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1.
Reprod Health ; 18(1): 48, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622358

RESUMO

BACKGROUND: Contraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. Attitude and perspectives about contraception of community members including adolescent girls themselves may be likely to limit contraceptive use among adolescent girls. This study was conducted to explore and compare adults'/parents' and adolescent girls' narratives and perspectives about contraception in Narok and Homa Bay counties, Kenya. METHODS: Qualitative data from 45 in-depth-interviews conducted with purposively selected consenting adolescent girls aged 15-19 was used. Additionally, twelve focus group discussions were held with 86 consenting adults conveniently recruited from the two counties. All discussions were conducted in the local language and audio recorded following consent of the study participants. Female moderators were engaged throughout the study making it appropriate for the study to solicit feedback from the targeted respondents. RESULTS: Findings highlighted adults' perceptions on adolescents' sexuality and the presence of stringent conceptions about the side-effects of contraception in the study communities. Some participants underscored the need for open contraceptive talk between parents and their adolescent girls. Four main themes emerged from the discussions; (i) Perceptions about adolescents' sexuality and risk prevention, (ii) Conceptions about contraception among nulligravida adolescents: fear of infertility, malformation and sexual libertinism, (iii) Post-pregnancy contraceptive considerations and (iv) Thinking differently: divergent views regarding contraceptives and parent/adolescent discussion. CONCLUSIONS: Our findings suggest the need for increased attention towards adolescents and their caregivers particularly in demystifying contraceptive misconceptions. Programmatic responses and models which include the provision of comprehensive sexuality education and increased access to and utilization of SRH information, products and services through a well-informed approach need to be well executed. Programmatic efforts like SRH community education should further seek to enhance the capacity of parents to discuss sexuality with their adolescents.


Assuntos
Comportamento Contraceptivo , Casamento , Relações Pais-Filho , Percepção , Psicologia do Adolescente , Adolescente , Comportamento do Adolescente/fisiologia , Adulto , Anticoncepção/métodos , Anticoncepção/psicologia , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/uso terapêutico , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Quênia/epidemiologia , Casamento/psicologia , Casamento/estatística & dados numéricos , Relações Pais-Filho/etnologia , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Gravidez na Adolescência/estatística & dados numéricos , Pesquisa Qualitativa , Educação Sexual/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adulto Jovem
2.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32943535

RESUMO

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.


Assuntos
Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Asma/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Austrália/epidemiologia , Estatura , Criança , Cognição , Estudos de Coortes , Gorduras na Dieta/administração & dosagem , Escolaridade , Feminino , Humanos , Inteligência , Estudos Longitudinais , Transtornos Mentais/epidemiologia , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Qualidade de Vida , Comportamento Sexual , Transtornos do Sono-Vigília/epidemiologia , Evasão Escolar/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Adulto Jovem
4.
Natl Vital Stat Rep ; 69(6): 1-12, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32730736

RESUMO

Objectives-This report presents changes in state-specific birth rates for teenagers between 2017 and 2018 by race and Hispanic origin of mother. Methods-Data are from birth certificates of the 50 states and the District of Columbia (D.C.). Teen birth rates, the number of births to females aged 15-19 per 1,000 females aged 15-19, are shown by state for all births and for non-Hispanic single-race white, non-Hispanic single-race black, and Hispanic females for 2017 and 2018. Results-Birth rates for females aged 15-19 declined in 38 states between 2017 and 2018; nonsignificant declines were reported in eight additional states and D.C. Among non-Hispanic white teenagers, rates declined in 29 states between 2017 and 2018; nonsignificant declines were reported in 16 additional states. Teen birth rates for non-Hispanic black females declined in 10 states between 2017 and 2018; nonsignificant declines were seen in 21 additional states and D.C. For Hispanic teenagers, birth rates declined in 10 states between 2017 and 2018; nonsignificant declines were reported in 30 additional states and D.C. The magnitude of change between 2017 and 2018 varied by state for each race and Hispanic-origin group.


Assuntos
Coeficiente de Natalidade/etnologia , Grupos de Populações Continentais/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Gravidez na Adolescência/etnologia , Adolescente , Coeficiente de Natalidade/tendências , Feminino , Humanos , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
5.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32690805

RESUMO

Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This technical report discusses the new data and trends in adolescent sexual behavior and barrier protection use. Since 2017, STI rates have increased and use of barrier methods, specifically external condom use, has declined among adolescents and young adults. Interventions that increase availability of or accessibility to barrier methods are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research informs public health interventions for adolescents that increase the consistent and correct use of barrier methods and promote dual protection of barrier methods for STI prevention together with other effective methods of contraception.


Assuntos
Preservativos Femininos , Preservativos , Comportamento Sexual , Adolescente , Fatores Etários , Preservativos/estatística & dados numéricos , Preservativos Femininos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relações Interpessoais , Profilaxia Pré-Exposição , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Gravidez não Planejada , Fatores Raciais , Sexo Seguro , Autoimagem , Educação Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Apoio Social
6.
PLoS One ; 15(6): e0233985, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492055

RESUMO

INTRODUCTION: In sub-Saharan Mozambique, high adolescent fertility rates are a significant public health problem. Understanding the consequences of teenage pregnancies facilitates effective strategies for improving the quality of care of both mother and the newborn. AIMS: To identify the factors associated with adolescent motherhood in Tete (Mozambique). METHODS: This was a cross-sectional study including 821 pregnant women (255 teenagers) admitted to the general maternity ward of the Provincial Hospital between March and October 2016. The survey included clinical data of the mother and newborn. RESULTS: The overall prevalence of adolescent deliveries was 31.8% (95% CI 27.9% - 34.2%). Multivariate analysis showed that independent factors associated with teenage motherhood were: number of pregnancies (OR 0.066; 95% CI 0.040-0.110), pregnancy follow-up (OR 0.29; CI 0.173-0.488) and previous abortions (OR 4.419; 95% CI 1.931-10.112). When the age of the mother was analysed as a continuous variable, positively associated factors were body mass index, arterial hypertension, HIV infection, previous abortions, pregnancy follow-up, and the weight of the newborn. Negatively associated factors were episiotomy and respiratory distress in the newborn. CONCLUSION: Teenage motherhood is a serious public health problem in Mozambique. Intensive sexual and reproductive health planning for adolescents is needed.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Saúde do Lactente/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Aborto Induzido/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Estudos Transversais , Feminino , Número de Gestações , Planejamento em Saúde/organização & administração , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Mortalidade Materna , Moçambique/epidemiologia , Gravidez , Gravidez na Adolescência/prevenção & controle , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
7.
Gac Med Mex ; 156(2): 150-155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285856

RESUMO

Globally, adolescent pregnancy constitutes a serious public health problem of a multifactorial nature. Specifically for women, it entails various educational, economic and social implications that affect their life project and widen the social gaps in this age group. Furthermore, adolescent girls are more vulnerable because of the health risk involved with pregnancy at a younger age. According to the World Health Organization, "the probability of maternal death is twice as high in adolescents in comparison with women aged between 20 and 30 years, and for those younger than 15 years, the risks are five times higher". In general, adolescents are in great need for education on sexual and reproductive health issues, which should be aimed at increasing information and knowledge about correct use and access to modern contraceptive methods, as well as at demystifying fears and beliefs around their possible side effects. Ensuring proper counseling with trained personnel is equally vital. Public institutions have a social responsibility to support efforts aimed at preventing adolescent pregnancy, based on relevant lines of action and health policies.


Assuntos
Gravidez na Adolescência , Adolescente , Adulto , Anticoncepção , Feminino , Humanos , México , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Comportamento Sexual , Fatores de Tempo , Adulto Jovem
8.
PLoS One ; 15(4): e0231557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287303

RESUMO

BACKGROUND: Information on repeat adolescent birth remains scarce in sub-Sahara Africa. We investigated the prevalence and time trends in repeat adolescent birth in Uganda, and associated factors. METHODS: We analyzed Uganda Demographic and Health Survey data of women age 20-24 years collected on 6 surveys (1988/89-2016) to estimate repeat adolescent birth (first live birth <18 years of age followed by another live birth(s) <20 years). Further, we estimated the wantedness of the second order birth and the prevalence of short birth intervals birth (<13 months) between the first and second such birth. On the 2016 survey, we examined factors associated with repeat adolescent birth using bivariate and multivariate modified Poisson regression. RESULTS: At the 1988/89 survey, 58.9% of women with first birth <18 years reported a repeat adolescent birth. This percentage increased to 66.8% in 2006 (+7.9 percentage points [pp], p = 0.010) and thereafter declined to 55.6% by 2016 (-11.2 pp, p<0.001), nevertheless, no change occurred between 1988/89 and 2016 (-3.3pp, p = 0.251). Among women with repeat adolescent births, the mean number of live births by exact age 20 years (2.2 births) and prevalence of short birth intervals (3.5% in 1988/89, 5.4% in 2016) (+1.9pp, p = 0.245) did not change. Increasingly more women with repeat adolescent births preferred to have had the second child later, 22.5% in 1995 and 43.1% in 2016 (+20.6pp, p = <0.001). On the 2016 survey, women from poorer households and those of younger age at first birth were significantly more likely to report repeat adolescent birth. CONCLUSION: Following a first birth <18 years, more than half of the women report a repeat adolescent birth (<20 years), with no decline observed in 30 years. Increasingly more women wanted the second adolescent pregnancy later, highlighting the need to support adolescents with improved family planning services at each contact.


Assuntos
Paridade , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Adulto , Ordem de Nascimento/psicologia , Coeficiente de Natalidade/tendências , Serviços de Planejamento Familiar/tendências , Feminino , Inquéritos Epidemiológicos , Humanos , Idade Materna , Parto/psicologia , Gravidez , Uganda/epidemiologia , Adulto Jovem
10.
BMC Pregnancy Childbirth ; 20(1): 120, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075596

RESUMO

BACKGROUND: Adolescent pregnancy is an important health and social issue that affects both individual and social well-being. However, deriving a national estimate is challenging in a country with multiple incomplete national databases especially the abortion statistics. The objective of this study was to estimate the adolescent pregnancy rates in Thailand using capture-recapture method. METHODS: An application of capture-recapture method was conducted using two cross-sectional databases (i.e., the national birth registration and the Ministry of Public Health standard health databases) and one hospital-based data source from medical record reviews. A 3-sources capture-recapture with log-linear model was applied to estimate adolescent pregnancy rates. RESULTS: A total number of 741,084, 290,922 and 25,478 records were respectively identified from the birth registrations, standard health databases and hospital-based survey data during 2008 to 2013. The estimated adolescent pregnancy rates /1000 adolescent women (95% confidence intervals (CI)) ranged from 56.3 (49.4, 66.9) to 70.3 (60.3, 76.6). The estimated rates were about 12-31% higher than adolescent birth rates reported by the Thailand Public Health Statistics. CONCLUSIONS: With the capture-recapture method, more accurate adolescent pregnancy rates were estimated. This method should be able to apply to any setting with similar context.


Assuntos
Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Gravidez , Taxa de Gravidez , Projetos de Pesquisa , Tailândia/epidemiologia , Adulto Jovem
11.
Int J Gynaecol Obstet ; 149(2): 160-165, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32043575

RESUMO

OBJECTIVE: To compare pregnant Turkish women and Syrian refugee women in terms of demographic data and obstetric and neonatal outcomes. METHODS: In a retrospective study, the records of Turkish women and Syrian refugee women who gave birth at the Health Sciences University Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey, between January 1, 2016, and July 31, 2017 were examined. Maternal characteristics and obstetric and neonatal outcomes were compared between the two groups. RESULTS: The study, which included 7950 Turkish women and 620 Syrian refugee women, found significant differences in maternal age according to nationality. The rate of normal delivery was significantly lower for the Turkish women at 51.6% (P=0.001) compared to 61.3% for the Syrian refugee women. The rate of delivery prior to 37 weeks of gestation was 1.8% for the Turkish women and 3.2% for the Syrian refugee women, indicating earlier delivery for the Syrian refugees than the Turkish women (P=0.017). A significant difference was found between the birth weights of infants born in the two groups (P=0.001). CONCLUSION: According to the study results, Syrian refugees have a higher rate of adolescent birth and low-birth-weight neonates which could be attributed to poor care and insufficient nutrition during pregnancy while living as a refugee in Turkey.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Idade Materna , Resultado da Gravidez/etnologia , Gestantes/etnologia , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Cuidado Pré-Natal/normas , Estudos Retrospectivos , Síria/etnologia , Turquia/epidemiologia
12.
Cien Saude Colet ; 25(2): 439-448, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32022185

RESUMO

This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.


Assuntos
Fracasso Acadêmico , Relações Familiares , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Brasil , Estudos de Casos e Controles , Feminino , Humanos , Estilo de Vida , Mães/estatística & dados numéricos , Gravidez , Fatores de Proteção , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
14.
Biomed Res Int ; 2020: 3124847, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32051825

RESUMO

Introduction: One of the major public health issues across the whole world these days is teenage pregnancy which is defined as being pregnant in the age ranging from 13-19 years. About 11% of all births which occurred worldwide accounted for girls aged 15 to 19 years. From these, 95% teenage deliveries occur in low- and middle-income countries. World health 2014 statistics show that complications during pregnancy and childbirth are the second cause of death for 15-19-year-old girls globally. The aim of this study was to determine adverse obstetrical and perinatal outcomes of teenage pregnancy among deliveries at Lemlem Karl General Hospital, Tigray, Ethiopia, 2018. Result: This study result showed that 17.5% of the teenagers and 6.8% of the adults deliver low birth weight neonates. From the total teenage mothers, about thirty-five (11.3%) of them had developed pregnancy-induced hypertension, whereas about thirteen (4.2%) of adults develop pregnancy-induced hypertension. Regarding cesarean delivery, forty (12.9%) of those teenage mothers deliver by a cesarean section while 58 (18%) of the adult mothers deliver by cesarean delivery. Teenage pregnancy was significantly associated with adverse obstetric and perinatal outcomes, a cesarean delivery (AOR: 0.57; 95% CI, 0.36-0.90), episiotomy (AOR: 2.01; 95% CI, 1.25-3.39), and low birth weight (AOR: 2.22; 95% CI, 1.13-4.36), and premature delivery were 2.87 (1.49-5.52). This study shows that adverse obstetric and perinatal outcomes were significantly associated with teenagers than adult mothers. Therefore, giving health education on focused ANC is very important to bring change to the teenager at this study area.


Assuntos
Parto Obstétrico , Hospitais , Complicações na Gravidez/epidemiologia , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Adulto , Cesárea/estatística & dados numéricos , Episiotomia , Etiópia/epidemiologia , Feminino , Humanos , Hipertensão , Recém-Nascido de Baixo Peso , Recém-Nascido , Parto , Gravidez , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Adulto Jovem
15.
Ciênc. Saúde Colet ; 25(2): 439-448, Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1055803

RESUMO

Abstract This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.


Resumo Este artigo visa investigar fatores associados à maternidade em adolescentes moradoras em Porto Alegre, com idade entre 14 e 16 anos. Estudo caso-controle com 431 mães adolescentes (casos) e 862 adolescentes que nunca tiveram filho (controles). Os dados foram obtidos através de visitas domiciliares e mediante aplicação de questionário estruturado. Foram estudadas variáveis sociodemográficas, qualidade das relações sociais e familiares, estilo de vida e histórico de abuso como possíveis determinantes da maternidade na adolescência. Os dados foram analisados através de regressão logística condicional, utilizando modelo hierarquizado. Os resultados mostram que pertencer aos estratos socioeconômicos mais baixos, possuir mãe que teve o seu primeiro filho até os 19 anos, defasagem escolar, uso de tabaco e embriaguez alcóolica pelo menos uma vez na vida foram positivamente associados à maternidade na adolescência. Menarca mais tardia e ter familiares ou ter amigos em quem confiar foram fatores de proteção. Defasagem escolar, que obteve razão de odds mais elevada, aponta o importante papel da escola na formação desta população e no seu potencial para estimular hábitos de vida sadios.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Gravidez na Adolescência/estatística & dados numéricos , Relações Familiares , Fracasso Acadêmico , Fatores Socioeconômicos , Brasil , Estudos de Casos e Controles , Inquéritos e Questionários , Fatores de Risco , Fatores de Proteção , Estilo de Vida , Mães/estatística & dados numéricos
16.
J Womens Health (Larchmt) ; 29(6): 815-818, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31990605

RESUMO

Background: Rapid repeat pregnancy (RRP) is common among adolescents and is associated with adverse maternal and infant outcomes. Despite evidence that use of long-acting forms of contraception before hospital discharge can help minimize RRP rates, barriers to placement existed within the state of Indiana. We sought to determine state-specific RRP and induced abortion rates for adolescents based on chosen postpartum contraception to inform policy change. Methods: We examined a retrospective cohort of 227 adolescents (ages 12-18 years) who gave birth in Indiana between 2010 and 2012. Demographics, postpartum contraception, and subsequent pregnancies or abortions after the sentinel delivery were obtained. Rates of RRP based on type of immediate postpartum contraception, etonogestrel (ENG) contraceptive implant, depo-medroxyprogesterone acetate (DMPA) injection, and short-acting methods were compared. Bivariate and logistic regression analyses were conducted. Results: RRP rates were 3.7% for those with ENG contraceptive implant, 22.6% for those with DMPA, and 39.1% for those who choose short-acting methods (p = 0.01). Adolescents who did not choose an ENG contraceptive implant were significantly more likely to have an RRP (adjusted odds ratio [aOR] = 11.8, 95% confidence interval: 2.74-110.3), compared with other contraceptive methods, even after adjusting for covariates such as age, prior pregnancies, and postpartum visit attendance. Conclusions: Immediate postpartum receipt of ENG implant was significantly associated with a lower likelihood of RRP in adolescents in Indiana. These data facilitated state policy change regarding insurance reimbursement to improve statewide access for all women, regardless of age, showing how local data can inform policy change.


Assuntos
Aborto Induzido/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Política de Saúde/legislação & jurisprudência , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Criança , Estudos de Coortes , Anticoncepcionais Femininos/uso terapêutico , Desogestrel/uso terapêutico , Implantes de Medicamento/uso terapêutico , Feminino , Humanos , Indiana , Cobertura do Seguro/legislação & jurisprudência , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Acetato de Medroxiprogesterona/uso terapêutico , Razão de Chances , Período Pós-Parto , Gravidez , Estudos Retrospectivos , Fatores de Tempo
17.
Midwifery ; 82: 102619, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31923708

RESUMO

OBJECTIVE: This study examined the sociodemographic and sociocultural factors associated with the pattern of birth assistance used among adolescent mothers aged 15-19 in Nigeria. DESIGN: The study used a quantitative design, using secondary data from the Nigeria Demographic and Health Surveys conducted between 2003 and 2013. SETTING: The study was nationally representative and conducted across Nigeria. PARTICIPANTS: A weighted sample of 2,096 adolescent mothers aged 15-19. MEASUREMENTS AND FINDINGS: Data were analysed using frequencies, chi square tests and multinomial logistic regression respectively. It was discovered that mothers aged 18 and above had lower odds of using traditional and skilled birth attendants (aORs = 0.68 (0.51-0.92); 0.63 (0.44-0.92)); Igbo mothers had lower odds of using TBAs (aOR = 0.03 (0.002-0.53)); and mothers in female-headed households were less likely to use SBAs (aOR = 0.40 (0.20-0.82)). Rich mothers were more likely to use SBAs (aOR = 2.21 (1.23-3.94)). Mothers whose partners had at least primary education were more likely to use SBAs (aOR = 1.73 (1.09-2.73); 1.64 (1.03-2.59)). Adolescent mothers in the North East (aOR = 5.79 (2.91-11.51)), North West (aOR = 8.24 (4.01-16.93)), South East (aOR = 69.70 (13.96-348.05)) and South South (aOR = 27.84(7.80-99.30)) were more likely to use TBAs, while mothers in the North East (aOR = 0.46 (0.28-0.76)) and North West (aOR = 0.50 (0.29-0.84)) were less likely to use SBAs. Mothers who used partial ANC were more likely to use SBAs (aOR = 5.73 (3.43-9.56)), while those who used full ANC were more likely to use SBA (aOR = 7.33 (4.76-11.29)). KEY CONCLUSIONS: Higher socioeconomic status mothers were more likely to use skilled birth attendance. IMPLICATIONS FOR PRACTICE: Interventions to increase SBA use among adolescent mothers in Nigeria must consider the continued preference for traditional and unskilled birth attendants and unassisted births, and design culturally sensitive programmes.


Assuntos
Comportamento do Adolescente/psicologia , Trabalho de Parto/psicologia , Gravidez na Adolescência/psicologia , Adolescente , Distribuição de Qui-Quadrado , Feminino , Humanos , Modelos Logísticos , Mães/psicologia , Nigéria , Razão de Chances , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Fatores Socioeconômicos , Adulto Jovem
18.
Pediatr Int ; 62(2): 140-145, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31758823

RESUMO

BACKGROUND: The number of reports of child abuse and neglect in Japan has increased each year. A causal relationship between socially high-risk pregnant women and child abuse is strongly suggested. This study aims to investigate the characteristics of socially high-risk pregnant women and their children's outcomes, to help prevent child abuse. METHODS: In total, 2,342 births were retrospectively analyzed from medical records. We extracted the frequency, factors, and circumstances of socially high-risk pregnant women, and the presence of social interventions for their children. RESULTS: There were 538 (23%) socially high-risk pregnant women out of 2,342 cases investigated. Related factors (with duplication) were: economic problems (258 cases, 48%), mental disorders (139 cases, 26%), teenage pregnancies (112 cases, 21%), multiple pregnancies (90 cases, 17%), and pregnancy conflict (73 cases, 14%). Sixty-four (12%) expectant mothers received their first health examination in late pregnancy or were not receiving pregnancy health examinations. An analysis of births showed neonatal intensive care unit hospitalization in 40% of the children born to socially high-risk pregnant women. The hospital Child Abuse Prevention Committee intervened in 71 cases, and child consultation centers intervened in 55 cases. Twenty-two children entered social care facilities and four children died of unknown causes. CONCLUSIONS: Socially high-risk pregnant women had various social and individual problems, and received multidisciplinary interventions for child rearing support. Antenatal assessment and multidisciplinary early intervention for socially high-risk pregnant women are necessary to prevent child abuse.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Japão/epidemiologia , Transtornos Mentais/epidemiologia , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Gravidez Múltipla/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Retrospectivos , Fatores Socioeconômicos
19.
J Pediatr Adolesc Gynecol ; 33(2): 149-152, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31751764

RESUMO

STUDY OBJECTIVE: Teenage pregnancies and associated induced abortions represent an important public health issue. The aim of this study was to investigate the prevalence, the time trends, and associated factors of teenage induced abortions in Greece. DESIGN: A cross-sectional study was conducted between 2018 and 2019. SETTING: Third Academic Department of Obstetrics and Gynecology of the Aristotle University of Thessaloniki. PARTICIPANTS: All pregnant women who underwent a second trimester anomaly scan were eligible for the study. INTERVENTIONS AND MAIN OUTCOME MEASURES: Epidemiological characteristics were recorded and 5 age groups were created. Trends in the rates of teenage induced abortions were analyzed and we compared several parameters between women with and without history of abortions. RESULTS: Overall, 3370 women were eligible and agreed to participate in the study. The prevalence of women who reported a history of at least 1 abortion at 15-19 years was 9.7% (n = 328/3370). The abortion rates across the 5 age groups were: 20-24: 7.5%; 25-29: 8.4%; 30-34: 8.2%; 35-39: 12%; and 40 years and older: 13.9%. Moreover, a history of 1 or more teenage abortions was more common in multiparous women (58.2% vs 46.5%; P < .001; odds ratio, 1.605; 95% confidence interval, 1.274-2.022) and in current smokers (27.4% vs 11%; P < .001; odds ratio, 3.066; 95% confidence interval, 2.346-4.008). CONCLUSION: A significant decline in the teenage induced abortion rates was identified in the study population. A history of teenage induced abortion was associated with smoking and multiparity. More efforts are needed to provide appropriate education on effective contraception and family planning.


Assuntos
Aborto Induzido/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Grécia/epidemiologia , Humanos , Gravidez , Prevalência , Adulto Jovem
20.
J Pediatr Adolesc Gynecol ; 33(2): 153-159, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31634579

RESUMO

STUDY OBJECTIVE: To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors. DESIGN: Retrospective cohort study using perinatal and neonatal databases. SETTING: Tertiary care hospital in SWO. PARTICIPANTS: Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia. RESULTS: Of 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P < .001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P < .001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P < .001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates. CONCLUSION: Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.


Assuntos
Resultado da Gravidez/epidemiologia , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Bases de Dados Factuais , Feminino , Humanos , Lactente , Recém-Nascido , Ontário/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
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