Obstetrics and perinatal outcomes of Thai pregnant adolescents: a retrospective study.

BACKGROUND: Adolescent pregnancy is considered a high risk pregnancy. OBJECTIVES: The purpose of this study was to compare pregnancy outcomes in adolescent females aged 19 and younger with those of adult women aged 20-34 years. DESIGN: A retrospective case control study was designed to address the purpose of the study. PARTICIPANTS: Participants of this study consisted of 401 randomly selected adolescent females and 815 adult mothers who gave birth at a regional hospital in Bangkok from 2001 to 2003. METHODS: Two domains of pregnancy outcomes; maternal and infant outcomes were collected from participants' medical and prenatal records by trained observers. RESULTS: The study revealed that, compared to the adult mothers, teenage mothers were less likely to make the first prenatal visit in their first trimester (16% and 38.9%, p<.001), to have adequate prenatal care (83% and 91%, p<.01), and cesarean sections (odds ratio (OR) 2.05, confidence interval (CI) 1.44, 2.92). They had higher rates of anemia (OR 0.44, CI 0.26, 0.75), preterm deliveries (OR 1.21, CI 1.01, 1.75), and lower mean birth weight babies (2931 g and 3077 g, p<.001). CONCLUSION: This study demonstrates that, while teenage pregnancy outcomes have improved in recent years due to medical accessibility, pregnant adolescents continue to be complicated requiring clinical interventions from the health care providers.

Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain and anxiety disorders.

OBJECTIVE: To compare clinical symptoms, diagnoses, and physiological measures in children and adolescents with recurrent abdominal pain (RAP) (n = 14), to a group with anxiety disorders (ANX) (n = 14) and a physically and psychiatrically healthy control group (HC) (n = 14). METHOD: The cross-sectional study examined group differences in clinical symptoms of anxiety, somatic complaints, depression, and behavior problems. Physiological measures included heart rate, systolic and diastolic blood pressure, and salivary cortisol in response to the Trier Social Stress Test for Children (TSST-C). Subjects were between the ages of 8 and 16 years. RESULTS: RAP and ANX subjects had comparable scores on most psychological measures, and their scores were higher (n < .05) than those of the HC. The ANX and RAP groups exhibited physiological findings that had more shared similarities than either group with the HC group. Few statistically significant group differences were noted in physiological measures, yet the pattern of findings in blood pressure and cortisol supported the use of the TSST-C and the direction of the findings was consistent with expectations. CONCLUSIONS: Understanding more about comorbidity between RAP and anxiety could have important management implications, with observed congruities between the disorders suggesting treatments already demonstrated to be efficacious for pediatric anxiety and depression might be applied productively to RAP.

Translation and validation of the condom self-efficacy scale with Thai adolescents and young adults.

PURPOSE: To translate the 14-item Condom Self-Efficacy Scale (CSES) into Thai and to validate the Thai version of the Condom Self-efficacy Scale (CSES-T) among Thai adolescents and young adults. METHODS: The CSES was translated using a back-translation technique and validated with a cluster-based sample of 425 participants aged 18 to 22 years from eight randomly selected private vocational schools in Bangkok. Participants completed anonymous self-administered scales. Principal component analysis with varimax rotation was conducted to identify latent factors. RESULTS: Factor analysis indicated three factors: communication, correct use, and consistent use. Items loading on the original CSES also loaded on the same factors of the CSES-T except one item. The Cronbach's alpha coefficients were .85 for the total scale, .70 for consistent use, .79 for correct use, and .80 for communication. CONCLUSIONS: Based on psychometric properties, the CSES-T is a valid and reliable tool. It is culturally appropriate for Thai young adults. Thai researchers and health care providers can use the CSES-T to assess adolescents' and young adults' self-efficacy to use condoms as well as to further develop and evaluate interventions to increase condom use.

Predictors of condom use among adolescent Thai vocational students.

PURPOSE: To describe the prevalence of premarital sexual behavior and condom use, and to identify predictors of condom use using the expanded health belief model (EHBM) among vocational students in Bangkok, Thailand. METHODS: A cross-sectional correlational design was used with a cluster-based sample of 425 students aged 18 to 22 years from eight randomly selected private vocational schools in Bangkok. Anonymous self-report questionnaires were used to collect the data. Stepwise multiple regression was conducted to identify predictors of condom use. RESULTS: Overall, 49.9% of participants were sexually active, 64.8% of men and 32% of women. Of the sexually active participants, only 6.3% reported using condoms every time when having sex in the beginning of the relationship, and 10.2% during the last few times. Twenty-four percent of sexually active participants had unplanned pregnancies, and 7% had sexually transmitted diseases (STDs). The predictive model of condom use consisted of perceived benefits from using condoms; interactions between intention to use condoms and gender: knowledge of STDs, HIV, AIDS, pregnancy and peer norms; and alcohol use and age. Adjusting for modifying factors, the predictor set explained 27% of the variance in condom use. CONCLUSIONS: Most of this sample of sexually active Thai vocational students practiced unsafe sex, and many had unplanned pregnancies and STDs. The EHBM provided a modest predictive model of condom use.