prepararse para el embarazo y el parto, sino que más bien elevaron sus niveles de ansiedad. Del mismo modo, el uso de estas aplicaciones disminuyó la utilización de servicios neonatales de urgencia por las madres adolescentes y los neonatos tuvieron menor probabilidad de tener lactancia materna exclusiva. Las participantes apreciaron la instrucción basada en los medios sociales, pero esta exposición no se tradujo en un cambio considerable de rutinas y hábitos. Conclusión. Las soluciones digitales y basadas en la web tuvieron la capacidad de influir en los resultados de los embarazos de adolescentes, pero se requiere de otras investigaciones para evaluar hasta qué punto son útiles estos servicios de apoyo en este grupo poblacional.

Objetivo. Conhecer o efeito dos aplicativos digitais nos resultados maternos e neonatais em gestantes jovens. Métodos. Foi realizada uma estratégia de busca nas bases de dados online PubMed/Medline e CINAHL e utilizando os termos "tecnologia digital"; "mães adolescentes"; e "bebê, recém-nascido" e operadores booleanos. Resultados. Os resultados revelaram que os APPs utilizados produziram efeitos positivos e negativos nas mães e nos neonatos. Alguns foram eficazes, especialmente em termos de melhoria da saúde mental, enquanto outros não ajudaram necessariamente os adolescentes a prepararem-se para a gravidez e o parto, mas antes aumentaram os seus níveis de ansiedade. Da mesma forma, o uso desses aplicativos diminuiu a utilização de serviços neonatais de emergência por mães adolescentes e os neonatos tiveram menor probabilidade de serem amamentados exclusivamente. Os participantes apreciaram a instrução baseada nas redes sociais, mas esta exposição não se traduziu em mudanças consideráveis nas rotinas e hábitos. Conclusão. As soluções digitais e baseadas na web tiveram a capacidade de influenciar os resultados da gravidez na adolescência, mas são necessárias mais pesquisas para avaliar até que ponto estes serviços de apoio são úteis neste grupo populacional.

Educational intervention for the maintenance of exclusive breastfeeding in adolescent mothers: A feasibility study.

PURPOSE: The purpose of this study was to evaluate the feasibility of implementing the nursing intervention Breastfeeding Counseling (5244) in first-time adolescent mothers and its effect on the knowledge and maintenance of exclusive breastfeeding in the first 6 months of life. METHODS: Randomized, controlled feasibility study with 166 first-time mothers between 14 and 19 years of age, from 20 to 30 weeks of gestation, assigned to an experimental group (nursing intervention: breastfeeding counseling) or a control group (usual education plus nursing intervention not related to breastfeeding). The rate of abandonment of exclusive breastfeeding and the level of knowledge about breastfeeding were evaluated. FINDINGS: The inclusion was 91.7% (166/181), dropout during the intervention was 39.75% (n = 66), and loss in the follow-up was 8.43% (n = 14). Compliance with the intervention protocol was 100%. The pregnant women and family members were satisfied with the intervention and perceived the health benefits for the mothers and their children. Outcome measures in the experimental group did not reveal a significant effect on breastfeeding abandonment rates at 2, 4, and 6 months postpartum, but they did manage to improve and maintain the level of knowledge about breastfeeding. CONCLUSIONS: It was found that it is feasible to implement the nursing intervention: "Breastfeeding counseling" in prenatal classes, achieving an increase in the level of knowledge about breastfeeding in adolescent mothers, but without a reduction in the rate of abandonment of breastfeeding. Nursing professionals need to know and address barriers to exclusive breastfeeding in adolescents. IMPLICATIONS FOR NURSING PRACTICE: The nursing intervention "Breastfeeding counseling (5244)" and the outcome "Knowledge: Breastfeeding (1800)" supported the processes of education and knowledge assessment on breastfeeding in pregnant adolescents, which should be instituted in perinatal nursing care.

OBJETIVO: Evaluar la factibilidad en la implementación de la intervención de enfermería Asesoramiento en la lactancia (5244), en madres adolescentes primerizas y su efecto en el conocimiento y mantenimiento de la lactancia materna exclusiva en los primeros seis meses de vida. MÉTODOS: Estudio de factibilidad controlado aleatorizado con 166 madres primigestantes entre 14 y 19 años, de 20 a 30 semanas de gestación, asignadas a un grupo experimental (intervención de enfermería: asesoramiento en la lactancia) o a un grupo control (educación habitual más intervención de enfermería no relacionada con la lactancia materna). Se evaluó la tasa de abandono de la lactancia materna exclusiva y el nivel de conocimiento sobre la lactancia. RESULTADOS: La inclusión fue del 91.7% (166/181), la deserción durante la intervención del 39.75% (n = 66) y en el seguimiento del 8.43% (n = 14). El cumplimiento del protocolo de intervención fue del 100%. Las gestantes y familiares se encontraron satisfechos con la intervención y percibieron los beneficios en la salud de las madres y sus hijos. Las medidas de resultado en el grupo experimental no revelaron un efecto significativo en las tasas de abandono de lactancia materna a los 2,4 y 6 meses posparto, pero sí logró mejorar y mantener el nivel de conocimientos sobre lactancia materna. CONCLUSIONES: Se encontró que es factible implementar la intervención de enfermería: "Asesoramiento en la lactancia" en las clases prenatales, logrando incrementar el nivel de conocimientos sobre lactancia en las madres adolescentes, pero sin disminución de la tasa de abandono de la lactancia materna. Los profesionales de enfermería requieren conocer y abordar las barreras para la lactancia exclusiva en adolescentes. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: La intervención de enfermería "Asesoramiento en la lactancia (5244)" y el resultado "Conocimiento: lactancia materna (1800)" apoyaron los procesos de educación y evaluación del conocimiento sobre lactancia materna en gestantes adolescentes, por lo cual deberían ser instituidos en el cuidado de enfermería materno perinatal.

Life after teenage childbearing: A long-term view on teenage mothers' wellbeing.

BACKGROUND: This study aims to address the lack of information about the long-term wellbeing of (former) teenage mothers in the Netherlands. It provides data which policymakers can use to ensure that support programmesmeet the needs of teenage mothers. METHODS: Women who had given birth before the age of twenty were recruited online by Fiom, expertise centre on unintended pregnancy (December 2018-February 2019; N = 248). Survey data were obtained to assess how they perceived their wellbeing, employment, education, housing, and social support. Respondents were divided into three groups: 0-3 years after teenage childbearing (short term), 4-12 years (medium term), >12 years (long term). Results were analysed using univariate and bivariate descriptions in SPSS. RESULTS: Almost 80% of respondents reported that they were doing well and were satisfied with their lives, 63% had a job, and 17% were students. Short-term mothers worked fewer hours per week, received more benefits, and were less satisfied with their living conditions compared to medium- and long-term mothers. 36% Of the respondents smoked cigarettes. Most support was given by family (83%), mainly by female relatives. About 24% received formal support from social workers or institutions. CONCLUSIONS: Respondents, on average, reported they were doing well and were satisfied with their lives, in both the short and long term. These results suggest that as the years pass, teenage mothers overcome difficulties. Regarding income and housing, however, short-term mothers were in a less favourable position. Tailored interventions are recommended to address smoking among (former) teenage mothers.

Percepciones sobre la lactancia materna y características sociodemográficas de un grupo de madres adolescentes colombianas / Perceptions about breastfeeding and sociodemographic characteristics of a group of Colombian adolescent mothers

La baja adherencia a la lactancia materna en los primeros seis meses de vida del bebé es un gran problema en Colombia. Investigar las percepciones de las madres adolescentes es esencial para el incentivo a la lactancia materna exclusiva. Así, el objetivo de este estudio fue conocer las percepciones sobre la lactancia materna y describir las características sociodemográficas de madres adolescentes lactantes que participan en el Programa de Crecimiento y Desarrollo de la Corporación Hospital San Juan de Dios UniRemington en Colombia. Se trata de un estudio observacional cualitativo transversal realizado entre 2020 y 2021 mediante entrevistas semiestructuradas. Estas se realizaron según un guión de preguntas abiertas a madres adolescentes que amamantan a bebés menores de 2 años, utilizando grabadora de audio, diarios de campo y datos sociodemográficos obtenidos de registros hospitalarios. La muestra y resultados se basearon en la saturación de datos, según las narrativas organizados en temas a partir del análisis temático junto con repeticiones de observaciones y descripciones de datos sociodemográficos. De las diez jóvenes, el 70% tenía un bajo nivel de escolarización y su percepción de la lactancia estaba relacionada con su conocimiento de los beneficios de la lactancia para la nutrición del bebé y el vínculo madre-hijo, pero con muchas dificultades esta realidad se ha convertido en una utopía. Hubo una díada de alegría y dolor en las vivencias. Se concluyó que las percepciones estaban relacionadas con la falta de apoyo médico y familiar para madres adolescentes. Se sugieren más estudios en diferentes poblaciones maternas.

Low adherence to breastfeeding in the first six months of a baby's life is a major problem in Colombia. Investigating the perceptions of adolescent mothers is essential to encourage exclusive breastfeeding. Thus, the objective of this study was to learn about the perceptions of breastfeeding and to describe the sociodemographic characteristics of breastfeeding adolescent mothers who participated in the Growth and Development Program of the Hospital San Juan de Dios UniRemington Corporation in Colombia. This is a cross-sectional qualitative observational study conducted between 2020 and 2021 using semi-structured interviews. These were carried out according to a script of open-ended questions to teenage mothers who were breastfeeding babies under 2 years of age, using tape recorders and field diaries and sociodemographic data obtained from hospital registers. The sample and results were based on data saturation according to narratives organized into themes from the thematic analysis together with repetitions of observations and descriptions of sociodemographic data. Of the ten young women, 70% had a low level of schooling and their perception of breastfeeding was related to their knowledge of the benefits of breastfeeding for baby nutrition and mother-child bond, but with many difficulties this reality has become a utopia. There was a dyad of joy and pain in the experiences. It was concluded that the perceptions were related to the lack of medical and family support for adolescent mothers. Further studies in different maternal populations are suggested.

Poor nutritional status of fifteen-year-old or younger adolescent mothers enhances the risk of small-for-gestational-age newborns

Introduction: To analyze the factors (socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures) associated with the birth of small for gestational age newborns.Methods: A cross-sectional study was performed with 15 years old or younger postpartum adolescents divided into small-for-gestational-age newborn (SGA) and non-small-for-gestational age newborn groups (NSGA). Socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures (triceps skinfold (TS), and mid-arm circumference, (MAC)) were collected.Results: 8,153 women gave birth at the obstetric ward and 364 (4.46%) ≤ 15 years old adolescents were enrolled in the study. The proportion of SGA newborns was 34.61%. The SGA group attended fewer prenatal visits (p = 0.037), had a higher prevalence of nutritional status classified as "very low weight" (p < 0.001) and vaginal delivery (p = 0.023), compared to the NSGA group. The nutritional status and vaginal delivery remained significant even after adjustment for confounders. The prevalence risk for SGA birth was 30% higher in the group of mothers with nutritional status classified as "very low weight" (odds ratio 1.30, 95% confidence interval 1.13 to 1.50) (p < 0.001).Conclusions: 15.4% of adolescents ≤ 15 years of age had an arm circumference compatible with the "very low weight" condition, demonstrating the high prevalence of poor maternal nutritional status in this group. The birth of SGA among adolescents ≤ 15 years of age is independently associated with maternal nutritional status classified as "very low weight" by the mid-arm circumference measures (MAC).

Anemia en madres adolescentes y su relación con el controlprenatal / Anemia in adolescent mothers and its relationship with prenatalcare

Introducción: La OMS recomienda tener controles prenatales de forma oportuna para realizar acciones de promoción y prevención de salud en enfermedades como la anemia. Objetivo: Determinar la asociación entre el control prenatal y la anemia en las gestantes adolescentes en etapa tardía. Métodos: Estudio de tipo analítico, retrospectivo con diseño casos y controles realizado en el Instituto Nacional Materno Perinatal de Lima, Perú, entre el 1ro. de enero de 2015 y el 31 de diciembre de 2019. Se utilizó la base de datos institucional de adolescentes embarazadas de 15 a 19 años con un universo de 5408 distribuidos en 1490 casos y 3918 controles. Las variables clínicas estudiadas fueron primer control prenatal y número de controles prenatales. Los resultados se expresaron en números absolutos y porcentajes y para la relación entre variables se estimó el odds ratio ajustado con intervalo de confianza de 95 por ciento. Resultados: La población tuvo una mediana de 18 años, 25,2 por ciento con una edad gestacional ≤12 semanas en el primer control prenatal, 24,2 por ciento contaba con controles prenatales≥ 8. El 27,6 por ciento tenía anemia y entre ellas, 20,0 por ciento anemia leve, 7,4 % anemia moderada y 0,2 % anemia severa. El primer control prenatal después de 12 semanas de gestación (OR ajustado: 3,48, IC 95 por ciento: 2,87-4,22) constituyó un factor de riesgo de anemia. Conclusiones: El control prenatal después de 12 semanas de gestación incide de forma significativa en la aparición de la anemia en las gestantes adolescentes en etapa tardía(AU)

Introduction: The WHO recommends having prenatal controls in a timely manner to carry out health promotion and prevention actions in diseases such as anemia. Objective: To determine the association between prenatal control and anemia in pregnant adolescents in late stage. Methods: Analytical, retrospective study with case-control design conducted at the National Maternal Perinatal Institute of Lima, Peru, between the January 1st 2015 and December 31, 2019. The institutional database of pregnant adolescents aged 15 to 19 years was used with a universe sample of 5408 distributed in 1490 cases and 3918 controls. The clinical variables studied were first prenatal control and number of prenatal controls. The results were expressed in absolute numbers and percentages and for the relationship between variables the adjusted odds ratio was estimated with a 95% confidence interval. Results: The population had a median age of 18 years, 25.2 percent with a gestational age ≤12 weeks in the first prenatal control, percent had prenatal controls≥ 8. 27.6 percent had anemia and among them, 20.0 percent mild anemia, 7.4 percent moderate anemia and 0.2 percent severe anemia. The first antenatal check-up after 12 weeks' gestation (adjusted OR: 3.48, 95 percent CI: 2.87-4.22) was a risk factor for anemia. Conclusions: Prenatal control after 12 weeks of gestation significantly affects the appearance of anemia in pregnant adolescents in late stage(AU)

Which factors affect postpartum educational enrollment of adolescent mothers in South Africa? A latent class analysis.

Interrupted education of adolescent mothers remains a major concern, but limited evidence-based programming exists to support postpartum schooling of this group. This study aimed to better understand the factors that render some adolescent mothers vulnerable to school non-enrollment, and how to reduce these risks. Data from 1,046 adolescent and young mothers (10-24 years) from rural and urban communities in South Africa's Eastern Cape was obtained through a questionnaire containing validated and study-specific measures relating to sociodemographic characteristics, schooling, relationships, violence exposure, and health. Using latent class analysis, we explored emerging latent groups and their relationship to mothers' enrollment in school, college, or tertiary education. The analyses revealed three distinct groups of mothers: The 'most disadvantaged' subgroup (39%) experienced multiple risks, including food insecurity, living in informal housing, lacking positive relationships with their caregiver, and the highest distance to school; The 'disadvantaged' subgroup (44%) did not experience food insecurity whilst reporting better caregiver relationships and lower distance to school. However, this group still showed high probabilities of residing in informal housing and in communities that expose them to violence; A 'least disadvantaged' subgroup (17%) was largely unaffected by economic and community risks and experienced good caregiver relationships. Compared to the most disadvantaged mothers, the least disadvantaged mothers showed the highest probability of being enrolled in education (65% versus 45%). Adolescent motherhood can impede continued enrollment in education and individual-centered interventions alone might not be sufficient to mitigate the risks for non-enrollment. Services and provisions that address severe poverty and improve family relationships might provide an opportunity to positively influence schooling among adolescent mothers.

Interacciones vinculares mamá-bebé: impacto de las creencias maternas / Mother and baby interactions: Impact of maternal beliefs / Interações entre a mãe e o bebê: impacto das crenças maternas

Resumen (analítico) Las ideas parentales sobre el desarrollo infantil pueden guiarse por falsas creencias e influir en las interacciones tempranas. En este trabajo se estudian las ideas e interacciones en la relación mamá adolescente-bebé. La maternidad adolescente implica riesgos vinculares, llegando incluso hasta el maltrato. Se clasificó a las madres en modernas (activas) o tradicionales (pasivas), según la estimulación y acompañamiento del niño/a. Se evaluaron 145 díadas en los primeros dos años de vida. Los resultados indican peores interacciones en las madres tradicionales, siendo significativos en los contactos cara a cara, las interacciones táctiles y la función de sostén materna. El patrón de apego también se presenta más inseguro. Estos resultados permiten organizar programas de capacitación parental apuntando a la deconstrucción de ideas erróneas sobre el desarrollo y orientando interacciones saludables.

Abstract (analytical) Parental ideas about child development can be guided by false beliefs and influence early interactions. Adolescent mother and baby bonding ideas and interactions are related in this study. Adolescent motherhood implies additional risks, which even include abuse. Mothers are classified as modern -active- or traditional -passive-, based on the stimulation and accompaniment they provide to their child. 145 dyads are evaluated in the first two years of life. The results indicate worse interactions among traditional mothers, based on face-to-face contact, tactile interactions and the maternal support function. The attachment pattern is also more insecure. These results make it possible to organize parental training programs aimed at the deconstruction of erroneous ideas about development and guiding healthy interactions.

Resumo (analítico) As ideias dos pais sobre o desenvolvimento infantil podem ser guiadas por falsas crenças e influenciar as interações iniciais. As idéias e interações do vínculo mãe-bebê adolescente estão relacionados aqui. A maternidade na adolescência implica riscos relacionados, chegando mesmo ao abuso. As mães são classificadas em modernas -ativas- ou tradicionais -passivas-, de acordo com o estímulo e o acompanhamento do filho. 145 díades são avaliadas nos primeiros dois anos de vida. Os resultados indicam piores interações nas mães tradicionais, sendo significativos nos contatos face a face, nas interações táteis e na função de apoio materno. O padrão de apego também é mais inseguro. Esses resultados possibilitam a organização de programas de treinamento parental com o objetivo de desconstruir ideias errôneas sobre o desenvolvimento e orientar interações saudáveis.

Acceptability and impact of group interpersonal therapy (IPT-G) on Kenyan adolescent mothers living with human immunodeficiency virus (HIV): a qualitative analysis.

BACKGROUND: Task shifting is a well-tested implementation strategy within low- and middle-income countries that addresses the shortage of trained mental health personnel. Task shifting can increase access to care for patients with mental illnesses. In Kenya, community health workers (CHWs) are a combination of community health assistants and community health volunteers and have played a crucial role on this front. In our study, we seek to assess the acceptability and feasibility of Group Interpersonal Psychotherapy (IPT-G) delivered by CHWs among depressed postpartum adolescents (PPAs) living with human immunodeficiency virus (HIV). METHOD: The study used theoretical framework of behaviour change including: Capability, Opportunity and Motivation (COM-B model) to help understand behavioural changes due to IPT-G intervention delivered by the CHWs. 24 PPAs were administered IPT-G by trained CHWs from two health centres. A two-arm study design (IPT-G intervention and treatment as usual) with an intent to treat was used to assess the acceptability and feasibility of IPT-G. With purposeful sampling, participants who scored > 10 on the Edinburgh postnatal depression scale and who were 6-12 weeks postpartum were eligible for the study. Participants were equally distributed into two groups: one group for intervention and another as a wait-listed group. This was achieved by randomly allocating numerical numbers and separating those with odd numbers (intervention group) and even numbers (wait-listed group). Focus group discussions and in-depth interviews ascertained the experiences and perceptions of the PPAs and the CHWs during IP-G delivery process. In addition to weekly face-to-face continuous supportive supervision for the CHWs, the researchers also utilized phone calls, short messages services and WhatsApp instant messaging services. RESULTS: The CHWs found the intervention useful for their own knowledge and skill-set. With regards to participation, 21 out of the 24 adolescents attended all sessions. Most of the adolescents reported an improvement in their interpersonal relationships with reduced distress and lessening of HIV-related stigma. Primary healthcare workers embraced the intervention by accommodating the sessions in their routine clinic activities. CONCLUSION: Our study demonstrates the possible benefits of task shifting in addressing mental health problems within low-resource settings in Kenya, and IPT-G is demonstrated to be both acceptable and feasible by health workers and adolescents receiving care.

Perfil epidemiológico dos nascidos de mães adolescentes com gestações repetidas em um hospital de referência na cidade de Blumenau/SC, no período de janeiro de 2007 a dezembro de 2011 / Epidemiological profile of children of adolescent mothers with repeat pregnancies at a referral hospital in Blumenau between january 2007 and december 2011

Introdução: No mundo, por ano, cerca de 10% do total de partos são de adolescentes. No Brasil, 26,75% são filhos de mães adolescentes. A reincidência da gestação ocorre em 22,9%. A gestação na adolescência apresenta maiores complicações, resultando em maior morbimortalidade. Objetivos: Avaliar o perfil epidemiológico dos recém-nascidos de mães adolescentes com gestações recorrentes em hospital de referência para gestação de alto risco na cidade de Blumenau/SC, no período de janeiro de 2007 a dezembro de 2011. Métodos: Estudo descritivo, retrospectivo e documental. Resultados: Foram identificadas 1684 gestantes adolescentes, sendo a idade média ao parto de 16,9 (± 1,17). Destas, 105 engravidaram pela segunda vez e 6 pela terceira vez durante a adolescência. Foi possível a aplicação do questionário em 42 adolescentes com gestação recorrente. O peso do RN na primeira gestação apresentou-se menor que nas demais. Na análise do Apgar do primeiro e do quinto minuto, houve diferença significativa (p<0,001), sendo que o Apgar > 6 ocorreu 76% das vezes na primeira gestação, 88% na segunda e 93% na terceira. Discussão: Contrariamente à literatura, demonstraram-se desfechos favoráveis quanto ao peso do nascimento, Apgar no primeiro e quinto minuto de vida, além de demonstrar uma melhora desses índices ao longo das gravidezes subsequentes. Conclusão: Este estudo foi realizado em uma cidade com elevado IDH e boas condições de vida, além de contar com amplo acesso à saúde. Assim, os resultados obtidos devem ser interpretados com ressalvas e mais estudos são necessários sobre o tema.

Introduction: Each year, around 10% of all births worldwide are to adolescents. In Brazil, around 26.75% of the population was born to adolescent mothers. Pregnancy recurrence occurs in 22.9% of the cases. Adolescent pregnancies present greater complications, resulting in higher morbidity and mortality. Objectives: To assess the epidemiological profile of newborns to adolescent mothers with repeat pregnancies at a referral hospital for high-risk pregnancies in Blumenau between January 2007 and December 2011. Methods: This is a descriptive, retrospective, and documental study. Results: We identified 1,684 pregnant teenagers whose mean age at delivery was 16.9 (± 1.17) years. Of these, 105 were pregnant for the second time and 6 were pregnant for the third time in adolescence. We were able to apply the questionnaire to 42 adolescents with repeat pregnancies. The weight of newborns of first pregnancies was lower than that for other pregnancies. First- and fifth-minute Apgar scores presented significant differences (p<0.001), and Apgar scores > 6 were observed in 76% of first pregnancies, 88% of second pregnancies, and 93% of third pregnancies. Discussion: In contrast with the literature, favorable outcomes of birth weight and first- and fifth-minute Apgar scores were observed in our sample, and these indices were improved in subsequent pregnancies. Conclusion: This study was performed in a city with a high human development index and good life conditions, as well as broad access to health care. Therefore, the obtained results should be interpreted with caution and more studies on this subject are required.

Experiencias de madres adolescentes en un programa de maternidad segura de Cartagena, Colombia / Experiences of Adolescents Mothers from a Safe Maternity Program in Cartagena, Colombia

Introducción: La atención prenatal es esencial para proveer cuidado obstétrico que permita un parto seguro, buscando minimizar riesgos para madre e hijo. Objetivo: Analizar las experiencias de madres adolescentes en relación con la importancia de control prenatal en el Programa de Maternidad Segura del Hospital Canapote, Cartagena, haciendo énfasis en la primera etapa del embarazo. Métodos: Estudio cualitativo, fenomenológico en el Hospital Canapote en Cartagena, Colombia, durante el período comprendido entre diciembre del 2019 y diciembre del 2020, basado en grupos focales de 14 madres adolescentes. La entrevista contó con aspectos sociodemográficos y experiencias en los controles prenatales, de las que emergieron los conceptos que se organizaron en categorías y subcategorías de análisis. Resultados: Las adolescentes tenían como promedio entre 16 y 17 años, solteras, de familias nucleares, bachilleres, del régimen subsidiado. Las experiencias fueron favorables, sobre todo en relación a la atención del médico y el trato empático de las enfermeras, esto ha transfigurado sentimientos negativos a positivos. Conclusiones: La experiencia de las madres adolescentes se caracterizó por la percepción positiva, lo que aportó un sentimiento de temor hasta llegar a la alegría y tranquilidad al final de los controles durante el embarazo(AU)

Introduction: Prenatal care is essential to provide obstetric care that allows a safe delivery, seeking to minimize risks for the mother and her child. Objective: To analyze the experiences of adolescent mothers regarding the importance of prenatal care in the safe motherhood program of Canapote Hospital, Cartagena. Methods: A qualitative and phenomenological study was carried out at Canapote Hospital in Cartagena, Colombia, during the period from December 2019 to December 2020, based on focus groups of fourteen adolescent mothers. Sociodemographic aspects and experiences regarding prenatal checkups were included in the interview, from which concepts emerged that were organized into categories and subcategories of analysis. Results: The adolescents were 16-17 years old on average, single, from nuclear families, senior high school graduates, under subsidized regime. The experiences were favorable, especially in relation to the doctor's care and the nurses' kind treatment, which has turned negative feelings into positive ones. Conclusions: The experience of adolescent mothers was characterized by positive perception, which brought a feeling of fear until reaching joy and tranquility at the end of the checkups during pregnancy(AU)

Investigating the disjoint between education and health policy for infant feeding among teenage mothers in South Africa: a case for intersectoral work.

BACKGROUND: Many low-and-middle-income countries, including South Africa, have high rates of teenage pregnancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. At the same time, South Africa's education department, in the interest of learners, promotes adolescents' early return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option. METHODS: Recognising his this policy tension, we aimed to explore how policies are interpreted and implemented by the health and education sectors through interviews with key informants who produce, interpret and implement these policies. Using an interview guide developed for this study, we conducted in-depth interviews with 24 health policy makers, managers in both sectors, school principals and nursing staff who manage adolescent mothers (aged 16-19) and their babies. Data was analysed using thematic analysis. RESULTS: Informants from both sectors expressed discomfort at pregnant learners remaining in school late in pregnancy and were uncertain about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breastfeeding was not common. While health professionals highlighted the benefits of extended breastfeeding for infants and mothers, they recognised the potential conflict between the need for the mother to return to school and the recommendation for longer breastfeeding. Additionally, the need for ongoing support of young mothers and their families was highlighted. CONCLUSIONS: Our findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breastfeeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents' mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage to facilitate the interests of both the mother and infant: some exclusive infant feeding together with a supported return to school for the adolescent mother.

Exclusive breastfeeding abandonment in adolescent mothers: a cohort study within health primary services / Abandono do aleitamento materno exclusivo em mães adolescentes: um estudo de coorte em serviços primários de saúde / Abandono de la lactancia materna exclusiva en madres adolescentes: un estudio de cohorte en los servicios de atención primaria de salud

Abstract Objective: to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant's life. Method: this is a cohort study of 105 adolescent mothers followed at the child's 2-, 4- and 6-months of age. The epidemiological approach was adopted, supported by the positivism paradigm. Exposure variables were those directly related to breastfeeding and sociodemographic, family, maternal and child conditions. Data were collected by interview and analyzed by bivariate and multivariate statistics. The Hazard Ratio (HR) was calculated with a 95% confidence interval (95%CI). The tests were performed, admitting an error type I of 5%. The confidentiality of data was ensured. Results: the cumulative incidences of exclusive breastfeeding abandonment were 33.3%, 52.2% and 63.8%, at 2, 4 and 6 months, respectively. The variables that remain in the final multivariate model were maternal perception of milk quality (HR=11.6; 95%CI 3.6-37.5), pacifier use (HR=1.9; 95%CI 1.2-3.3), and time of first breastfeeding session (HR=1.4; 95%CI 0.5-12.9). Conclusion: the highest abandonment rate occurs before the fourth month. A perception of having poor-quality milk by the adolescent mother and pacifier use are factors that favor the abandonment of exclusive breastfeeding. Determining the factors associated with breastfeeding abandonment may allow their timely management, especially in more vulnerable populations.

Resumo Objetivo: analisar os fatores associados ao abandono do aleitamento materno exclusivo em mães adolescentes durante os primeiros seis meses de vida do bebê. Método: trata-se de um estudo de coorte com 105 mães adolescentes acompanhadas aos dois, quatro e seis meses de vida de seus filhos. Uma abordagem epidemiológica, apoiada por um paradigma positivista, foi adotada. As variáveis de exposição escolhidas foram aquelas diretamente relacionadas ao aleitamento materno e a condições sociodemográficas, familiares, maternas e infantis. Os dados usados foram coletados através de entrevistas e analisados por estatísticas bivariadas e multivariadas. A razão de risco (RR) foi calculada com um intervalo de confiança de 95% (IC95%). Os testes foram realizados, admitindo um erro tipo I de 5%. A confidencialidade dos dados foi garantida. Resultados: as incidências acumuladas de abandono do aleitamento materno exclusivo foram de 33,3%, 52,2% e 63,8%, aos dois, quatro e seis meses de vida dos bebês, respectivamente. As variáveis que permaneceram no modelo multivariado final foram percepção materna da qualidade de seu leite (HR=11,6; 95% IC 3,6-37,5), uso de chupeta (HR=1,9; 95% IC 1,2-3,3) e tempo de primeira sessão de aleitamento materno depois do nascimento (HR=1,4; 95% IC 0,5-12,9). Conclusão: a maior taxa de abandono ocorre antes do quarto mês de vida dos bebês. Mães adolescentes que julgaram seu leite como ruim e bebês que usam chupeta são fatores que favorecem o abandono do aleitamento materno exclusivo. A determinação dos fatores associados ao abandono do aleitamento materno pode permitir sua gestão oportuna, especialmente em populações mais vulneráveis.

Resumen Objetivo: analizar los factores relacionados con el abandono de la lactancia materna exclusiva en madres adolescentes durante los primeros seis meses de vida del bebé. Método: se trata de un estudio de cohorte de 105 madres adolescentes con un seguimiento a los dos, cuatro y seis meses de vida de sus hijos Se adoptó un enfoque epidemiológico, basado en un paradigma positivista. Las variables de exposición escogidas fueron aquellas directamente relacionadas con la lactancia materna y con las condiciones sociodemográficas, familiares, maternas e infantiles. Los datos utilizados fueron recolectados a través de entrevistas y analizados por estadística bivariada y multivariada. El riesgo relativo (RR) se calculó con un intervalo de confianza del 95% (IC 95%). Las pruebas se realizaron asumiendo un error tipo I del 5%. Se garantizó la confidencialidad de los datos. Resultados: las incidencias acumuladas de abandono de la lactancia materna exclusiva fueron del 33,3%, 52,2% y 63,8%, a los dos, cuatro y seis meses de vida de los bebés, respectivamente. Las variables que permanecieron en el modelo final multivariado fueron la percepción materna de la calidad de su leche (HR=11,6; IC 95% 3,6-37,5), uso de chupete (HR=1,9; IC 95% 1, 2-3,3) y momento de la primera lactancia (HR=1,4; IC 95% 0,5-12,9). Conclusión: la mayor tasa de abandono de LME se manifiesta antes del cuarto mes de vida de los bebés. Las madres adolescentes que perciben su leche inadecuada y los bebés que usan chupete son factores que favorecen el abandono de la lactancia materna exclusiva. Determinar las causas relacionadas con el abandono de la lactancia materna exclusiva pueden permitir su adecuada gestión, especialmente en poblaciones más vulnerables.

Vulnerabilidade ao nascer e condicionalidades: estimação com efeitos fixos entre 2012 e 2016 / Vulnerability at birth and conditionalities: estimation with fixed effects between 2012 and 2016 / Vulnerabilidad al nacer y condicionalidades: estimación con efectos fijos entre 2012 y 2016

Resumo O objetivo deste trabalho é analisar a relação da vulnerabilidade ao nascer, representada pela variável baixo peso ao nascer (BPN), com variáveis selecionadas, tais como PIB real per capita e cobertura do Programa Bolsa Família, além de indicadores municipais acerca de características maternas que envolvem idade, número de consultas pré-natais, raça, estado civil e anos de estudo. Estes indicadores foram obtidos a partir de microdados de todos os recém-nascidos provenientes de cada município do território brasileiro, registrados no Sistema de Informações sobre Nascidos Vivos (Sinasc). Os resultados sugerem que as principais causas do BPN para a amostra considerada são o fato de o município possuir um menor PIB real per capita, a maior cobertura do Programa Bolsa Família, a maior proporção de mães com menos de 19 anos e mais de 39 anos e a maior proporção de mães que realizaram até três consultas pré-natais. Conclui-se que políticas públicas que contribuam para o aumento da renda das famílias, estimulem o acompanhamento pré-natal e levem a prevenir a gravidez na adolescência podem contribuir para a redução da ocorrência de peso baixo ao nascer.

Abstract The objective of this paper is to analyze the relationship between vulnerability at birth, represented by the variable low birth weight, and selected variables, such as real GDP per capita and an indicator of the Bolsa Família Program coverage, in addition to municipal indicators about maternal characteristics that involve age, number of prenatal checkups, race, marital status and years of education. These indicators were obtained from microdata of all newborns from each municipality in the Brazilian territory registered in the Information System on Live Births (SINASC). The results found suggest that the main causes of LBW for the sample considered refer to the municipality having a lower real GDP per capita, higher Bolsa Família Program coverage, higher proportion of mothers under 19 and over 39 years old and greater proportion of mothers who had up to three prenatal checkups. It is concluded that public policies that help increase family income, encourage prenatal care and lead to preventing teenage pregnancy can contribute to reducing the incidence of low birth weight.

Resumen El objetivo de este trabajo es analizar la relación entre la vulnerabilidad al nacer, representada por la variable bajo peso al nacer, con variables seleccionadas, tales como producto interno bruto (PIB) real per cápita y un indicador de cobertura del programa Bolsa Familia, además de indicadores municipales acerca de características maternas que implican edad, número de consultas prenatales, etnia-raza, estado civil y años de estudio. Estos indicadores fueron obtenidos a partir de microdatos de todos los recién nacidos provenientes de cada municipio del territorio brasileño registrados en el Sistema de Informaciones sobre Nacidos Vivos (SINASC). Los resultados sugieren que las principales causas del bajo peso al nacer para la muestra considerada implican que el municipio posee un menor PIB real per cápita, mayor cobertura del programa Bolsa Familia, mayor proporción de madres menores de 19 años y mayores de 39 años y mayor proporción de madres que hicieron hasta tres consultas prenatales. Se concluye que políticas públicas que contribuyan al aumento de la renta de las familias, estimulen el acompañamiento prenatal y prevengan el embarazo en la adolescencia pueden contribuir con la reducción de la incidencia de peso bajo al nacer.

Atribuciones, creencias, expectativas de madres adolescentes y adultas colombianas y su interacción con variables sociodemográficas / Attributions, beliefs, expectations of Colombian adolescent and adult mothers and their interaction with socio-Demographic variables

Resumen Las atribuciones, creencias y expectativas de los padres influyen en su interacción con los hijos. Este estudio compara las atribuciones, creencias y expectativas de madres adolescentes y adultas acerca de sus hijos, de todos los niños y de sí mismas como madres, y analiza la interacción con el sexo del hijo, procedencia, estado civil, grado educativo y nivel socioeconómico de las madres. Se administró la guía de entrevista para padres y el Cuestionario de Factores Cognitivos de los padres a 200 madres biológicas, 100 adolescentes con una edad promedio de 19.7 años y 100 adultas con una edad promedio de 37.1, de niveles socioeconómicos bajo y medio, procedentes de diferentes regiones de Colombia. La prueba t evidenció atribuciones sesgadas y creencias distorsionadas acerca de los hijos y de todos los niños y creencias de poco control y baja autoeficacia en las madres adolescentes. Las madres adultas presentan expectativas irreales acerca de los hijos y de todos los niños, y atribuciones distorsionadas con respecto a sí mismas como madres. El análisis de varianza bifactorial confirma que el estado civil interactúa significativamente con las expectativas que tienen las madres acerca de todos los niños y con las atribuciones acerca de sí mismas como madres. El tamaño del efecto indicó que la edad y procedencia de las madres tienen un efecto moderado en las creencias con respecto a los hijos y en las atribuciones y creencias acerca de todos los niños. Intervenciones psicológicas que modifiquen las atribuciones, creencias y expectativas de madres adolescentes y adultas permitirán relaciones madres-hijos sanas.

Abstract Parents' attributions, beliefs, and expectations influence their interaction with their children. This study compares the attributions, beliefs and expectations of adolescent and adult mothers about their own children, all children and themselves as mothers. It also analyzes the interaction with the sex of the child, origin, marital status, educational and socioeconomic level of the mothers. The Questionnaire of Parents' Cognitive Factors was administered to 200 biological mothers, 100 adolescents with an average age of 19.7 years old and 100 adults with an average age of 37.1, all of them from low and medium socioeconomic levels and different regions of Colombia. The t Test showed biased attributions and distorted beliefs about own children and all children, as well as low-control and low-self-efficacy in adolescent mothers. Adult mothers present unrealistic expectations about their own children and all children and distorted attributions regarding themselves as mothers. The Bifactorial Analysis of Variance confirms that marital status interacts significantly with mothers' expectations about all children and with attributions about themselves as mothers. The effect size indicated that the age and provenance of mothers have a moderate effect on beliefs regarding their own children and on attributions and beliefs about all children. Psychological interventions that modify the attributions, beliefs and expectations of adolescent and adult mothers will allow healthy mother-child relationships.

Madres adolescentes de Valparaíso: Riesgo relacional, apego y síntomas depresivos en comparación a madres adultas / Teenage mothers of Valparaiso: relational risk, attachment and depressive symptoms compared to adult others

El embarazo adolescente es considerado un factor de riesgo tanto para la salud de la madre como para la de su futuro hijo por significar una doble crisis del ciclo vital, poniendo en riesgo el proceso de vinculación. Objetivos. El presente estudio busca analizar el riesgo relacional, tipo de apego y comparar la aparición de síntomas depresivos en madres adolescentes y adultas durante la gestación y en el período postparto. Métodos. Estudio prospectivo de dos cohortes de primigestas adolescentes y adultas, pertenecientes a centros de atención primaria de Valparaíso durante el año 2013. Resultados. Las madres adolescentes presentaron una mayor prevalencia de apego no seguro, mayores tasas de alto riesgo relacional materno-fetal y madre-bebé y mayor prevalencia de síntomas depresivos en comparación a madres adultas. Sin embargo, sólo la diferencia en la prevalencia de apego no seguro entre ambas cohortes fue estadísticamente significativa.

Teenage pregnancy is considered a risk factor for both the mother and her child's health and wellbeing. It can be hypothesized that going through a double psychological crisis might be harmful to the development of a secure relationship of attachment in the dyad. Objectives. This investigation seeks to analyze relational risks, attachment styles, and to compare the prevalence of depressive symptoms between teenage mothers and adult mothers during pregnancy and postpartum. Methods. An observational prospective cohort study was carried out, considering primiparous mothers, both teenage and adults, who attended primary public healthcare centers in Valparaíso during 2013. Results: In comparison to adult mothers, teenage mothers were more likely to exhibit insecure attachment styles, depressive symptoms in pregnancy and postpartum, and scored higher in the relational risk assessment scale. However, only the difference on the rate of insecure attachment styles between teenage and adult mothers was statistically significant.

Mães adolescentes com bebês em UTI neonatal: reflexões fenomenológicas sobre a vida e a morte / Adolescent mothers with babies in neonatal ICU: phenomenological reflections on life and death / Madres adolescentes con bebés en UCI neonatal: reflexiones fenomenológicas sobre la vida y la muerte

A maternidade na adolescência, tema relevante para a realidade dos serviços de saúde no Brasil, acarreta importante impacto na vida das jovens mães. Pesquisas apontam que filhos de mães adolescentes são um público em potencial para as Unidades de Terapia Intensiva Neonatal, cenário de fortes emoções, onde mães enfrentam o adoecimento e possibilidade de morte de seus filhos. A presente pesquisa objetiva compreender a experiência da maternidade para adolescentes mães de bebês internados em UTI neonatal, a partir da Fenomenologia Hermenêutica heideggeriana. As participantes da pesquisa foram cinco adolescentes com idades entre 15 e 19 anos. A construção dos dados partiu de uma questão disparadora: Como é para você ser adolescente e mãe de um bebê internado em Unidade de Terapia Intensiva Neonatal? A análise foi realizada com base na fenomenologia hermenêutica heideggeriana. As narrativas das adolescentes lançam luz sobre algumas facetas do fenômeno em estudo: o lugar das relações familiares; as rupturas e mudanças advindas da maternidade; o temor suscitado pelo ambiente da UTI neonatal; o tornar-se mãe a partir do cuidado ao filho; a presença da religião como recurso de enfrentamento do incontornável e da incerteza e o temor de lidar com a possibilidade da morte do filho.

Adolescent motherhood is a relevant subject for the reality of health services in Brazil, considering that this phenomenon has an important impact on adolescents' lives. Children of adolescent mothers may be a potential audience for the Neonatal Intensive Care Units, a setting of strong emotions, where mothers are facing the illness and death of their babies. This study aims to understand the experience of motherhood for adolescent mothers of infants hospitalized in Neonatal ICU, from the heideggerian Hermeneutic Phenomenology. The sample is composed of five adolescents aged 15 to 19. The construction of the data came from a triggering question: How is it for you to be a teenager and the mother of a baby hospitalized in the Neonatal Intensive Care Unit? The analysis was based on the heideggerian hermeneutic phenomenology. The narratives of adolescents shed light on some facets of the phenomenon under study: the place of family relationships; the ruptures and changes arising from motherhood; the fear raised by the neonatal ICU environment; becoming a mother by the child care; the presence of religion as a defense and the fear of dealing with the finitude of the baby.

La maternidad en la adolescencia constituye un tema relevante para la realidad de los servicios de salud en Brasil, considerando que dicho fenómeno lleva a un importante impacto en la vida de las adolescentes. Hijos de madres adolescentes pueden ser un público potencial para las Unidades de Cuidado Intensivo Neonatal, escenario de fuertes emociones, donde madres enfrentan la enfermedad y la posibilidad de muerte de sus bebés. La presente investigación tiene como objetivo comprender la experiencia de la maternidad para adolescentes madres de bebés internados en la UCI Neonatal, desde la Fenomenología Hermenéutica heideggeriana. La investigación es compuesta por cinco adolescentes con edades entre 15 y 19 años. La construcción de los datos partió de una cuestión disparadora: Cómo es para usted ser adolescente y madre de un bebé internado en Unidad de Terapia Intensiva Neonatal? Las narrativas de las adolescentes arrojan luz sobre algunas facetas del fenómeno en estudio: el lugar de las relaciones familiares; las roturas y cambios derivados de la maternidad; el temor suscitado por el ambiente de la UCI neonatal; el convertirse en madre a partir del cuidado al hijo; la presencia de la religión como recurso de enfrentamiento de lo ineludible y de la incertidumbre y temor para enfrentarse con la finitud del bebé.