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1.
Health Econ ; 33(7): 1528-1545, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38483024

RESUMO

I examine the effect of city-level juvenile curfews on teenage birth rates using the National Center for Health Statistics birth data from 1982 to 2002. I compare differences in birth rates between younger and older age groups in cities with and without curfew ordinances. Before curfew adoption, the age differential in birth rates trended similarly for cities that did and did not adopt a curfew. There were significant decreases in the age differential birth rates in cities that adopted a curfew relative to cities that did not. Curfews reduced birth rates by approximately 3 births per 1000 women ages 15-17. I find a decrease in birth rates among white women. The main results are corroborated using a variety of robustness checks and specifications.


Assuntos
Coeficiente de Natalidade , Gravidez na Adolescência , Humanos , Adolescente , Feminino , Gravidez na Adolescência/estatística & dados numéricos , Coeficiente de Natalidade/tendências , Gravidez , Estados Unidos , Adulto Jovem , Fatores Etários
2.
BMC Womens Health ; 24(1): 335, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851734

RESUMO

BACKGROUND: Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. METHODS: This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20-24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20-24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05. RESULTS: Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors. CONCLUSION: This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results.


Assuntos
Gravidez na Adolescência , Humanos , Feminino , Gravidez na Adolescência/estatística & dados numéricos , Malaui , Gravidez , Estudos de Casos e Controles , Adolescente , Adulto Jovem , Comportamento Contraceptivo/estatística & dados numéricos , Casamento/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Risco , Escolaridade , Anticoncepção/estatística & dados numéricos , Modelos Logísticos
3.
BMC Womens Health ; 24(1): 236, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38614989

RESUMO

BACKGROUND: Globally, teenage pregnancy is among the most social problems, affecting 21 million adolescents aged 15-19. Due to the increased responsibility of prenatal and postnatal care for their infants without support, pregnant and parenting teenagers, tend to experience mental health problems. Factors contributing to these problems among pregnant and parenting teenagers in rural African settings have hardly received scholarly attention and, therefore, are less understood. The purpose of the study was to explore mental health and challenges among pregnant and parenting teenagers,. METHOD(S): The study adopted a qualitative descriptive, exploratory, and phenomenological design. Purposive sampling was used to select 22 pregnant and parenting teenagers 18 years or older. Data were collected in ten selected clinics within the Demographic Surveillance Systems (HDSS) of DIMAMO and analysed using qualitative content analysis. RESULTS: The findings reveal that pregnant and parenting teenagers in rural areas experience various mental challenges such as depression. These challenges are caused by social problems such as stigmatisation, lack of support from families and friends, as well as parenting demands that contribute to poor progress at school or dropouts. Pregnant teens expressed concerns about the lack of spousal support resulting from abandoning their partners. CONCLUSIONS: Stress and depression were self-reported as mental problems among participants with various psychosocial implications, such as school dropout and miscarriage. There are various contributing factors to the mental health problems identified among pregnant and parenting teenagers, including inadequate family and spousal support. Access to integrated reproductive, psychosocial, and mental health services could be essential for these pregnant and parenting teenagers, to improve their mental well-being and improve the support system.


Assuntos
Aborto Espontâneo , Saúde Mental , Adolescente , Feminino , Humanos , Lactente , Gravidez , População Negra , Poder Familiar , África do Sul/epidemiologia , Adulto Jovem
4.
Birth ; 51(1): 218-228, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37849418

RESUMO

OBJECTIVES: This study aimed to estimate the prevalence of diagnosed postpartum depression (PPD) and the likelihood of PPD among primiparous women. We also evaluated differences in the influence of various maternal factors associated with PPD in adolescent versus adult mothers. METHODS: We conducted a retrospective cohort study using electronic health records linked to birth certificates to evaluate the associations between maternal factors and PPD diagnosis. The study population was stratified into adults and adolescents based on age at delivery. We evaluated socioeconomic, demographic, psychological, and clinical factors associated with PPD in each of the age-defined maternal cohorts using multivariable logistic regression analyses. RESULTS: A total of 61,226 primiparous women, including 6435 (11%) mothers younger than 20 years old, were included in the study. The overall PPD rate was 4.0%, with the age-specific PPD rate measuring 1.6 times higher in adolescents than in adult women (6.1% vs. 3.8%). Compared with adults, adolescents were less likely to obtain firsttrimester prenatal care (33% vs. 16%), more likely to have recent tobacco use (11% vs. 6%), and more likely to have had an infection during pregnancy (5% vs. 1%). In adjusted models, significant factors for PPD in both groups included a history of depression or anxiety, tobacco use, and long-acting reversible contraception use. CONCLUSIONS: In this cohort of first-time mothers, adolescents had higher rates of PPD diagnosis as well as PPD-associated maternal factors than adults. Increased awareness of PPD risk in adolescents and early intervention, including integrating mental healthcare into prenatal care, may help benefit adolescents and reduce the risk and severity of PPD.


Assuntos
Depressão Pós-Parto , Gravidez , Adulto , Feminino , Adolescente , Humanos , Adulto Jovem , Depressão Pós-Parto/psicologia , Estudos Retrospectivos , Fatores de Risco , Mães/psicologia , Cuidado Pré-Natal , Período Pós-Parto/psicologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-38831170

RESUMO

BACKGROUND: Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to determine the indirect effects of neighbourhood socioeconomic status (NSES) on the risk of spontaneous PTB. METHODS: We carried out a retrospective case-control study including sociodemographic and obstetric data of multigravid women who gave birth at a maternity hospital in Tucumán, Argentina, between 2005 and 2010: 949 women without previous PTB nor pregnancy loss who delivered at term and 552 who had spontaneous PTB. NSES was estimated from the Unsatisfied Basic Needs index of census data. Variables selected through penalised regressions were used to create a data-driven Bayesian network; then, pathways were identified and mediation analyses performed. RESULTS: Maternal age less than 20 years mediated part of the protective effect of high NSES on spontaneous PTB [natural indirect effect (NIE) -0.0125, 95% confidence interval (CI) (-0.0208, -0.0041)] and on few prenatal visits (< 5) [NIE - 0.0095, 95% CI (-0.0166, -0.0025)]. These pathways showed greater sensitivity to unobserved confounders that affect the variables mediator-outcome in the same direction, and exposure-mediator in the opposite direction. They did not show sensitivity to observed potential confounders, nor to the parameterization used to define NSES. Meanwhile, urinary tract infections showed a trend in mediating the effect of low NSES on spontaneous PTB [NIE 0.0044, 95% CI (-0.0006, 0.0093), P 0.0834]. CONCLUSIONS: High NSES has protective indirect effects on spontaneous PTB risk, mainly associated with a lower frequency of teenage pregnancy.

6.
Cult Health Sex ; : 1-16, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38315580

RESUMO

Using a feminist narrative approach, this article explores how unintended pregnancy can rupture young lives, and how young people respond to and navigate these ruptures. We analyse qualitative data from a longitudinal cohort study in Luwero, Uganda, focusing on narratives of a girl and a boy about their recent experiences of unintended and unwanted pregnancy during COVID-19 school closures. We argue that laws, policies and norms relating to education, sexual and reproductive health, and the family in Uganda position young people in complex and contradictory ways, that create the conditions for unintended pregnancies, and restrict the choices open to them. The analysis traces how pregnancy ruptures their everyday lives, their identities, and relationships. Their narratives reveal gendered ways in which they enact identities to manage the ruptures. Families are sites of contestation, where gender and sexuality are regulated, but are also mobilised by young people to support their efforts to repair the ruptures. Our analysis underscores the importance of working with young people to understand their positionalities, resource environments and social networks as they make and navigate decisions about pregnancy, and of addressing the structural forces that underpin the rupturing effects of pregnancy on teenage lives.

7.
Cult Health Sex ; 26(4): 563-574, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37052126

RESUMO

Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.


Assuntos
Violência de Gênero , Gravidez na Adolescência , Gravidez , Adolescente , Feminino , Humanos , Peru , Violência , Indonésia
8.
Cult Health Sex ; 26(1): 30-45, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37105132

RESUMO

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.


Assuntos
Gravidez na Adolescência , Gravidez , Adolescente , Feminino , Humanos , Masculino , Papel de Gênero , Colômbia/epidemiologia , Estudos Transversais , Estudos Retrospectivos
9.
Artigo em Inglês | MEDLINE | ID: mdl-38789834

RESUMO

BACKGROUND: The risks of sexually transmitted infections (STIs) and teenage pregnancy in the offspring of parents with schizophrenia remain unknown. METHODS: From the Taiwan National Health Insurance Research Database, 5,850 individuals born between 1980 and 1999 having any parent with schizophrenia and 58,500 age-, sex-, income- and residence-matched controls without parents with severe mental disorders were enrolled in 1996 or on their birthdate and followed up to the end of 2011. Those who contracted any STI or became pregnant in adolescence during the follow-up period were identified. RESULTS: Cox regression analyses demonstrated that offspring of parents with schizophrenia (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 1.02-1.44), especially daughters (HR: 1.30, 95% CI: 1.06-1.58), were more likely to contract any STI later in life than the control comparisons. In addition, daughters of parents with schizophrenia had an elevated risk of being pregnant in their adolescence (HR: 1.47, 95% CI: 1.29-1.67) compared with those having no parents with severe mental disorders. DISCUSSION: The positive relationship between parental schizophrenia and offspring STIs and teenage pregnancy necessitates clinicians and public health officers to closely monitor the sexual health in the offspring of parents with schizophrenia so that optimal and prompt preventive measures can be taken in the at-risk group.

10.
J Pediatr ; 253: 135-143.e6, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36179892

RESUMO

OBJECTIVES: To study sexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior. STUDY DESIGN: Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother's first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure. RESULTS: A linear dose-response relationship existed between gestational age and STCT and teenage pregnancy; adjusted hazard for STCT decreased by 1.6% (95% CI, 0.7%-2.6%), and for teenage pregnancy by 3.3% (95% CI, 1.9%-4.8%) per each week decrease in gestational age. Those born extremely preterm (23-27 completed weeks) had a 51% (95% CI, 31%-83%) lower risk for criminal offending than their full-term born counterparts, and those born very preterm (range, 28-31 weeks) had a 28% (95% CI, 7%-53%) higher hazard for payment defaults than those born at full term. Gestational age was not associated with substance abuse. CONCLUSIONS: The lower risk-taking that characterizes people born preterm seems to generalize to sexual and to some extent criminal behavior. Those born very preterm are, however, more likely to experience payment defaults.


Assuntos
Gravidez na Adolescência , Nascimento Prematuro , Transtornos Relacionados ao Uso de Substâncias , Recém-Nascido , Criança , Gravidez , Feminino , Humanos , Adulto Jovem , Adolescente , Adulto , Estudos de Coortes , Idade Gestacional , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Assunção de Riscos , Nascimento Prematuro/epidemiologia
11.
BMC Womens Health ; 23(1): 23, 2023 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-36650514

RESUMO

BACKGROUND: Teenage pregnancies are persistently high among adolescent women in high fertility countries in sub-Saharan Africa. It has been attributed to the high unmet need for family planning in this population. The aim of this study was to determine the prevalence and factors associated with teenage pregnancy in high fertility countries in sub-Saharan Africa. METHODS: Data for this study was obtained from the most recent Demographic and Health Surveys. A total weighted sample of 33,391 adolescent girls who had ever had sexual contact were included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors for teenage pregnancy. Finally, the Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to declare as statistically significant. RESULTS: The overall teenage pregnancy in sub-Saharan Africa high frtility countries was 24.88% (95% CI, 24.42, 25.35). Educational status; no formal education (AOR = 1.39, 95% CI, 1.23, 1.56) and primary education (AOR = 1.45, 95% CI, 1.30, 1.62), not working (AOR = 1.32, 95% CI, 1.21, 1.45), being married (AOR = 67.88, 95% CI, 61.33, 75.12), poor (AOR = 1.47, 95% CI, 1.32, 1.65) and middle wealth quantile (AOR = 1.21, 95% CI, 1.07, 1.35), knowledge about contracptives (AOR = 2.45, 95% CI, 2.19, 2.74), unmet need for family planning (AOR = 2.42, 95% CI, 2.14, 2.74), Angola (AOR = 9.59, 95% CI, 7.82, 11.77), Chad (AOR = 3.05, 95% CI, 2.49, 3.74), DR.Congo (AOR = 3.77, 95% CI, 3.06, 4.65), and Mali (AOR = 1.84, 95% CI, 1.47, 2.28) were factors significantly associated with teenage pregnancy. CONCLUSIONS: This study found that teenage pregnancy remains a common public health problem in the study areas. Level of education, marital status, occupation, wealth index, unmet need for family planning, knowledge about contraceptives, and country were significantly associated with teenage pregnancy. Hence, for sustainable development goal 3 to be realized by 2030, there must be investment in policy implementation and evaluation, as well as engagement with stakeholders in adolescents' sexual and reproductive health.


Assuntos
Gravidez na Adolescência , Gravidez , Adolescente , Feminino , Humanos , Análise Multinível , Prevalência , Comportamento Sexual , Fertilidade , Inquéritos Epidemiológicos
12.
BMC Public Health ; 23(1): 218, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36726092

RESUMO

BACKGROUND: Generally, recurrent teenage pregnancies are public health menaces that impede the quality of life of teenage mothers, their offspring, and society as a whole. However, there is paucity of information regarding factors influencing this social issue especially, in developing countries where Ghana is no exception. Moreover, this menace has been least investigated from the perspective of the teenager with multiple pregnancies. Hence, this study aimed at identifying the factors influencing recurrent teenage pregnancies and the challenges confronted by these teenage mothers. METHOD: This study is a phenomenological qualitative study that was conducted in the Effutu Municipality in the Central Region of Ghana. Employing convenience and snowball sampling, 40 participants who were residents of the study area, had a child each, and were pregnant at the time of the study were included. Other participants included teenage mothers who had at least two (2) children. A face-to-face in-depth interview with the help of an interview guide was conducted. Proceedings were recorded, transcribed, and analysed using thematic analysis. Quotations were used in the result presentation. RESULTS: The results of the study revealed that factors influencing recurrent teenage pregnancies are multifactorial. It includes peer pressure, parental neglect, poverty, living with a partner, and inadequate knowledge of family planning. The teenager with recurrent pregnancy is confronted with financial difficulties and is faced with stigmatisation in the society where she finds herself. CONCLUSION: To this effect, it is important to intensify education on family planning and good parental practices among parents with teenage mothers while providing a similar form of sensitization for members of the society about the harmful effects of stigmatisation on the teenage mother and her children. Again, a social support network for teenagers with recurrent pregnancies could be formed to help curb this public health menace.


Assuntos
Gravidez na Adolescência , Gravidez , Feminino , Adolescente , Criança , Humanos , Mães Adolescentes , Gana , Qualidade de Vida , Serviços de Planejamento Familiar , Mães
13.
BMC Public Health ; 23(1): 794, 2023 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-37118688

RESUMO

BACKGROUND: Child marriage persists in many countries and has severe impacts on health, education, economic and social status of girls. Child marriage has many interlinked causes. This study aimed to explore the drivers of child marriage in specific contexts in Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia. METHODS: The study combined a household survey among youth (15-24 years) with focus group discussions and interviews conducted with youth (15-24 years) and parents. A variety of community stakeholders were interviewed as well. Logistic regression was done to explore associations between individual and family-level characteristics of young women and the occurrence of child marriage. Transcripts were analysed using an inductive approach. Narratives on the main drivers of child marriage across study contexts were written and inspired by the theory of normative spectrum. RESULTS: A lack of education was associated with the occurrence of child marriage in Ethiopia, Kenya and Zambia. In all countries, teenage pregnancy was associated with child marriage. In Ethiopia, Kenya and Mozambique, fathers' education seemed a protective factor for child marriage. Narratives of study participants showed that in Ethiopia, Indonesia and (to a lesser extent) Kenya, child marriage was perceived as an 'appropriate practice' to avoid premarital sex or pregnancy, whether it involved sex with or without consent. In all countries, child marriage was driven by difficult economic circumstances, which were often intertwined with disapproved social circumstances, in particular teenage pregnancy, in case of Kenya, Malawi, Mozambique and Zambia. These circumstances made child marriage an 'acceptable practice'. Some youth, particularly in Indonesia, made their own choices to marry early, making child marriage a 'possible practice'. CONCLUSIONS: Multiple intersecting drivers, which were present in different degrees in each country setting, influenced the occurrence of child marriage. We found that child marriage is a manifestation of social norms, particularly related to girls' sexuality, which are intersecting with other factors at individual, social, material, and institutional level - most prominently poverty or economic constraints. Child marriage was, in some cases, a result of girls' agentic choices. Efforts to prevent child marriage need to take these realities of girls and their families into account.


Assuntos
Casamento , Adolescente , Feminino , Humanos , Gravidez , Etiópia , Indonésia , Quênia , Malaui , Moçambique , Zâmbia , Adulto Jovem
14.
BMC Public Health ; 23(1): 2184, 2023 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-37936107

RESUMO

BACKGROUND: Teenage pregnancy is a global public health issue, and it poses a serious threat to the health and socioeconomic status of mothers and their newborn children. Although Papua New Guinea has recorded one of the highest teenage pregnancy rates among Asia-Pacific countries, few studies have conducted research on the related inequality in the country. Therefore, this study aimed to assess socioeconomic inequality in teenage pregnancy and its contributing factors in Papua New Guinea. METHODS: Data for this cross-sectional study were obtained from the 2016-2018 Papua New Guinea Demographic and Health Survey. The analytical sample consisted of 2,864 girls aged 15-19 years. We employed Erreygers normalized concentration index (ECI) and concentration curves to measure and depict socioeconomic inequality in teenage pregnancy. Decomposition analysis was likewise performed to identify the contributions of determinants to the observed inequality. RESULTS: Weighted ECI for teenage pregnancy was - 0.0582 (P < 0.001), thereby indicating that teenage pregnancy in Papua New Guinea is disproportionately concentrated among poor girls. Decomposition analysis suggested that education level (65.2%), wealth index (55.2%), early sexual debut (25.1%), region (8.5%), and sex of household head (4.1%) are the main determinants explaining the pro-poor socioeconomic inequality in teenage pregnancy. CONCLUSIONS: A pro-poor socioeconomic inequality of teenage pregnancy was present in Papua New Guinea. This inequality may be alleviated by such interventions as ensuring that teenage girls receive education; implementing poverty alleviation projects, eliminating child, early, and forced marriages; strengthening promotion for household head to support teenagers in accessing sexual and reproductive health education; improving geographical accessibility to health facilities on contraceptive services, and taking necessary precautions and responses to sexual misconduct.


Assuntos
Gravidez na Adolescência , Gravidez , Feminino , Recém-Nascido , Adolescente , Humanos , Fatores Socioeconômicos , Estudos Transversais , Papua Nova Guiné/epidemiologia , Classe Social
15.
Reprod Health ; 20(1): 16, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653839

RESUMO

BACKGROUND: Teenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy as well as its individual and contextual determining factors. METHODS: A total pooled weighted sample of 10,010 teenagers (in the age group 15-19) from four waves of the Zambia Demographic and Health Surveys were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Bayesian parameter estimates were produced using lme4 package in R statistical programming environment. RESULTS: Results of the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four survey. In multilevel analysis, the odds of being pregnant were higher for teenagers who were employed (aOR = 1.21, 95% CI: 1.02-1.42), married (aOR = 7.71, 95% CI: 6.31-9.52) and those with knowledge of ovulation period (aOR = 1.58, 95% CI: 1.34-1.90). On the other hand, belonging to households in high wealth quintiles, being literate, exposure to mass-media family planning messages and delayed sexual debut were associated with decreased odds of teenage pregnancy. CONCLUSION: The study shows that teenage pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy include marital status, and employment, knowledge of ovulation period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.


Teenage pregnancy continues to be a major social and public health challenge in developing countries, particularly in Sub-Saharan Africa (SSA), where prevalence rates are on the rise. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. This study in Zambia, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy as well as its individual and contextual determining factors. Here, we used a pooled dataset from Zambia's 2001 to 2018 DHS to run separate multilevel logistic regression models to examine several individual and contextual level factors influencing teenage pregnancy. Findings show that trends of teenage pregnancy in Zambia have shown an overall decrease of only 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy. The study shows that teenage pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.


Assuntos
Gravidez na Adolescência , Gravidez , Feminino , Adolescente , Criança , Humanos , Zâmbia/epidemiologia , Análise Multinível , Teorema de Bayes , Comportamento Sexual , Inquéritos Epidemiológicos
16.
Reprod Health ; 20(1): 163, 2023 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-37925395

RESUMO

BACKGROUND: Pregnancy and childbirth complications are the leading cause of death among girls aged 15-19 years globally, with low- and middle-income countries (LMICs) accounting for 99% of global maternal deaths of women aged 15-49 years. Despite teenage pregnancies declining in many developing countries in recent years, the COVID-19 period intensified the problem and altered the trend for most countries. We determined the effect of the COVID-19 lockdown on the teenage pregnancy trend in Pakwach district, Uganda, to understand its magnitude in our study population. METHODS: Using interrupted time series analysis (ITS), sometimes known as quasi-experimental time series analysis. We constructed a time series of the first ANC service utilization records for girls aged 10-19 years in Pakwach district, Uganda, and conducted an interrupted series analysis. We compared the two periods of March 2019 to March 2020 and March 2020 to March 2021. We used Stata 15 to conduct our analysis, performed OLS, and plotted the results. RESULTS: The teenage pregnancy trend before the lockdown was decreasing by - 0.203 pregnancies per month, but in the first month after the institution of the lockdown (March 20, 2020), there was an increase in the teenage pregnancy rate of 13.9 pregnancies [95% CI: - 33.6 to 61.5], which corresponds to an increase in the monthly trend in teenage pregnancies (relative to the period before the COVID-19 lockdown trend) of 1.53 girls per month. CONCLUSION: Teenage pregnancies increased during the lockdown. This slight increase depicted the impact of the pandemic on the teenage pregnancy trend associated with the COVID-19 outbreak. The government needs to focus on intervention to reduce this trend and avoid any further increases.


Assuntos
COVID-19 , Gravidez na Adolescência , Gravidez , Adolescente , Humanos , Feminino , Uganda/epidemiologia , Análise de Séries Temporais Interrompida , COVID-19/epidemiologia , Controle de Doenças Transmissíveis
17.
Cult Health Sex ; 25(1): 33-47, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34951335

RESUMO

Teenage pregnancy rates in the Peruvian Amazon are double the national average and among the highest in Latin America. Peruvian women living in rural, underserved and Amazon areas are more likely to become teenage mothers but the factors contributing to this socio-demographic trend are unclear. Thirty-one interviews and ethnographic observations of teenage and adult mothers living in the Peruvian Amazon were conducted to examine how social class and gender impacted their motherhood experiences. Despite preconceptions concerning the undesirability of teenage pregnancy, results show that teenage and adult mothers have similar experiences of motherhood. Both groups of women lack career and educational opportunities and are therefore economically dependent on men. This, combined with the cultural valorisation of motherhood, pushes them toward pregnancy and motherhood. In other words, pregnancy is a response to a lack of career and educational opportunities and not vice versa. The one difference found between teenage and adult mothers is that the former have less agency over reproductive decision making. In conclusion, motherhood among teenage and adult mothers in the Peruvian Amazon is an adaptive mechanism that gives women protection and fulfilment but is also the result of gender and class constraints that limit their life choices.


Assuntos
Gravidez na Adolescência , Gravidez , Adulto , Masculino , Adolescente , Feminino , Humanos , Peru , Pobreza , Mães , Escolaridade
18.
Cult Health Sex ; 25(9): 1116-1130, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36309823

RESUMO

Over the past few decades growing attention has focused on the perceived challenge of adolescent pregnancy and the need for girls to make 'smart choices'. This has generated considerable debate particularly because of the failure of many programmes and interventions to consider the structural constraints faced by young women in accessing sexual and reproductive health and rights (SRHR). Yet limited attention has been given to the views and experiences of girls' parents and caregivers, many of whom were often adolescent parents themselves. We use data from the Real Choices, Real Lives longitudinal study conducted by Plan International to consider how the experiences of girls' families shape their attitudes to teenage pregnancy in the Dominican Republic and El Salvador. Many families believe girls need to practise abstinence and avoid men and boys but given the lack of provision for SRHR faced by young women this response is not unexpected.


Assuntos
Gravidez na Adolescência , Gravidez , Masculino , Adolescente , Humanos , Feminino , República Dominicana , El Salvador , Estudos Longitudinais , Comportamento Sexual , Atitude
19.
Eur Child Adolesc Psychiatry ; 32(10): 2001-2008, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35771292

RESUMO

Teenage pregnancy is a major public health concern. However, few studies have investigated the relationship between pediatric bipolar disorder and early pregnancy, and whether bipolar disorder medications reduce the risk of early pregnancy remains unknown. In total, 3218 adolescent girls with bipolar disorder and 32,180 controls matched for age, family income, residence, and time of enrollment were enrolled in this study from 2001 to 2009. Early pregnancy, defined as pregnancy occurring in patients younger than 20 years old, was identified during the follow-up period from enrollment until the end of 2011. After adjustment for demographic data, psychiatric comorbidities, and bipolar disorder medications, adolescent girls with bipolar disorder had 20 times the risk of early pregnancy (hazard ratio [HR] = 20.63, 95% confidence interval [CI] [15.68, 27.16]) and about 25 times the risk of repeated early pregnancy (HR = 24.59, 95% CI [15.20, 39.78]) compared with those without bipolar disorder. Long-term use of both mood stabilizers (HR = 0.34, 95% CI [0.23, 0.52]) and atypical antipsychotics (HR = 0.32, 95% CI [0.20, 0.51]) was associated with a reduced risk of early pregnancy. Bipolar disorder was associated with an increased risk of early pregnancy in adolescent girls. Bipolar disorder medications reduced this risk. The results suggest that interventions targeting the vulnerable population of adolescent girls with bipolar disorder are warranted to prevent early pregnancies.


Assuntos
Antipsicóticos , Transtorno Bipolar , Gravidez na Adolescência , Gravidez , Feminino , Humanos , Adolescente , Criança , Adulto Jovem , Adulto , Estudos de Coortes , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Gravidez na Adolescência/psicologia , Fatores de Risco , Antipsicóticos/uso terapêutico
20.
Afr J Reprod Health ; 27(10): 46-56, 2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37915131

RESUMO

Teenage pregnancy occurring in girls aged 10-19 years remains a serious worldwide health problem. Stillbirths and newborn deaths are 50% higher among infants born to adolescent mothers than among those born to mothers aged 20-29 years, which contributes to the increased deliveries of newborn babies among females aged 10 to 19 years. The aim of the study was to gain understanding of the views of teenagers towards teenage pregnancy in the Capricorn district, Limpopo province. A qualitat ive, explorative, and descriptive study was adopted. The target population constituted 15 purposively selected male and female teenagers aged between 13 and 19 years, from three secondary schools. Data were collected using in-depth interviews and analysed using the thematic approach. An inductive thematic approach was used to identify common and recurring themes. Four themes emerged during data collection namely: essentially, optionally, socio-cultural, and economic motivated influences. The findings showed that peer pressure, lack of knowledge on sexual issues, social media, inadequate parental guidance and support, poor access to health facilities, awkward operating hours, bad attitudes of nurses, and absence of youth-friendly services space contribute to the increased number of teenage pregnancies.


Les grossesses adolescentes survenant chez les filles âgées de 10 à 19 ans restent un grave problème de santé mondial. Les mortinaissances et les décès de nouveau-nés sont 50 % plus élevés chez les nourrissons nés de mères adolescentes que chez ceux nés de mères âgées de 20 à 29 ans, ce qui contribue à l'augmentation des accouchements de nouveau-nés chez les femmes âgées de 10 à 19 ans. Le but de l'étude était de mieux comprendre les opinions des adolescentes à l'égard de la grossesse précoce dans le district du Capricorne, province du Limpopo. Une étude qualitative, exploratoire et descriptive a été adoptée. La population cible était constituée de 15 adolescents et adolescentes sélectionnés à dessein, âgés de 13 à 19 ans, issus de trois écoles secondaires. Les données ont été collectées à l'aide d'entretiens approfondis et analysées selon l'approche thématique. Une approche thématique inductive a été utilisée pour identifier des thèmes communs et récurrents. Quatre thèmes ont émergé lors de la collecte des données, à savoir : essentiellement, facultativement, les influences socioculturelles et économiques. Les résultats ont montré que la pression des pairs, le manque de connaissances sur les questions sexuelles, les médias sociaux, l'encadrement et le soutien parental inadéquats, le faible accès aux établissements de santé, les horaires d'ouverture difficiles, les mauvaises attitudes des infirmières et l'absence d'espace de services adaptés aux jeunes contribuent à l'augmentation de la population. nombre de grossesses chez les adolescents.


Assuntos
Gravidez na Adolescência , Gravidez , Lactente , Recém-Nascido , Adolescente , Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Comportamento Sexual , Coleta de Dados , Necessidades e Demandas de Serviços de Saúde
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