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1.
Reprod Health ; 19(1): 10, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033103

RESUMEN

BACKGROUND: Adolescent childbearing increases the risk of adverse health and social consequences including school dropout (SDO). However, it remains unclear why some teenage mothers drop out of school and others do not, especially in sub-Saharan Africa settings. We aimed to investigate the background and behavioral characteristics of single mothers, associated with school dropout in a sample of 18,791 Cameroonian girls, who had their first child during adolescence. METHODS: We used data from a national registry of single mothers, collected during the years 2005-2008 and 2010-2011. Both bivariate analysis and logistic binary regression models were used to explore the relationship between adolescence motherhood and SDO controlling for a range of socio-economic, family, sexual and health seeking behavior characteristics. RESULTS: Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. The multivariable regression model showed that SDO was more common in those who were evicted from their parental home (aOR: 1.85; 95% CI: 1.69-2.04), those who declared having other single mothers in their family (aOR: 1.16; 95% CI 1.08-1.25) and in mothers who had their first child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout. CONCLUSIONS: Strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.


There is compelling, worldwide evidence that pregnancy and birth during teenage years are significant contributors to high school dropout rates, especially in developing countries. Research has also shown that education continuity of teenage mothers can lessen the long term negative social consequences of teenage pregnancies and childbearing. In this study, we investigated the factors associated with school dropout in a sample of Cameroonian teenage mothers.The information collected included socio-economic, family, sexual characteristics, and health-seeking behavior.Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. School dropout was more common in those who were evicted from their parental home, those who declared having other single mothers in their family and in mothers who had their 1st child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout.In conclusion, strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Camerún , Niño , Femenino , Humanos , Madres , Embarazo , Abandono Escolar
2.
Artículo en Inglés | PAHO-IRIS | ID: phr-55342

RESUMEN

[ABSTRACT]. Objective. To present and assess evidence from Latin America and the Caribbean (LAC) on public policies and targeted programs which may have influenced variations in adolescent pregnancy or its proximate determinants, and to identify knowledge gaps that require further research. Methods. A systematic review was performed based on the 2015 PRISMA protocol. Five databases were searched for articles published between 2000 and 2019 that refer to at least one country in LAC. The outcomes of interest were adolescent pregnancy or its proximate determinants (sexual behavior, contraceptive use, and/or abortion). Only studies exploring correlations between the outcomes of interest and public policies or targeted programs were included in the analysis. Results. Thirty studies spanning 14 countries were selected for analysis. Twenty-three of these (77%) were not included in prior systematic reviews on adolescent pregnancy. Public policies related to conditional cash transfers and compulsory education have the strongest evidence of correlation with adolescent pregnancy prevention. Emerging research points to the potential positive impact of life-skills programs for adolescents. Evidence from public health policies and programs was limited. Conclusions. Further research which incorporates an intersectional analysis is needed to better understand which policies and programs could lead to steeper declines in adolescent pregnancy in the region. Evidence on effects of expanded family planning services and secondary school attainment upon adolescent pregnancy are particularly absent.


[RESUMEN]. Objetivo. Presentar y evaluar evidencia de América Latina y el Caribe sobre las políticas públicas y los programas específicos que pueden haber influido en las variaciones en el embarazo en adolescentes o los factores determinantes relacionados, e identificar lagunas en el conocimiento que requieren más investigación. Métodos. Se realizó una revisión sistemática de acuerdo con el protocolo PRISMA del 2015. Se llevaron a cabo búsquedas en cinco bases de datos en busca de artículos publicados entre el 2000 y el 2019 que se refirieran al menos a un país en América Latina y el Caribe. Los resultados de interés fueron embarazos en adolescentes o los factores determinantes relacionados (comportamiento sexual, uso de métodos anticonceptivos o aborto). Solo se incluyeron en el análisis estudios que exploraban las correlaciones entre los resultados de interés y las políticas públicas o programas específicos. Resultados. Se seleccionaron para el análisis 30 estudios que abarcaban catorce países. Veintitrés de estos (77%) no estaban incluidos en revisiones sistemáticas anteriores sobre el embarazo en adolescentes. Las políticas públicas relacionadas con las transferencias monetarias condicionadas y la educación obligatoria arrojan la evidencia más fuerte de su correlación con la prevención de embarazos en la adolescencia. La investigación emergente indica una posible repercusión positiva de los programas para el desarrollo de aptitudes para la vida cotidiana dirigidos a adolescentes. La evidencia de las políticas de salud pública y los programas era limitada. Conclusiones. Es necesario realizar investigaciones adicionales que incorporen un análisis interseccional para comprender mejor qué políticas y programas podrían conducir a un descenso más pronunciado del embarazo de adolescentes en la Región. La evidencia sobre los efectos de la ampliación de los servicios de planificación familiar y el nivel de estudios secundarios tras los embarazos en adolescentes es especialmente escasa.


[RESUMO]. Objetivo. Apresentar e avaliar evidências da América Latina e do Caribe (ALC) sobre políticas públicas e programas direcionados que podem ter influenciado as variações na gravidez na adolescência ou em seus determinantes imediatos e identificar lacunas de conhecimento que requerem mais pesquisas. Métodos. Foi realizada uma revisão sistemática com base no protocolo PRISMA de 2015. Buscas foram feitas em cinco bases de dados de artigos publicados entre 2000 e 2019 que se referem a pelo menos um país da ALC. Os resultados de interesse foram a gravidez na adolescência ou seus determinantes imediatos (comportamento sexual, uso de métodos anticoncepcionais e/ou aborto). Somente os estudos que analisavam as correlações entre os resultados de interesse e políticas públicas ou programas direcionados foram incluídos nesta análise. Resultados. Trinta estudos englobando 14 países foram selecionados para a análise. Vinte e três deles (77%) não foram incluídos em revisões sistemáticas prévias sobre gravidez na adolescência. As políticas públicas relacionadas a transferências monetárias condicionais e à educação obrigatória têm as evidências mais sólidas de correlação com a prevenção de gravidez na adolescência. Pesquisas recentes apontam para o potencial impacto positivo de programas de habilidades para a vida para adolescentes. As evidências de políticas e programas de saúde pública foram limitadas. Conclusões. São necessárias mais pesquisas que incorporem uma análise cruzada para entender melhor quais políticas e programas levariam a uma maior diminuição da gravidez na adolescência na região. Particularmente, faltam evidências sobre os efeitos dos serviços ampliados de planejamento familiar e da conclusão do ensino médio na gravidez na adolescência.


Asunto(s)
Embarazo en Adolescencia , Política Pública , Salud Sexual y Reproductiva , Política Informada por la Evidencia , Américas , Embarazo en Adolescencia , Política Pública , Salud Sexual y Reproductiva , Política Informada por la Evidencia , Américas , Embarazo en Adolescencia , Salud Sexual y Reproductiva , Política Informada por la Evidencia , Américas
3.
BMC Pregnancy Childbirth ; 21(1): 834, 2021 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-34906105

RESUMEN

BACKGROUND: Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. METHODS: Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. RESULTS: Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. CONCLUSION: Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.


Asunto(s)
Parto Obstétrico/estadística & datos numéricos , Edad Materna , Parto , Embarazo en Adolescencia/etnología , Embarazo en Adolescencia/estadística & datos numéricos , Adolescente , África del Sur del Sahara , Demografía , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Femenino , Humanos , Embarazo , Adulto Joven
4.
Pan Afr Med J ; 40: 162, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34970404

RESUMEN

Introduction: a repeated pregnancy represents a failure of health and social systems to educate and provide the necessary services and skills to ensure adolescent girls do not experience any further unwanted pregnancies during this young age. We aimed to determine trends and factors associated with repeated adolescent pregnancies in Tanzania 2004-2016. Methods: an analytical cross-sectional study was conducted using secondary data from Tanzania demographic and health surveys of the years 2004-2005, 2010 and 2015-2016 among adolescent mothers aged 15 to 19 years. Data analysis was performed using STATA version 15 and considered the complex survey design. The Poisson regression model was used to estimate prevalence ratios (PR) and 95% confidence intervals for factors associated with repeated adolescent pregnancy. Results: the proportion of repeated adolescent pregnancies increased from 15.8% in 2004/2005 to 18.6% in 2010, then to 18.8% in 2015/2016. Adolescents who delivered their first pregnancy at home (APR: 1.36, 95% CI: 1.03, 1.78) and who started sexual activity before 15 years of age (APR: 1.80, 95% CI: 1.40, 2.31) were likely repeated adolescent pregnancy. In contrast, adolescents who used contraception (APR: 0.52, 95% CI: 0.34, 0.81) had a lower prevalence of repeated adolescent pregnancies. Conclusion: the prevalence of repeated adolescent pregnancies has increased and remains unacceptably high. Adolescents who had low education delivered their first pregnancy at home and were non-contraceptive users need to be targeted in policies and programs for the prevention of repeated adolescent pregnancies.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Conducta Anticonceptiva , Estudios Transversales , Demografía , Femenino , Encuestas Epidemiológicas , Humanos , Embarazo , Tanzanía/epidemiología
5.
Pan Afr Med J ; 40: 34, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34795815

RESUMEN

Introduction: adolescent pregnancy in Ghana, like in most low and middle income countries, is an issue of immense public health importance. Pregnant adolescents are faced with the stronger dilemma of either terminating the unwanted pregnancy or keeping it. This discourse which is based on findings from empirical research in Accra Ghana aims at contributing to the usefulness of understanding the meaning and scope of autonomy when it comes to providing ethically grounded, and adolescent friendly, reproductive health care services to pregnant adolescents. The aim of this work was to document the meaning and determinants of autonomous decision making among pregnant adolescents in the James Town area of Accra, Ghana. Methods: thirty (30) semi-structured in depth interviews were conducted among adolescents who had been pregnant at least once, 23 in depth interviews among purposively selected stakeholders (parents, teachers, NGO staff working in reproductive health, community volunteers), and 8 focus group discussions among parents, teachers, adolescent students who had not been pregnant before, and adolescents who had at least one pregnancy in the past. Data were transcribed verbatim and analyzed thematically. Results: most adolescents reported that the final decision to continue a pregnancy to term or go in for an abortion was taken by them. The partner´s willingness to take responsibility of the pregnant adolescent and baby, as well as financial considerations, were main players in deciding upon the pregnancy outcomes. Cultural desirability for children and health care provider/father paternalism (power dynamics) in the decision-making process were central considerations in the decision-making process. Unaffordable and unfriendly safe abortion services pushed adolescents to either continue pregnancies to term against their will, or opt to visit unsafe abortion care providers. Conclusion: adolescents stand to make truly autonomous decisions if they are provided with the right information, at the right time, at the right place, by the right persons, and in the right way. Health system, economic, and cultural factors play significant roles in rendering pregnant adolescent autonomy meaningful when deciding upon their pregnancy outcomes. Continuing pregnancies to term against one´s will or being forced to go in for an abortion are ethically unjustified. Further research is required to examine the long-term consequences of forced pregnancy terminations or births.


Asunto(s)
Toma de Decisiones , Autonomía Personal , Embarazo en Adolescencia/psicología , Mujeres Embarazadas/psicología , Aborto Inducido/psicología , Adolescente , Femenino , Grupos Focales , Ghana , Humanos , Entrevistas como Asunto , Paternalismo , Embarazo , Embarazo no Deseado/psicología , Servicios de Salud Reproductiva/organización & administración
6.
Multimedia | Recursos Multimedia | ID: multimedia-9263
7.
8.
Reprod Health ; 18(1): 203, 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34641910

RESUMEN

BACKGROUND: Adolescent pregnancy carries a high risk of severe health issues for both the mother and the newborn. Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America. Most of the risk factors are met in indigenous communities, which is an underrepresented and poorly studied population. We aimed to assess the determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle. METHODS: Through a case-control study, female adolescents aged 13 to 19 years old from seven indigenous communities of the Peruvian central jungle were interviewed. Adolescents with (cases) and with no (controls) pregnancy history, such as current pregnancy, children and abortion, fulfilled our eligible criteria. Our instrument explored: sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. We performed a penalized maximum likelihood logistic regression analysis to obtain Odds Ratios (OR) and their 95% confidence intervals (95% CI). RESULTS: We enrolled 34 cases and 107 controls. Overall, 53.9% were 15 to 19 years old. We found a significant association of being 15-19 years old (OR = 6.88, 95% CI 2.38-19.86, p < 0.0001) and an elementary school level of instruction (OR = 5.59, 95% CI 1.95-16.06, p = 0.001) with the risk of adolescent pregnancy. A marginal statistical significance between having five to six siblings and adolescent pregnancy was also reported (OR = 2.70, 95% CI 0.85-8.61, p = 0.094). Furthermore, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy (OR = 0.17, 95% CI 0.06-0.47, p = 0.001). CONCLUSION: Our results suggest that public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health topics with adolescents.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Femenino , Humanos , Recién Nacido , Perú/epidemiología , Embarazo , Salud Reproductiva , Conducta Sexual , Adulto Joven
9.
BMC Public Health ; 21(1): 1875, 2021 10 18.
Artículo en Inglés | MEDLINE | ID: mdl-34663262

RESUMEN

BACKGROUND: Adolescent pregnancy in Uganda declined from 31% in 2000-01 to 25% in 2006 but thereafter stalled at 25% from 2006 to 2016. This paper investigates the factors associated with the recent stall in the rate of decline of adolescent pregnancy in Uganda. METHODS: We used logistic regression models for 4 years (2000-01, 2006, 2011 and 2016) of data from the Uganda Demographic Health Survey to explore proximate and distal factors of adolescent pregnancy in Uganda. We carried out Blinder-Oaxaca decomposition models to explore the contributions of different factors in explaining the observed decline in adolescent pregnancy between 2001 and 2006, and the subsequent stall between 2006 and 2016. RESULTS: We found that marriage among women aged 15-19 years, and early sexual debut, were strongly associated with adolescent pregnancy. These declined substantially between 2000 and 01 and 2006, leading to a decline in adolescent pregnancy. Their decline was in turn associated with rising levels of female education and household wealth. After 2006, education levels and household wealth gains stalled, with associated stalls in the decline of marriage among women aged 15-19 years and sexual debut, and a stall in the decline of adolescent pregnancy. CONCLUSIONS: The stall in the decline of adolescent pregnancies in Uganda was linked to a stall in the reduction of adolescent marriage, which in turn was associated with limited progress in female educational attainment between 2006 and 2016. We emphasize the need for a renewed focus on girl's education and poverty reduction to reduce adolescent pregnancy in Uganda and subsequently improve health outcomes for adolescent girls.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Femenino , Humanos , Matrimonio , Pobreza , Embarazo , Conducta Sexual , Factores Socioeconómicos , Uganda/epidemiología
10.
BMC Public Health ; 21(1): 1850, 2021 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-34645405

RESUMEN

BACKGROUND: As reported by the World Health Organization, adolescent pregnancy is a major public health concern given its impact on the life of mothers and their family members. In this study we investigated possible cause-effect relations between teenage pregnancy and school dropout, and other attributes that gravitate around them, using the Bayesian network approach. METHODS: We used a database prepared by the Adolescent House Project and invited experts in the areas of Health, Education and Social Assistance to answer a survey containing questions aimed at detecting possible causal relationships. To perform the statistical analysis and the numerical simulations we employed the language and formalism of Bayesian networks. RESULTS: The analysis indicated a strong cause-effect relation between teenage pregnancy and school dropout, bolstered by economic vulnerability. We were able to identify the profile of the female teenager who drops out from school: white girls older than 15 years who got pregnant at least once, are not working to generate an income, and who belong to the group where the family income is less than or equal to US$780 per month. Also we detected the "maternal impact factor", i.e., the effect caused by whether or not the mothers of the teenagers have experienced teenage pregnancy. CONCLUSION: There are many factors that lead teenagers to drop out of school; we confirmed not only the commonsense notion that pregnancy of the teenager is a major factor but found that a history of teenage pregnancy on the part of the mother is a major factor. Moreover, Bayesian networks emerged as an interesting mathematical framework to perform the statistical analysis.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Teorema de Bayes , Brasil/epidemiología , Femenino , Humanos , Madres , Embarazo , Abandono Escolar
11.
Int J Equity Health ; 20(1): 232, 2021 10 20.
Artículo en Inglés | MEDLINE | ID: mdl-34670575

RESUMEN

BACKGROUND: Adolescent pregnancy in rural areas is a persistent health problem that has still not properly been understood. Studies with qualitative perspectives that address this phenomenon as a complex social process, which involves the recognition of the voices of the actors involved and the analysis of the specific context in which it takes place, are limited. OBJECTIVE: This research explored the perceptions of young people and other social actors (municipalities of Palmira and El Cerrito in Colombia) of the social forces and dimensions of the social determination of adolescent pregnancy in the Amaime river basin. These geographic areas have been scenes of armed violence with various groups in combat within the context of a long-standing political conflict in Colombia. After the 2016 Havana agreements were signed, peacebuilding has been underway in its territories. METHODS: A qualitative study that implemented focus groups and semi-structured interviews was conducted. The theoretical approach of social determination of health proposed by Breilh was used to study the social process entailed in adolescent pregnancy. Perceptions about social conditions, specific ways of life, and lifestyles were addressed. Galtung and Fischer's theoretical approach on violence and peacebuilding was also incorporated to enrich the understanding of the Colombian context. The analysis was conducted with approaches from phenomenology. RESULTS: Living conditions with strong social stigma and demand for social, political, and cultural opportunities were found. Regarding ways of life, little communication and information about sex education was perceived. As for lifestyles, there are youthful behaviors infused by sociocultural traditions that affect life projects and sexual behavior. Gender relations are precarious, and there are various types of violence that limit effective peacebuilding. CONCLUSIONS: This study contributes to a priority issue in sexual and reproductive health, with an approach that generates analytical elements to comprehensively expand the social and health interventions required.


Asunto(s)
Embarazo en Adolescencia , Salud Sexual , Adolescente , Conflictos Armados , Colombia , Femenino , Humanos , Percepción , Embarazo , Investigación Cualitativa
12.
Artículo en Inglés | MEDLINE | ID: mdl-34682377

RESUMEN

Several studies have identified explicative factors for adolescents' sexual risk behaviors and related outcomes such as unintended pregnancy; however, less is known about the mechanisms through which such factors act. Our study explored the role of female education and partner age difference as explicative mechanisms of the association between age at first sexual intercourse (AFSI) and unintended pregnancy while controlling for the role of other contextual factors (i.e., socioeconomic status, ethnicity, religious beliefs, and place of residence) and sexual-related mechanisms (i.e., number of sexual partners) that are known to be associated with adolescent pregnancy. The sample consisted of 613 sexually experienced female adolescents who did not intend to become pregnant: 349 were pregnant for the first time, and 264 had never been pregnant. Mediation and moderation analyses were performed. An earlier AFSI was associated with unintended pregnancy 1-6 years after first sexual intercourse by increasing the adolescents' likelihood of having less education and being involved with partners older than themselves. There was no significant direct effect of AFSI on pregnancy occurrence after controlling for the mediators. Our findings bring to light nonsexual mechanisms that must be considered in public health interventions aimed at preventing unintended pregnancies among adolescents who engaged in sexual intercourse at early ages. Specific implications are discussed.


Asunto(s)
Embarazo en Adolescencia , Embarazo no Planeado , Adolescente , Coito , Femenino , Humanos , Embarazo , Embarazo en Adolescencia/prevención & control , Asunción de Riesgos , Conducta Sexual
13.
Rev Assoc Med Bras (1992) ; 67(5): 759-765, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34550269

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the frequency of teenage pregnancy in all Brazilian regions and states in the period of 2000-2019 among two age groups, namely, 10-14 and 15-19 years old, and correlate it with the human development index. METHODS: A cross-sectional study was performed by using the data from the Live Birth Info System from the National Health System's database. RESULTS: The percentage of live births from teenage mothers (age 10-19 years) in Brazil decreased by 37.2% (i.e., 23.4 in 2000 to 14.7% in 2019) in all regions. Amazonas and Maranhão were the only states to show increased fertility rates for teens in the age group of 10-14 years. The fertility index decreased from 80.9-48% in all states among mothers aged 15-19 years. Only the Southeast and South regions showed levels below the Brazilian average (i.e., 38.2 and 39%, respectively). The proportion of live birth showed an inversely proportional trend to the human development index score. CONCLUSIONS: Brazil shows a decline in the percentage of live birth among adolescent mothers and the fertility rate. Live birth is inversely proportional to the human development index score. However, the teenage pregnancy numbers are still high, with great regional inequality in the country.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Adulto , Tasa de Natalidad , Brasil/epidemiología , Niño , Estudios Transversales , Femenino , Fertilidad , Humanos , Embarazo , Estados Unidos , Adulto Joven
14.
J Sch Health ; 91(11): 915-927, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34553379

RESUMEN

BACKGROUND: Latinx adolescents are at increased risk of teen pregnancy. This study evaluates the impact of Re:MIX, a comprehensive sexuality education program cofacilitated by professional health educators paired with young parent educators implemented with primarily Latinx youth in Texas. METHODS: A cluster randomized trial was conducted with students in grades 8-10 in 57 classrooms across three schools. Students completed baseline, post-test, and long-term follow-up surveys to determine the impact of the program on behavioral outcomes-sexual experience and unprotected sex-and on mediating factors including intentions, attitudes, knowledge, and self-efficacy related to sexual activity and contraception. RESULTS: Re:MIX was implemented with fidelity and educators were well-received. At post-test, compared to control students, Re:MIX students were more likely to intend to use hormonal or long-acting contraceptive methods if they had sex, had greater reproductive health knowledge, had more confidence in their ability to ask for and give consent, and were more likely to know where to obtain contraception. Most findings were sustained at the long-term follow-up, but there were no impacts on behaviors. CONCLUSIONS: The implementation and impact findings highlight the promising approach of pairing young parent educators with experienced health educators for teen pregnancy prevention among Latinx students.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Femenino , Humanos , Padres , Embarazo , Embarazo en Adolescencia/prevención & control , Servicios de Salud Escolar , Instituciones Académicas , Educación Sexual
15.
Nutrients ; 13(9)2021 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-34579063

RESUMEN

Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents' offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge-purge behaviors. The main events were GWG and offspring's birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg; adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (ß = 0.67, p = 0.039), compensatory (ß = 0.65, p = 0.044), and binge-purge behaviors (ß = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/complicaciones , Ganancia de Peso Gestacional , Complicaciones del Embarazo/psicología , Embarazo en Adolescencia/psicología , Adolescente , Peso al Nacer , Índice de Masa Corporal , Niño , Femenino , Humanos , Modelos Lineales , Embarazo , Estudios Prospectivos , Factores de Riesgo , Adulto Joven
16.
BMC Womens Health ; 21(1): 341, 2021 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-34563201

RESUMEN

BACKGROUND: The inclusion of protective factors ("assets") are increasingly supported in developing culturally grounded interventions for American Indian (AI) populations. This study sought to explore AI women's cultural assets, perspectives, and teachings to inform the development of a culturally grounded, intergenerational intervention to prevent substance abuse and teenage pregnancy among AI females. METHODS: Adult self-identified AI women (N = 201) who reside on the Navajo Nation completed a cross-sectional survey between May and October 2018. The 21-question survey explored health communication around the transition to womanhood, cultural assets, perceptions of mother-daughter reproductive health communication, and intervention health topics. Univariate descriptive analyses, chi squared, and fisher's exact tests were conducted. RESULTS: Respondents ranged in age from 18 to 82 years, with a mean age of 44 ± 15.5 years. Women self-identified as mothers (95; 48%), aunts (59; 30%), older sisters (55; 28%), grandmothers (37; 19%), and/or all of the aforementioned (50; 25%). 66% (N = 95) of women admired their mother/grandmother most during puberty; 29% (N = 58) of women were 10-11 years old when someone first spoke to them about menarche; and 86% (N=172) felt their culture was a source of strength. 70% (N = 139) would have liked to learn more about reproductive health when they were a teenager; 67% (N = 134) felt Diné mothers are able to provide reproductive health education; 51% (N = 101) reported having a rite of passage event, with younger women desiring an event significantly more than older women. Responses also indicate a disruption of cultural practices due to government assimilation policies, as well as the support of male relatives during puberty. CONCLUSIONS: Results informed intervention content and delivery, including target age group, expanded caregiver eligibility criteria, lesson delivery structure and format, and protective cultural teachings. Other implications include the development of a complementary fatherhood and/or family-based intervention to prevent Native girls' substance use and teen pregnancy.


Asunto(s)
Madres , Embarazo en Adolescencia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Comunicación , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Núcleo Familiar , Embarazo , Embarazo en Adolescencia/prevención & control , Adulto Joven
17.
Eur J Public Health ; 31(4): 790-796, 2021 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-34473276

RESUMEN

BACKGROUND: In the last 30 years, Estonia has undergone major socio-economic changes, including profound educational and healthcare reforms. The study aimed to analyse trends in teenage delivery and induced abortion rates among younger and older teens, including Estonians and non-Estonians, and to study trends in repeat teenage pregnancies in more detail. METHODS: The register-based study included data on 29 818 deliveries (1992-2019) and 25 865 (1996-2019) induced abortions among 15-19-year-old girls. Delivery and abortion rates per 1000 girls were calculated by age group, ethnicity and reproductive history. Poisson regression models were applied to estimate average annual percentage changes in delivery and abortion rates over the whole period and in two sub-periods with change points in the trend in 2007. RESULTS: The delivery rate decreased by 5.3% per year, from 49.9 in 1992 to 8.4 in 2019; the abortion rate decreased by 6.0% per year, from 42.4 in 1996 to 8.6 in 2019. A faster decline in delivery rates took place among Estonians than non-Estonians, but the opposite trend occurred in abortion rates. Delivery rates for first and repeat pregnancies decreased nearly at the same pace, while abortion rates for repeat pregnancies decreased faster than those for first pregnancies. CONCLUSIONS: A decreasing trend in teenage births is evident in parallel with society becoming wealthier. A remarkable decline in teenage abortions occurs when young people's rights to safe abortion, contraception, mandatory sexuality education and youth-friendly services are ensured. There always remains a small group of adolescents who repeatedly become pregnant.


Asunto(s)
Aborto Inducido , Embarazo en Adolescencia , Adolescente , Adulto , Anticoncepción , Estonia/epidemiología , Femenino , Humanos , Embarazo , Educación Sexual , Adulto Joven
18.
PLoS One ; 16(9): e0256479, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34473750

RESUMEN

BACKGROUND: The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch. OBJECTIVE: To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda. METHODS: A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care. RESULTS: Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition. CONCLUSION: Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.


Asunto(s)
Conducta Anticonceptiva/psicología , Anticonceptivos/uso terapéutico , Dispositivos Anticonceptivos Femeninos/estadística & datos numéricos , Embarazo en Adolescencia/psicología , Embarazo no Planeado/psicología , Consejo Sexual/métodos , Adolescente , Anticoncepción/métodos , Miedo/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Grupo Paritario , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Refugiados , Uganda
19.
BMC Pregnancy Childbirth ; 21(1): 616, 2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496791

RESUMEN

BACKGROUND: Adolescent motherhood (AM) remains a public health problem, especially in low and middle income countries, where approximately 95% of these births occur. Evidence from studies with population representativeness about events associated with AM is limited. We assessed the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes. METHODS: A population-based cross-sectional study on maternal and child health of women aged 10 to 49 years, living in the state of Ceará, in northeastern Brazil was carried out to assess the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes. The definition of adolescence used in the study was the one utilized by the WHO. In addition to the interview, data were double-checked according to the information in the government's pregnancy health booklet. Sample-adjusted logistic models to determine the association of socioeconomic factors and AM, as well as the association of AM with obstetric outcomes, with a causal approach to multivariate analyses, were used. RESULTS: The prevalence of adolescent motherhood was 18.6%. Poverty and household crowding were associated with greater chances of AM (p values of 0.038 and <  0.001, respectively), as well as not being in a stable relationship (OR 2.26 (95%CI: 1.67, 3.07), p <  0.001). AM showed a greater chance of not using community health services (p <  0.001), had fewer prenatal consultations (ß - 0.432 (95%CI: - 0.75, - 0.10)) and started prenatal care at a later date (ß 0.38 (95%CI: 0.21, 0.55), p <  0.001)). AM are also less likely to be tested for HIV and more likely to have urinary tract infections. CONCLUSIONS: Interventions aimed at socially-vulnerable adolescents are suggested. However, if pregnant, adolescents should receive proactive and differentiated prenatal care.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Composición Familiar , Femenino , Humanos , Persona de Mediana Edad , Pobreza , Embarazo , Atención Prenatal , Prevalencia , Factores Socioeconómicos , Adulto Joven
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