Adolescent parenting: outcomes and maternal perceptions.

OBJECTIVE: To describe selected outcomes and maternal perceptions of adolescent parenting. DESIGN: Qualitative and quantitative methods, interview, and two standardized instruments were combined in this follow-up study of adolescents who received perinatal services between 1985 and 1988. SETTING: Data were collected in the mothers' homes. PARTICIPANTS: Mothers who were randomly selected for an earlier chart outcome audit (N = 98) and could be located (n = 19). MAIN OUTCOME MEASURES: Subsequent pregnancies; school completion; children's development, indicated by the Developmental Profile II (DPII); parental attitudes, indicated by the Adult-Adolescent Parenting Inventory (AAPI); and maternal perceptions. RESULTS: Responses revealed irregular use of contraceptives as one reason for the initial pregnancy and for subsequent unplanned pregnancies. Sixteen mothers completed high school, and 18 intend to complete postsecondary programs. The DPII indicated age-appropriate development of the children. AAPI scores for 84% of the mothers indicated nonnurturing attitudes. Mothers described family support, motherhood, and their children. CONCLUSIONS: Research is needed with larger samples and to test interventions to promote regular use of contraception. Findings support the need for research-based programs to educate and promote the development of adolescent mothers and their children.

PIP: This study uses quantitative and qualitative methods for describing the nature of US adolescent mothers' pregnancies and parenting experiences and children's health and development. The sample was drawn from mothers who attended the Teen Obstetrical Perinatal and Parenting Service (TOPPS) clinic at the University of Arkansas for Medical Sciences during 1985-88 and were followed up later in their homes. Reference is made in the literature review to five child-rearing practices among adolescent mothers: insensitivity to infant cues, preference for physical punishment, a pattern of nonverbal interaction, lack of knowledge of child development, and an inadequate learning environment in the home. Descriptive statistics among the study population apply to pregnancy, education, developmental status of children, parenting attitudes, and maternal perceptions of family support, clinic advice, and the maternal role variables. Mothers reported on the status of child health and nutrition, positive and negative characteristics of their child, and discipline. In general, adolescent mothers were found to become pregnant largely due to misunderstandings about reproduction and birth control. Adolescent mothers continued to be at risk for subsequent unplanned pregnancies. Most adolescent mothers completed high school. Most children were developmentally on track for their age. Adolescent mothers were found to be at risk for non-nurturing behaviors, such as inappropriate expectations and reversal of parenting roles. Mothers could identify available support systems. Most would have postponed the pregnancy. Most had realistic perceptions of their children and provided basic health care. It is suggested that adolescent mothers should continue to receive developmentally appropriate services. Education about abstinence and contraception is needed as well as education aimed at promoting self-esteem, interpersonal skills, and age-appropriate development of adolescent parents and children.

Evaluation of a clinic for pregnant adolescents.

A random retrospective review of the Teen Obstetrical Parenting Perinatal Services (TOPPS) clinic medical records for 1985 to 1989 was completed on 120 adolescent mothers (30 charts for each year). The purpose of this study was to evaluate maternal and infant outcomes related to the goals of the TOPPS clinic located at University Hospital on the UAMS campus in Little Rock, Arkansas. The clinic was cofounded by Lee Lee Doyle, Ph.D., who is now professor of obstetrics/gynecology at UAMS, and Betty Rouse, R.N., M.N.Sc., who is a clinical associate professor at UAMS, College of Nursing. The outcomes measured were nutritional status as measured by maternal weight gain, infant birth weight, gestational age and Apgar scores. Referrals to appropriate agencies during pregnancy were also reviewed. Analysis of the data revealed that 31% of clients received documented nutritional counseling, 60.2% of the babies were healthy (88% term and 87% appropriate for gestational age), and documented referrals (i.e. WIC, AFDC, Medicaid, etc.) were made in 32% of the cases. Conclusions were that both mothers and infants had positive outcomes. Documentation of referrals needs to be improved or rationale stated for non-referral.

Impaired cerebral vascular blood flow in the premature infant.

Approximately 40% to 60% of infants born prior to 32 weeks' gestation experience an IVH. The impact of unregulated CBF precipitating an IVH has ramifications far beyond the walls of the neonatal intensive care unit. Infants who survive alterations in CBF may experience impaired neurologic development. Cerebral ischemia can lead to poor articulation, dysphasia, attention deficit, low intelligence quotient, dyspraxia, dyssynergia, spasticity, and short-term memory dysfunction. The neurologic and intellectual development of these premature infants must continue to be a crucial factor in planning their nursing care.