Sexual abuse and neglect situations as risk factors for adolescent pregnancy / Abuso sexual y situaciones de negligencia como factores de riesgo de embarazo adolescente

ABSTRACT

Abstract Background: In Colombia, one out of five women between the ages of 15 and 19 years have been pregnant. Almost two-thirds (64%) of these pregnancies were unplanned. Objectives: To examine the socio-demographic, psychosocial and clinical risk factors associated with adolescent pregnancy. Methods: An analytical prevalence study was performed using secondary data from the First Demographic Study of Mental Health in Medellin, Colombia. Female adolescents between 13 and 19 years of age were included in the study. The population was evaluated using the Composite International Diagnosis Interview, a structured interview developed by the World Health Organization, which establishes diagnoses according to the DSM-IV and ICD-10 criteria. Results: A sample of 499 female adolescents was obtained, in which 135 adolescent pregnancies were identified, representing a prevalence of 21.5%. The large majority (84.4%) were between 16 and 19 years old. The median age was 17 years, with an interquartile range of 2 years. Almost two-thirds (61.2%) of female adolescents had initiated sexual activity at the age of 15 or later. Almost one-third (31.9%) reported being physically abused during childhood, and 6.7% sexually abused. Of those who were pregnant, 66.7% reported previous sexual abuse. A bivariate analysis showed that sexual abuse (OR = 7.68), childhood negligence (OR = 4.33), and having a partner (OR = 6.31) were factors associated with an adolescent pregnancy. Conclusions: Negligence and sexual abuse in childhood and adolescence can be prevented, and adolescent pregnancies can be decreased. This finding has important implications for clinical management and prognosis, and requires public preventive policies.

RESUMEN

Resumen Introducción: En Colombia, 1 de cada 5 mujeres de 15-19 años ha estado embarazada. El 64% de estos embarazos no fueron planeados. Objetivo: Explorar los factores sociodemográficos, psicosociales y clínicos asociados con el embarazo adolescente. Métodos: Estudio de prevalencia analítica, de fuente secundaria (Primer Estudio Poblacional de Salud Mental Medellín). La muestra fue evaluada usando el Compositum International Diagnosis Interview, instrumento desarrollado por la Organización Mundial de la Salud para realizar diagnósticos con base en criterios diagnósticos del DSM-IV y el CIE-10. Resultados Se obtuvo una muestra de 499 adolescentes. Se identificaron 135 embarazos adolescentes, lo que lleva a una prevalencia de embarazo adolescente del 21,5%. El 84,4% de las adolescentes embarazadas tenían entre 16 y 19 años, y la edad mediana era 17 [intervalo intercuartílico, 2] anos. El 61,2% de ellas iniciaron la vida sexual a los 15 años. Del total de adolescentes, el 31,9% afirmaba haber sufrido maltrato físico y el 6,7%, haber sido violadas en la niñez. Del subgrupo de embarazadas, el 66,7% reportó haber sufrido violación. En el modelo bivariable, las variables que mostraron asociación con el embarazo adolescente fueron ser víctima de violación (odds ratio [OR] = 7,68), negligencia en la niñez (OR = 4,33) y tener pareja (OR = 6,31). Conclusiones: La negligencia y el abuso sexual en la infancia pueden evitarse buscando impactar positivamente el embarazo adolescente.