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1.
Medicina (Kaunas) ; 57(8)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34441047

RESUMO

Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13-18 years old. Material and Methods: The survey was conducted between 2015 and 2017 and had four parts, collecting data about sociodemographic variables, the level of knowledge about sexuality, sexually transmitted diseases, and contraception. The respondents were mothers of female teenagers hospitalized in a tertiary pediatric clinic. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 25 (Inc., Chicago, IL, USA). Results: One hundred and thirty-five mothers (42.46 ± 6.81 years old) were included in the research. Most of them were from rural areas, had graduated secondary school, were Christian-orthodox, married, and with a stable job. More than half of the mothers (61.42%) declared that they personally knew adolescents that were already mothers. In great proportion, mothers proved good knowledge about sexual education, contraception, and STDs. They considered that the minimum age for becoming married, in general, is about M = 18.62 ± 2.09 years old but in the case of their daughters, mothers appreciated that the best age would be 23.56 ± 9.37. Mothers considered that they had good communication with their daughters (M = 4.28 ± 0.99) and two-thirds sustained that they had discussed with them about sexual activity, pregnancy, sexually transmitted diseases, and contraception. In case of unwanted pregnancy of their daughters, one-third of the mothers (38.50%) would advise their girls to continue the pregnancy and 7.40% mentioned the termination of pregnancy. Two-thirds of them (74.10%) agreed to school-based sexual education. In the order of preferred sources for sexual education, mothers mentioned parents (85.90%), teachers (33.30%), and family doctors (24.40%). Comparative results regarding their own sex life and that of their daughters are presented. Conclusions: School-based programs should meet parental beliefs about sexuality and sexual education. School, as a creator of values and models, should find the golden ratio to better shape the personal, familial, and social needs for the healthy sexual behavior of the new generation.


Assuntos
Gravidez na Adolescência , Adolescente , Adulto , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Mães , Gravidez , Gravidez na Adolescência/prevenção & controle , Romênia , Instituições Acadêmicas , Educação Sexual , Comportamento Sexual , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34444266

RESUMO

Adolescent pregnancy remains a health issue worldwide also in developed countries, since it has been associated with adverse maternal and neonatal outcomes. Some data suggest that very young adolescents have higher risk, likely due to immaturity. Therefore, we aimed to assess the influence of maternal age on complications during gestation and labor in pregnant women between 13 and 19 years of age. In particular, we evaluated the possible association between maternal age and obstetric, fetal and labor complications. This is a retrospective, observational and exploratory study conducted at Hospital Universitario La Paz (HULP, Madrid, Spain). The clinical history of 279 women who delivered between 2013 and 2018 was analyzed. Maternal age and the presence of maternal, fetal and labor complications, as well as risk of postpartum depression and breastfeeding intention, were recorded. General regression models were used to analyze the contribution of maternal age on each complication. The percentage of adolescent pregnancies at HULP between 2013 and 2018 was 0.9%. The risk of all the maternal complications analyzed decreased significantly with every year of age of the mother (hyperemesis, lower back pain, anemia, gestational diabetes mellitus, and threat of premature labor and premature rupture of membranes). Every year of maternal age decreased 0.8-fold [0.8; 0.9] the prevalence of fetal complications and also reduced the risk of C-section, postpartum hemorrhage and obstetrical hysterectomy. Furthermore, higher maternal age increased 1.1-fold [1.0; 1.2] the breastfeeding intention. In conclusion, young adolescents are at higher risk of complications during pregnancy and labor.


Assuntos
Complicações do Trabalho de Parto , Trabalho de Parto Prematuro , Complicações na Gravidez , Gravidez na Adolescência , Nascimento Prematuro , Adolescente , Adulto , Cesárea , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Adulto Jovem
3.
Nutrients ; 13(7)2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34371886

RESUMO

Adequate infant and young child feeding (IYCF) improve child survival and growth. Globally, about 18 million babies are born to mothers aged 18 years or less and have a higher likelihood of adverse birth outcomes in India due to insufficient knowledge of child growth. This paper examined factors associated with IYCF practices among adolescent Indian mothers. This cross-sectional study extracted data on 5148 children aged 0-23 months from the 2015-2016 India National Family Health Survey. Survey logistic regression was used to assess factors associated with IYCF among adolescent mothers. Prevalence of exclusive breastfeeding, early initiation of breastfeeding, timely introduction of complementary feeding, minimum dietary diversity, minimum meal frequency, and minimum acceptable diet rates were: 58.7%, 43.8%, 43.3%, 16.6%, 27.4% and 6.8%, respectively. Maternal education, mode of delivery, frequency of antenatal care (ANC) clinic visits, geographical region, child's age, and household wealth were the main factors associated with breastfeeding practices while maternal education, maternal marital status, child's age, frequency of ANC clinic visits, geographical region, and household wealth were factors associated with complementary feeding practices. IYCF practices among adolescent mothers are suboptimal except for breastfeeding. Health and nutritional support interventions should address the factors for these indicators among adolescent mothers in India.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar/psicologia , Mães/estatística & dados numéricos , Gravidez na Adolescência/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Assistência Ambulatorial/estatística & dados numéricos , Aleitamento Materno/psicologia , Estudos Transversais , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda , Índia , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Mães/psicologia , Gravidez , Cuidado Pré-Natal/psicologia
4.
Artigo em Inglês | PAHO-IRIS | ID: phr-54606

RESUMO

[RESUMEN]. Se presentan las principales características y logros de la Estrategia Nacional e Intersectorial para la Prevención del Embarazo en Adolescentes, implementada en Uruguay entre 2016 y 2020. Este proceso se desarrolló en un contexto en el que el embarazo no intencional en adolescentes continúa siendo un problema social relevante para Uruguay y la Región, por lo que se requieren políticas públicas integrales, sostenidas y basadas en evidencias científicas. En Uruguay, la fecundidad adolescente se ha mantenido en niveles elevados por más de una década. Además de la acción intersectorial del Gobierno y la sociedad civil, la estrategia aprobada contó con asesoramiento científico desde el ámbito académico y la cooperación técnica y financiera de organismos regionales e internacionales. Las acciones y medidas adoptadas se basan en una visión socio-ecológica, con sensibilidad cultural, enfoque transformador de género y perspectiva de derechos humanos. Entre las barreras más importantes están las normas sociales que valoran la maternidad como el principal proyecto de vida para las mujeres que viven en contextos de pobreza, los estereotipos de género —el embarazo como una responsabilidad exclusiva de las adolescentes, sin involucrar a los adolescentes varones—, el estigma del aborto, la insuficiente oferta de servicios de salud sexual y reproductiva, y la resistencia a visibilizar el embarazo en niñas menores de 15 años víctimas de la violencia estructural e intrafamiliar. Es necesario asegurar la continuidad de las políticas públicas, ajustadas a un enfoque de género y de derechos humanos, y que se tomen en cuenta los nuevos escenarios, como el que impone la pandemia por COVID-19.


[ABSTRACT]. This article presents the main characteristics and achievements of Uruguay’s National and Intersectoral Strategy for Prevention of Adolescent Pregnancy, implemented from 2016 to 2020. This strategy was implemented in a context in which unintentional adolescent pregnancy continues to be a major social problem for Uruguay and the Region, necessitating comprehensive, sustained, and evidence-based public policies. In Uruguay, adolescent fertility rates have remained high for over a decade. In addition to intersectoral action by government and civil society, the strategy received scientific assistance from the academic community, and technical and financial cooperation from regional and international organizations. Its actions and measures were adopted based on a socio-ecological vision, with cultural sensitivity, a gender-transformative approach, and a human rights perspective. Major barriers include social norms that value maternity as the main life project for women living in poverty, gender stereotypes (pregnancy as the exclusive responsibility of adolescent girls, without involving adolescent boys), the stigma of abortion, a lack of sexual and reproductive health services, and resistance to raising the visibility of pregnancy in girls under 15 years of age who are victims of structural and family violence. It is necessary to ensure the continuity of public policies––adjusted to a gender and human-rights approach––that take into account new scenarios such as the one imposed by the COVID-19 pandemic.


[RESUMO]. Este artigo apresenta os principais aspectos e os resultados da Estratégia Nacional e Intersetorial para Prevenção da Gravidez na Adolescência, implementada no Uruguai entre 2016 e 2020. A gravidez não intencional na adolescência persiste como uma questão social importante no Uruguai e na Região, exigindo políticas públicas com base em evidências científicas que sejam abrangentes e permanentes. A fecundidade na adolescência no Uruguai tem se mantido elevada há mais de uma década. Além da ação intersetorial do governo e da sociedade civil, a estratégia aprovada recebeu orientação científica de entidades acadêmicas, e cooperação técnica e financeira de organismos regionais e internacionais. As ações e as medidas da estratégia foram elaboradas a partir de uma visão socioecológica, com sensibilidade cultural e enfoque transformador de gênero e uma perspectiva de direitos humanos. Entre as barreiras mais importantes enfrentadas estão as normas sociais que valorizam a maternidade como principal projeto de vida para a mulher que vive em situação de pobreza, os estereótipos de gênero (a gravidez é vista como responsabilidade exclusiva da adolescente, sem envolver o parceiro adolescente), o estigma do aborto, a oferta insuficiente de serviços de saúde sexual e reprodutiva, e a resistência a dar visibilidade à gravidez de menores de 15 anos que são vítimas de violência estrutural e intrafamiliar. É necessário garantir a continuidade das políticas públicas que incorporem uma perspectiva de gênero e direitos humanos, e que sejam adaptadas aos novos cenários da pandemia de COVID-19.


Assuntos
Gravidez na Adolescência , Política Pública , Uruguai , Gravidez na Adolescência , Política Pública , Gravidez na Adolescência , Uruguai
5.
Rev. ecuat. pediatr ; 22(2): 1-7, 31 de agosto del 2021.
Artigo em Espanhol | LILACS | ID: biblio-1284505

RESUMO

Introducción: El embarazo en adolescentes es un grave problema social con consecuencias perjudiciales para la madre y el niño. Es importante comprender los factores relacionados con este problema para poder desarrollar políticas sociales adecuadas. El presente trabajo identifica los factores predictores del embarazo en adolescentes en el Ecuador. Métodos: Se analiza la Encuesta Nacional de Salud y Nutrición 2018 (ENSANUT) del Instituto Nacional de Estadísticas y Censos del Ecuador. La muestra fue probabilística, se selecciona-ron registros mujeres de 10 a 24 años. Se utilizó estadística descriptiva y una análisis de regresión logística múltiple: la variable embarazo adolescente es la variable dependiente, las variables predictoras: educación, uso de anticonceptivos, situación socioeconómica, área, estado civil, edad en la primera relación sexual. Se reporta Odds ratio. Resultados: Fueron 38 casos/7587 (0.5%) casos de embarazo en mujeres de 10 a 14 años, 714/6053 (11.8%) de mujeres embarazadas de 15 a 18 años, y 1978/8599 (23%) casos de mu-jeres de 19 a 24 años que tuvieron una historia de embarazo adolescente. El embarazo adolescente fue de 2730 casos/22239 (12.28%). La variable estado civil "casada o de Unión libre" OR=2.53 (IC95% 2.50-2.56) P<0.001, relaciones sexuales antes de los 14 años OR 5.72 (IC95% 5.63-5.81) P<0.001, necesidades básicas insatisfechas OR = 1.57 (IC95% 1.55-1.59), Escolaridad OR=0.87 (IC95% 0.866-0.87) P<0.001 y el uso de anticonceptivos OR=0.53 (IC95% 0.525-0.537) P<0.001. La ecuación de predicción tiene una exactitud de 76.1%. Conclusiones: Es posible predecir el embarazo adolescente por lo que se debe trabajar en estas variables.


Introduction: Pregnancy in adolescents is a serious social problem with harmful consequences for the mother and the child. It is important to understand the factors related to this problem in order to develop adequate social policies. The present work identifies the predictive factors of adolescent pregnancy in Ecuador. Methods: The 2018 National Health and Nutrition Survey (ENSANUT) of the National Institute of Sta-tistics and Censuses of Ecuador is analyzed. The sample was probabilistic, female records between 10 and 24 years old were selected. Descriptive statistics and a multiple logistic regression analysis were used: the adolescent pregnancy variable is the dependent variable, the predictor variables: educa-tion, contraceptive use, socioeconomic status, area, marital status, age at first sexual intercourse. Odds ratio is reported. Results: There were 38 cases / 7587 (0.5%) cases of pregnancy in women aged 10 to 14 years, 714/6053 (11.8%) in pregnant women aged 15 to 18 years, and 1978/8599 (23%) cases of women. Women ages 19 to 24 who had a history of teenage pregnancy. Adolescent pregnancy was 2730 cases / 22239 (12.28%). The variable marital status "married or in a free union" OR = 2.53 (95% CI 2.50-2.56) P<0.001, sexual relations before the age of 14 OR 5.72 (95% CI 5.63-5.81) P<0.001, unsatisfied basic needs OR = 1.57 (95% CI 1.55-1.59), Schooling OR = 0.87 (95% CI 0.866-0.87) P<0.001 and contracep-tive use OR = 0.53 (95% CI 0.525-0.537) P<0.001. The prediction equation has an accuracy of 76.1%. Conclusions: It is possible to predict adolescent pregnancy, so it is necessary to work on these variables.


Assuntos
Humanos , Gravidez , Pré-Escolar , Criança , Adolescente , Gravidez na Adolescência , Análise de Regressão , Anticoncepcionais , Saúde Sexual , Saúde Sexual e Reprodutiva
6.
Matern Child Nutr ; 17 Suppl 1: e13159, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34241958

RESUMO

Adolescent pregnancy can result in serious risks to the mother and her baby; yet, adolescents are among the least likely to access healthcare. Specific nutrition or antenatal care (ANC) guidelines for supporting pregnant adolescents are not available. To understand experiences and decision-making of pregnant adolescents in Bangladesh related to ANC and nutrition practices, peer interviewers were trained to conduct qualitative interviews in Dhaka and Rangpur with pregnant adolescents (n = 48), adolescent mothers (n = 48), adolescents' family members (n = 64) and health service providers (n = 32). Key themes explored included perception and support of adolescent pregnancy, experiences in seeking ANC, dietary practices, sources of information and roles of male and female family members. Spheres of influence on adolescent pregnancy were identified through analytical framework informed by the socio-ecological model. Respondents felt that adolescent pregnancy is risky and that adolescents require support and guidance through this experience. Families were highly influential on the care seeking, health and nutrition of pregnant adolescents, and mothers/mothers-in-law primarily took on the decision-making roles, with husbands actively participating. Adolescents valued family support but felt a loss of autonomy and agency upon becoming pregnant. Financial constraints were the greatest perceived barrier to appropriate nutrition and healthcare; yet, both were valued. There is sometimes discord of health and nutrition beliefs between families and health service providers; more research is needed to understand this further. It is essential to engage family members and adolescents in initiatives to increase access to quality ANC for pregnant adolescents, improve dietary practices and support the ability to delay pregnancy.


Assuntos
Gravidez na Adolescência , Gestantes , Adolescente , Bangladesh , Feminino , Humanos , Masculino , Mães , Gravidez , Gravidez na Adolescência/prevenção & controle , Cuidado Pré-Natal , Pesquisa Qualitativa
7.
BMC Public Health ; 21(1): 1360, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243752

RESUMO

BACKGROUND: The importance of educating female adolescents has been recognized as critical to the development of any country. However, in low income countries like Zambia they often drop out of school due to poverty, early pregnancy and early marriages. Some studies indicate that economic support such as Social Cash Transfers (SCTs) can mitigate the effects of poverty on female adolescents by improving their school participation and helping postpone pregnancy and marriage. This study aimed to explore the role of economic support in influencing education and sexual decision making among female adolescents in a randomised controlled trial in Zambia. METHODS: The study adopted a qualitative approach. It utilized purposive and convenient sampling. Data were collected from 6 schools using 18 in-depth interviews (IDIs) and 4 focus group discussions (FGDs) comprising 48 school-going female adolescents in grade 8 aged 14 to 17. All participants received economic support in form of SCTs and payment of school fees as part of the Research Initiative to Support the Empowerment of Girls (RISE), a Cluster Randomised Controlled Trial. Data were analyzed using thematic analysis. RESULTS: Findings suggested several benefits of the economic support for the female adolescents such as economic independence and empowerment; increased assertiveness and autonomy; reduced desire for sexual relationships with boys in exchange for cash and gifts; increased motivation for school; enhanced parental and community support for female adolescents' education and; reduced school dropouts. However, they also experienced jealousy from those who did not benefit from the economic support. CONCLUSION: Economic support played a significant role in influencing both educational and sexual decision making among female adolescents. TRIAL REGISTRATION: ISRCTN Registry: ISRCTN12727868 , (4 March 2016).


Assuntos
Gravidez na Adolescência , Adolescente , Tomada de Decisões , Escolaridade , Feminino , Humanos , Masculino , Gravidez , Comportamento Sexual , Zâmbia
8.
BMC Public Health ; 21(1): 1481, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34325686

RESUMO

BACKGROUND: Adolescent childbearing is associated with various health risks to the mother and child, and potentially with adverse socioeconomic outcomes. However, little is known about the role of adolescent childbearing in maternal health outcomes in adulthood. This study investigates the link between childbirth in adolescence and later-life risk of hypertension among women in India. METHODS: We obtained nationally representative data on demographic and health outcomes for 442,845 women aged 25 to 49 from the India National Family Health Survey (NFHS) 2015-16. We assessed the difference in hypertension prevalence between women who gave birth in adolescence (age 10 to 19) and those who did not, for the full sample and various sub-samples, using linear probability models with controls for individual characteristics, hypertension risk factors, and geographic fixed effects. RESULTS: Nearly 40% of the women in the sample gave birth in adolescence. The adjusted probability of being hypertensive in adulthood was 2.3 percentage points higher for this group compared to women who did not give childbirth in adolescence. This added probability was larger for women who gave birth earlier in adolescence (4.8 percentage points) and for women who gave birth more than once in adolescence (3.4 percentage points). CONCLUSIONS: Adolescent childbearing was strongly associated with a higher probability of adult female hypertension in India. This finding illustrates the intertemporal relationship between health risk factors during the life cycle, informing the importance of addressing adverse early life events (e.g. child marriage and adolescent childbirth) for hypertension outcomes among women in India.


Assuntos
Hipertensão , Gravidez na Adolescência , Adolescente , Adulto , Criança , Feminino , Humanos , Hipertensão/epidemiologia , Índia/epidemiologia , Casamento , Gravidez , Fatores de Risco , Adulto Jovem
9.
Fam Community Health ; 44(4): 266-281, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34145194

RESUMO

Native American youth endure a complex interplay of factors that portend greater risk-taking behaviors and contribute to marked health disparities experienced in adolescence. The Asdzáán Be'eená ("Female Pathways" in Navajo) program was developed as a primary prevention program to prevent substance use and teen pregnancy among Navajo girls. The Asdzáán Be'eená program consists of 11 lessons delivered to dyads of girls ages 8 to 11 years and their female caregivers. Feasibility, acceptability, and preliminary impact on risk and protective factors were assessed through a pre-/post study design. Data were collected from girls and their female caregivers at baseline, immediate, and 3 months postprogram completion. Forty-seven dyads enrolled in the study, and 36 completed the 3-month evaluation. At 3 months postprogram, girls reported significant increases in self-esteem, self-efficacy, parent-child relationship, social support, cultural, and sexual health knowledge. Caregivers reported increased family engagement in Navajo culture and parent-child communication and improved child functioning (fewer internalizing and externalizing behaviors). Findings suggest Asdzáán Be'eená has potential to break the cycle of substance use and teen pregnancy in Native communities by improving protective and reducing risk factors associated with these adverse health outcomes. Additional rigorous efficacy trials are necessary to establish program effectiveness.


Assuntos
Índios Norte-Americanos , Gravidez na Adolescência , Serviços Preventivos de Saúde , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Criança , Estudos de Viabilidade , Feminino , Humanos , Índios Norte-Americanos/educação , Relações Pais-Filho , Gravidez , Gravidez na Adolescência/prevenção & controle , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
10.
Eur J Pediatr ; 180(8): 2645-2653, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34137918

RESUMO

There is limited data on the trends of childhood viable pregnancy and the risk of stillbirth in the United States. Our study assessed the trends in childhood viable pregnancy and associated stillbirth rates over the previous three decades, as well as the risk of stillbirth in these highly vulnerable child mothers aged 10-14 compared with teen mothers aged 15-19. We conducted a population-based retrospective cohort study that used birth datasets, fetal death datasets, and the US population census data: 1982-2017. To assess the association between various sociodemographic and maternal comorbidities and stillbirth, we generated adjusted hazard ratios (AHR) from Cox proportional hazards regression models. From 1982 to 2017, viable pregnancy rates declined among children (from 0.3/1000 to 0.06/1000 population) and teens (from 40.5/1000 in 1982 to 18.1/1000). Overall, there were declines in the stillbirth rates in both teens (15-19 years old) and child mothers aged 10-14 years, but the rate remained consistently higher among child mothers vs. teen mothers (14 per 1000 vs. 8 per 1000 viable pregnancies). Compared to teen mothers, childhood pregnancy was modestly associated with an elevated risk for stillbirth (AHR = 1.09; 95% CI = 1.05-1.12). Other factors significantly associated with increased risk of stillbirth included maternal race, preterm birth, arterial hypertension, diabetes, and eclampsia (P<0.0001).Conclusion: Childhood pregnancy may be a risk factor for stillbirth. This is the first study to assess the trends in childhood viable pregnancy and the associated stillbirth rates in the United States. These findings further underscore the need for sustained efforts and policies to prevent pregnancies in the early years of reproductive development. What is Known: • Childhood pregnancy, defined as pregnancy among 10-14 year-old females, may be associated with a number of pregnancy complications and adverse pregnancy outcomes, including preterm delivery, low birth weight, and infant mortality. • Structural disparities in socioeconomic status and access to healthcare place some teenagers at high risk of teen pregnancy. What is New: • Our study shows the trends in childhood pregnancy over the previous three decades; overall, there were declines in the stillbirth rates in both child mothers aged 10-14 years and teen (15-19 years old) mothers, but the rate remained consistently higher among child mothers. • Child mothers aged 10-14 were more likely to experience stillbirth than teenagers, and Black mothers had an increased risk of stillbirth than White mothers-all of which underscores the effects of structural health disparities.


Assuntos
Gravidez na Adolescência , Nascimento Prematuro , Adolescente , Adulto , Criança , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Natimorto/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 21(1): 1179, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154552

RESUMO

BACKGROUND: Early sexual initiation is associated with higher risk for sexually transmitted infection, teen pregnancy, domestic violence and substance use in later adolescence and early adulthood. Native American adolescents are more likely to have early sexual initiation compared to other racial/ethnic groups. Few programs designed with and for Native adolescents to delay sexual initiation and substance use have been tested through rigorous evaluations. This is the protocol for the randomized controlled trial of the Asdzáán Be'eena' program, a teen pregnancy and substance use prevention program for young Native girls and their female caregivers. METHODS: N = 410 female adolescents ages 10-14 and their female caregivers will be enrolled in the study and randomized to the intervention or control arm. The intervention consists of the 11-session Asdzáán Be'eena' program. The control arm consists of mailed non-monetary incentives. All participants will complete evaluations at baseline and 3 follow-up timepoints (immediate, 6 and 12 months post intervention). Evaluations include measures to assess protective factors associated with delayed sexual initiation and substance use. DISCUSSION: This is one of the first rigorous evaluations of a gender-specific, culturally tailored teen pregnancy and substance use primary prevention program for Native girls and their female caregivers. If proven efficacious, Native communities will have a culturally appropriate program for promoting protective factors associated with delayed substance use and sexual risk taking. TRIAL REGISTRATION: NCT04863729 ; April 27, 2021.


Assuntos
Gravidez na Adolescência , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Nativos Estadunidenses , Cuidadores , Criança , Feminino , Humanos , Gravidez , Gravidez na Adolescência/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Educação Sexual , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
12.
BMC Womens Health ; 21(1): 254, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34167542

RESUMO

BACKGROUND: In developing countries, 20,000 under 18 children give birth every day. In Ethiopia, teenage pregnancy is high with Afar and Somalia regions having the largest share. Even though teenage pregnancy has bad maternal and child health consequences, to date there is limited evidence on its spatial distribution and driving factors. Therefore, this study is aimed to assess the spatial distribution and spatial determinates of teenage pregnancy in Ethiopia. METHODS: A secondary data analysis was conducted using 2016 EDHS data. A total weighted sample of 3381 teenagers was included. The spatial clustering of teenage pregnancy was priorly explored by using hotspot analysis and spatial scanning statistics to indicate geographical risk areas of teenage pregnancy. Besides spatial modeling was conducted by applying Ordinary least squares regression and geographically weighted regression to determine factors explaining the geographic variation of teenage pregnancy. RESULT: Based on the findings of exploratory analysis the high-risk areas of teenage pregnancy were observed in the Somali, Afar, Oromia, and Hareri regions. Women with primary education, being in the household with a poorer wealth quintile using none of the contraceptive methods and using traditional contraceptive methods were significant spatial determinates of the spatial variation of teenage pregnancy in Ethiopia. CONCLUSION: geographic areas where a high proportion of women didn't use any type of contraceptive methods, use traditional contraceptive methods, and from households with poor wealth quintile had increased risk of teenage pregnancy. Whereas, those areas with a higher proportion of women with secondary education had a decreased risk of teenage pregnancy. The detailed maps of hotspots of teenage pregnancy and its predictors had supreme importance to policymakers for the design and implementation of adolescent targeted programs.


Assuntos
Gravidez na Adolescência , Regressão Espacial , Adolescente , Criança , Etiópia/epidemiologia , Feminino , Humanos , Gravidez , Somália , Análise Espacial
13.
Más Vita ; 3(2): 30-39, jun 2021. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1253891

RESUMO

Existen varios estudios sobre embarazos en adolescentes, factores de riesgo, consecuencias de los embarazos, prevalencias, pero ninguno cuenta con un documento validado para recolectar información pertinente y así poder abordar el problema. Objetivo: Validar un documento donde se pueda recoger datos para mostrar a la comunidad los problemas de salud que los aquejan, dando a expertos en el tema, un instrumento cualitativo con preguntas categorizadas y formuladas para abordar a los grupos de enfoque. Materiales y Métodos: Investigación de tipo mixta cuanti- cualitativa, transversal, descriptiva, de campo, retrospectivo, sobre datos en base RDACCA. Demográficamente se entrevistó a un total de 6 personas, 2 por cada grupo focal. La técnica que utilizada fue la entrevista a profundidad. Creando preguntas para iniciar una conversación normal, se organizaron 3 categorías codificadas, para evitar manipulación de la información, por parte de los participantes o intervinientes. El instrumento fue validado por expertos en el tema hasta conseguir una puntuación de 100 o dentro del rango aceptable. Resultados: La calificación otorgada por expertos obtuvo 95,83 considerando el instrumento como, ´´Muy confiable´´ Conclusión: La validación del instrumento dio como resultado que el instrumento es muy confiable, lo que significa que puede ser aplicado por el investigador para recoger datos que sean relevantes para evaluar la prevalencia y consecuencias de los embarazos en la adolescencia del área de influencia del centro de salud Macuma zona Indígena Shuar(AU)


There are several studies on teenage pregnancy, risk factors, consequences of pregnancy, prevalence, but none has a validated document to collect relevant information to address the problem. Objective: Validate a document where data can be collected to show the community the health problems that afflict them, giving experts on the subject, a qualitative instrument with categorized and formulated questions to address the focus groups. Materials and Methods: Qualitative, cross-sectional, descriptive, descriptive, field, retrospective, mixed quantitative-qualitative research on RDACCA data. Demographically, six people were interviewed, two for each focus group. The technique used was the in-depth interview. By creating questions to initiate a normal conversation, three coded categories were organized to avoid manipulation of the information by the participants. The instrument was validated by experts in the field until a score of 100 or within the acceptable range was achieved. The results: The rating given by the experts was 95.83, considering the instrument as ''Very reliable. Conclusion: The validation of the instrument resulted in the instrument being very reliable, which means that the researcher to collect data that are relevant to assess the prevalence can apply it and consequences of adolescent pregnancy in the area of influence of the Macuma health center in the Shuar indigenous zone(AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Gravidez na Adolescência , Fatores de Risco , Saúde do Adolescente , Pobreza , Saúde Sexual e Reprodutiva , Fracasso Acadêmico
14.
Afr J AIDS Res ; 20(2): 158-164, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33998958

RESUMO

Background: In Zimbabwe, adolescent girls and young women (AGYW) experience high rates of HIV and other sexual and reproductive health challenges. In 2013, the Zimbabwe Ministry of Health and Child Care partnered with the United Nations Population Fund to implement the Sista2Sista programme, a structured peer group intervention aimed at improving health outcomes among vulnerable in- and out-of-school AGYW.Methods: Programme data was analysed for 91 612 AGYW aged 10-24 years old who participated in Sista2Sista from 2013 to 2019. Logistic regression was used to determine odds ratios (OR) and evaluate programme exposure as a factor in a set of defined variables.Results: 58 471 AGYW (63.82%) graduated from the Sista2Sista programme by completing at least 30 of 40 exercises. Graduates were more likely to take an HIV test (2.78 OR 95% CI 2.52-3.10), less likely to get married (0.63 OR 95% CI 0.55-0.73) and less likely to drop out of school (0.60 OR 95% CI 0.53-0.69). At higher thresholds of programme completion, additional positive outcomes were observed. Participants who completed all 40 exercises were more likely to return to school (1.41 OR 95% CI 1.18-1.69), more likely to use contraception (1.38 OR 95% CI 1.21-1.56), more likely to report sexual abuse (1.76 OR 95% CI 1.17-2.66), and less likely to become pregnant as adolescents (0.41 OR 95% CI 0.24-0.72). Individual counselling improved the likelihood of programme graduation.Conclusions: The Sista2Sista programme had a positive effect on HIV and other sexual health outcomes among vulnerable AGYW in Zimbabwe. Strategies to improve graduation rates should be explored.


Assuntos
Infecções por HIV/prevenção & controle , Promoção da Saúde/estatística & dados numéricos , Grupo Associado , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Criança , Feminino , Violência de Gênero/prevenção & controle , Violência de Gênero/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Promoção da Saúde/organização & administração , Humanos , Casamento/estatística & dados numéricos , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Evasão Escolar/estatística & dados numéricos , Adulto Jovem , Zimbábue/epidemiologia
15.
Reprod Health ; 18(1): 107, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34039359

RESUMO

BACKGROUND: Few studies explore what it means to be an adolescent parent in the Philippines from the young parents' perspective. This study sought to improve understanding of how adolescent mothers and young fathers experienced pregnancy in Palawan, Philippines. METHODS: We conducted narrative analysis of 27 semi-structured interviews with 15 Filipino young parents. FINDINGS: Our findings point to three pathways to adolescent pregnancy differentiated by life circumstances and perceived self-efficacy: through early unions, through 'disgrasya' (accident) in romantic relationships, and when pregnancy is directly related to adversity and disadvantage. Some young people adopted agentic narratives and had intended pregnancies within early unions. Young people who had unintended pregnancies in romantic relationships recounted constrained choice narratives, taking responsibility for their decisions while emphasising external factors' influence on their decision-making. Other young mothers described the ways that prior adversity and disadvantage gave rise to unfavourable circumstances-including sexual violence-that led to unintended pregnancy but shared narratives showing how they had reclaimed agency in their lives. CONCLUSION: Our findings highlight the need to (1) address underlying poverty and structural inequalities that limit Filipino young people's life choices and contribute to their pathways to adolescent pregnancy; (2) provide Filipino young people with access to essential sexual and reproductive health information, services, and supplies; and (3) change social norms to rectify gender-based power imbalances and sexual violence.


Assuntos
Gravidez na Adolescência , Comportamento Sexual/psicologia , Saúde Sexual , Adolescente , Criança , Feminino , Humanos , Entrevistas como Assunto , Filipinas , Gravidez , Pesquisa Qualitativa , Saúde Reprodutiva , Fatores Socioeconômicos
16.
Rev. Saúde Pública Paraná (Online) ; 4(1): 133-150, abr. 2021.
Artigo em Português | Coleciona SUS, CONASS, SESA-PR | ID: biblio-1281249

RESUMO

O objetivo foi revisar e descrever na literatura nacional e internacional os determinantes sociais da saúde relacionados à gravidez na adolescência. Trata-se de uma revisão integrativa da literatura, realizada entre os meses de agosto e novembro de 2019. A busca dos artigos foi realizada nas bases de dados eletrônicas PubMed, SciELO e Portal Regional da Biblioteca Virtual em Saúde. A amostra final constituiu-se de 15 artigos, sendo agrupados em categorias temáticas: determinantes sociais da saúde e gravidez na adolescência, associação entre educação e a gravidez na adolescência, conhecimento dos adolescentes e pais relacionado à saúde sexual e reprodutiva.Os determinantes sociais da saúde têm uma relação com a gravidez na adolescência e precisam ser mais explorados nos estudos para maiores intervenções, sendo importantes para formulação de políticas com o objetivo de melhorar as condições de saúde da população. (AU)


The aim was review and describe in the national and international literature the social determinants of health related to teenage pregnancy. This is an integrative literature review, carried out between the months of August and November 2019. The search for the articles was carried out in the electronic databases PubMed, SciELO and Regional Portal of the Virtual Health Library. The final sample consists of 15 articles, being grouped into thematic categories; Social determinants of adolescent health and pregnancy, association Beethoven education and adolescent pregnancy, knowledge of adolescents and parents related to sexual and productive health. Social determinants of health are related to teenage pregnancy and need to be further explored in studies for greater interventions, being important for the formulation of policies in order to improve the health conditions of the population. (AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Gravidez na Adolescência , Saúde do Adolescente , Determinantes Sociais da Saúde
17.
PLoS One ; 16(4): e0248836, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33793592

RESUMO

BACKGROUND: Women who have experienced adolescent pregnancy and early motherhood are disproportionately affected in terms of their health and parenting capabilities, as well as their offspring's health. Guided by Stress Process and Social Determinants of Health (SDH) Frameworks, which posit that multiple sources of stressors and structural determinants of adolescent pregnancy influence adolescent mothers' subsequent health and quality of parenting (Xavier et al 2018, McLoyd 1998, Conger et al 2010, Gipson et al 2008). These dynamics then further impact offspring's outcomes. Using an Integrated Stress-SDH Process for Health Disparities model and we test on whether early motherhood is associated with and subsequent maternal and child health from two informal settlements in Nairobi. METHODS: A cross-sectional design with 394 mothers of 2-16 years old children who sought maternal and child health services at Kariobangi and Kangemi public health centers between October 2015 to April 2016 were recruited. Participating mothers were asked questions related to their adolescent pregnancy history, their current health, wellbeing, and parenting practices, and their child's health. Structural equation modeling (SEM) was utilized to examine hypothesized mediational pathways that adolescent pregnancy history has negative influences on women's health and parenting during adulthood, which also influence their child's health and development. RESULTS: Our study supports that women with a history of adolescent motherhood have poor physical and mental health outcomes as adults after adjusting for demographic confounders. SEM results partially support the Stress-SDH Process model that history of adolescent pregnancy had negative consequences on women's adulthood health, which also negatively impacted offspring's physical and mental health. CONCLUSION: Consistent with the Stress Process and SDH literature, we found consistent cross-cultural literature that adolescent pregnancy set the stage for, subsequent poor maternal health and child outcomes. Although history of adolescent pregnancy and motherhood was not necessarily associated with negative parenting, consistent with parenting literature, negative parenting was associated with poor child mental health. Findings suggest importance of providing integrated care that address health and parenting needs to optimize offspring's development in instances of early motherhood.


Assuntos
Desenvolvimento Infantil , Saúde Materna , Poder Familiar , Gravidez na Adolescência , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Lactente , Quênia , Saúde Mental , Gravidez , População Rural , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
18.
Front Public Health ; 9: 536342, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33898367

RESUMO

Background: Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care. Objective: To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services. Methods: This retrospective cohort study followed pregnant adolescents (aged 10-17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10-13 years were compared to those of adolescents aged 14-15 years and 16-17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences. Results: Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7-11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10-13 age group, 8.7% for the 14-15 age group and 12.1% for the 16-17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10-13, 14-15, and 16-17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups (p > 0.05). The infants born to mothers aged 10-13 years presented significantly (p < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range. Conclusions: Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.


Assuntos
Complicações na Gravidez , Gravidez na Adolescência , Adolescente , Brasil/epidemiologia , Criança , Feminino , Política de Saúde , Humanos , Recém-Nascido , Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos
19.
Reprod Health ; 18(1): 71, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789699

RESUMO

BACKGROUND: Adolescent pregnancy is a risk factor for suicide. We aimed to assess the prevalence of suicide attempts among young women with adolescent pregnancy in Bangladesh and to explore its associated factors. METHODS: In this cross-sectional study, we surveyed young women with adolescent pregnancy in urban and rural areas in Bangladesh to assess suicide attempts, socio-demographic and pregnancy-related characteristics, perceived health status, and perceived social support. Binary logistic regression analysis was conducted to explore the relationship between potentially related factors and suicide attempts. RESULTS: Of the participants, 6.5% (61/940) reported suicide attempts in the past 12 months, and the majority (88.5%) of the attempts happened within one year after the pregnancy. Participants with more years after first pregnancy (odds ratio (OR) = 0.47, 95% CI: 0.37-0.61) and more perceived social support from friends (OR = 0.69, 95% CI: 0.55-0.86) were less likely to have suicide attempts, and those perceived bad health status compared with good/fair health status (OR = 8.38, 95% CI: 3.08-22.76) were more likely to attempt suicide. CONCLUSIONS: Women with adolescent pregnancy were at high risk of suicide attempts, especially those during the first postnatal year. The risk of suicide attempts attenuated with the time after pregnancy, and perceived social support from friends was a protective factor and perceived bad health status was a risk factor for suicide attempts among young women who have experienced adolescent pregnancy.


Assuntos
Comportamento do Adolescente , Gravidez na Adolescência/psicologia , Tentativa de Suicídio , Adolescente , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Gravidez , Fatores de Risco , Apoio Social , Suicídio , Adulto Jovem
20.
AIDS Educ Prev ; 33(2): 89-102, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33821678

RESUMO

HIV/STDs and unintended pregnancy persist among adolescents in the United States; thus, effective sexual health interventions that can be broadly disseminated are necessary. Digital health interventions are highly promising because they allow for customization and widespread reach. The current project involved redeveloping and expanding HEART (Health Education and Relationship Training)-a brief, digital sexual health intervention efficacious at improving safer sex knowledge, self-efficacy, and behavior-onto an open-source platform to allow for greater interactivity and accessibility while reducing long-term program costs. The authors describe the process of adapting, reprogramming, and evaluating the new program, which may serve as a guide for investigators seeking to adapt behavioral interventions onto digital platforms. The final product is an open-source intervention that can be easily adapted for new populations. Among 233 adolescents (Mage = 15.06; 64% girls), HEART was highly acceptable and generally feasible to administer, with no differences in acceptability by gender or sexual identity.


Assuntos
Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Promoção da Saúde/métodos , Gravidez na Adolescência/prevenção & controle , Saúde Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Ciência da Implementação , Masculino , Gravidez , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Sexo Seguro , Autoeficácia , Comportamento Sexual
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