Search

AbstractBackgroundAimMethodsResultsConclusion\nSHORT CONDENSATIONIn low- and middle-income countries, pregnancy in adolescence represents an important public health issue. Rates of early pregnancy have significant social and economic consequences that extend beyond the individual sphere, impacting public/governmental budgets.To estimate the cost implications of early pregnancies from the perspective of the Brazilian Unified Public Health System.This retrospective secondary data analysis focuses on assessing direct hospital costs. The study cohort comprises adolescents and young adults who underwent prenatal care at a reference maternity hospital between January and December 2021. Individual procedure costs were extracted from hospital records and converted into monetary values using the Brazilian Federal Fee. The sample size for each group was determined based on preliminary data collected during a pilot study. Descriptive analyses presented costs stratified by age groups. To estimate budgetary impacts and sensitivity we used national live birth incidence rates.The mean cost per case of adolescent pregnancy was US$ 704.92 (SD: 1,707.74) and for adult pregnancy was US$ 592.40 (SD: 941.43). The cost of hospital admission accounted for 61% of the total cost of adolescent pregnancies. The annual budget impact of pregnancies among women under 30 years was estimated at US$ 1 billion, with 239 million coming from women under 20 years old.Pregnancy in adolescence may lead to a significant annual budget impact, representing 24% of costs attributed to pregnancies among women under 30 years. Costs related to hospital admissions and complications represent a substantial share of the total costs of adolescent pregnancy.Rates of early pregnancy have significant social and economic consequences that extend beyond the individual sphere, impacting public/governmental budgets. This article provides the annual impact of adolescent pregnancy on public health in Brazil, which amounts to US$ 239 million. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Setting Population Methods Main Outcome Measures Results Conclusions Child marriage forces a girl into adult roles before physical and psychological maturity, which can take a toll on women's health over the life course. This article aims to assess whether child marriage and adolescent childbearing are associated with elevated risk of gynaecologic disorders leading to hysterectomy.Cross‐sectional and time‐to‐event analysis.India.528 816 ever‐married women, aged 20–49 years.Women were grouped in four mutually exclusive categories: (i) married adult—not an adolescent mother (reference category), (ii) married adult—adolescent mother, (iii) married child—not an adolescent mother and (iv) married child—adolescent mother. Multivariable logistic regressions were fitted to assess the odds of hysterectomy for these groups. Nonparametric Kaplan–Meier survivor functions were estimated to evaluate survival rates across the groups.Whether had a hysterectomy and age when hysterectomy was performed.Compared to women married as adults, not an adolescent mother, women married in childhood and gave birth in adolescence were 1.87 (95% CI: 1.78–1.96) times more likely to have a hysterectomy. The latter group also had the lowest survival probability for hysterectomy at all ages (e.g., 85.80% [95% CI: 85.41–86.18] at age 49 years as compared to 91.65% [95% CI: 91.37–91.89] for the former group). Women married as children but not adolescent mothers and married as an adult but gave birth in adolescence also had higher odds of hysterectomy—1.40 (95% CI: 1.31–1.50) and 1.53 (95% CI: 1.40–1.66) times of that of the reference group, respectively.Our results, showing a strong relationship between child marriage and hysterectomy, contribute to the literature on later‐life health consequences of child marriage. [ABSTRACT FROM AUTHOR]

Teenage pregnancy is considered a public health problem, although the fertility rate in this age group has decreased, in Portugal in 2022 there were 6.2 ‰ pregnant teenagers. Some, without family support and in a situation of increased vulnerability; reside in shelter institutions, leading pregnant women to require psychosocial intervention to develop personal and parental skills that are fundamental to fulfilling the role of mother. Social support is essential to protect pregnant women and children, prevent risky behavior and promote the development of parental skills, facilitating the transition process to parenthood. The insufficient number of employees in social and health institutions has a negative impact on the development of their personal, social, professional or parental skills among pregnant teenagers. Objective: understand the process of acquiring parental skills among institutionalized pregnant teenagers. Methods Exploratory, descriptive study with a qualitative approach, using interviews with seven pregnant teenagers living in three shelter institutions. Results: The content analysis of the report of the life experiences of 7 participants reveals fear and insecurity. They consider nurses' support during pregnancy to be important for the acquisition of parental skills through the integration of childbirth and parenting preparation programs. They reveal a lack of postpartum support. Emphasizing that the support of techniques from the host institution is important. Conclusions. Pregnant teenagers need psychosocial support, pregnancy monitoring and postpartum follow-up that is more suited to individual needs. Greater coordination and complementarity between health and social services is imperative. [ABSTRACT FROM AUTHOR]

The impact of community-wide teen pregnancy prevention initiatives (CWIs) on local U.S. birth rates among adolescents aged 15 to 19 years was examined using synthetic control methodology within a quasi-experimental design. CWIs were implemented in 10 U.S. communities from 2010 to 2015. Each initiative implemented evidence-based teen pregnancy prevention interventions at local organizations and enhanced best practices in adolescent reproductive health care at local health centers, while engaging diverse community sectors. The synthetic control method was used to estimate the impact of each CWI on overall and race- and ethnicity-specific teen births relative to rates in synthetic control communities. Additionally, we estimated the overall effect of CWIs across communities by pooling results from the 10 synthetic control case studies using the mean percentile rank. Pooled data across all 10 communities indicated an estimated average of 6.6 fewer births per 1000 teens per year overall during the initiative relative to each community's synthetic control (p =.001). By race and ethnicity, there were an estimated average of 6.4 fewer births per 1000 teens per year among Black teens (p =.03), 10.7 fewer births among Hispanic teens (p =.03), and 4.2 fewer births (p =.10) among White teens. Results from individual communities indicated an intervention effect on overall and/or race/ethnicity-specific teen birth rates in five communities. This study demonstrates the value of synthetic control methods in evaluating community-level outcomes of programmatic efforts. Findings indicate the CWIs had a positive impact on teen birth rates and have the potential to address racial and ethnic disparities in those rates. [ABSTRACT FROM AUTHOR]

Background: Every human being has the right to affordable, high-quality health services. However, mothers and children in wealthier households worldwide have better access to healthcare and lower mortality rates than those in lower-income ones. Despite Somalia's fragile health system and the under-5 mortality rate being among the highest worldwide, it has made progress in increasing reproductive, maternal, and child health care coverage. However, evidence suggests that not all groups have benefited equally. We analysed secondary 2006 and 2018–19 data to monitor disparities in reproductive, maternal, and child health care in Somalia. Methods: The study's variables of interest are the percentage of contraceptive prevalence through modern methods, adolescent fertility rate, prenatal care, the rate of births attended by midwives, the rate of births in a health care facility, the rate of early initiation of breastfeeding, stunting and wasting prevalence and care-seeking for children under-five. As the outcome variable, we analysed the under-five mortality rate. Using reliable data from secondary sources, we calculated the difference and ratio of the best and worst-performing groups for 2006 and 2018–19 in Somalia and measured the changes between the two. Results: Between 2006 and 2018–19, An increase in the difference between women with high and low incomes was noticed in terms of attended labours. Little change was noted regarding socioeconomic inequities in breastfeeding. The difference in the stunting prevalence between the highest and lowest income children decreased by 20.5 points, and the difference in the wasting prevalence of the highest and the lowest income children decreased by 9% points. Care-seeking increased by 31.1% points. Finally, although under-five mortality rates have decreased in the study period, a marked income slope remains. Conclusions: The study's findings indicate that Somalia achieved significant progress in reducing malnutrition inequalities in children, a positive development that may have also contributed to the decrease in under-five mortality rate inequities also reported in this study. However, an increase in inequalities related to access to contraception and healthcare for mothers is shown, as well as for care-seeking for sick children under the age of five. To ensure that all mothers and children have equal access to healthcare, it is crucial to enhance efforts in providing essential quality healthcare services and distributing them fairly and equitably across Somalia. [ABSTRACT FROM AUTHOR]

Background: The prevalence of teenage pregnancy in Colombia is higher than the worldwide average. The identification of socio-geographical disparities might help to prioritize public health interventions. Aim: To describe variation in the probability of teenage maternity across geopolitical departments and socio-geographical intersectional strata in Colombia. Methods: A cross-sectional study based on live birth certificates in Colombia. Teenage maternity was defined as a woman giving birth aged 19 or younger. Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was applied using multilevel Poisson and logistic regression. Two different approaches were used: (1) intersectional: using strata defined by the combination of health insurance, region, area of residency, and ethnicity as the second level (2) geographical: using geopolitical departments as the second level. Null, partial, and full models were obtained. General contextual effect (GCE) based on the variance partition coefficient (VPC) was considered as the measure of disparity. Proportional change in variance (PCV) was used to identify the contribution of each variable to the between-strata variation and to identify whether this variation, if any, was due to additive or interaction effects. Residuals were used to identify strata with potential higher-order interactions. Results: The prevalence of teenage mothers in Colombia was 18.30% (95% CI 18.20–18.40). The highest prevalence was observed in Vichada, 25.65% (95% CI: 23.71–27.78), and in the stratum containing mothers with Subsidized/Unaffiliated healthcare insurance, Mestizo, Rural area in the Caribbean region, 29.08% (95% CI 28.55–29.61). The VPC from the null model was 1.70% and 9.16% using the geographical and socio-geographical intersectional approaches, respectively. The higher PCV for the intersectional model was attributed to health insurance. Positive and negative interactions of effects were observed. Conclusion: Disparities were observed between intersectional socio-geographical strata but not between geo-political departments. Our results indicate that if resources for prevention are limited, using an intersectional socio-geographical approach would be more effective than focusing on geopolitical departments especially when focusing resources on those groups which show the highest prevalence. MAIHDA could potentially be applied to many other health outcomes where resource decisions must be made. [ABSTRACT FROM AUTHOR]

Adolescent pregnancy is a major public health issue with profound implications for health and socioeconomic factors. The use of long-acting reversible contraception (LARC) could be an interesting strategy to reduce the unintended pregnancy rate. However, the cost of LARC is still a barrier to widespread adoption. This study aimed to analyze the effectiveness and economic impact of LARC compared with non-LARC methods in preventing unintended pregnancy among adolescent girls. This systematic review was registered in PROSPERO (CRD42023387735) and conducted following the PRISMA guidelines. We included articles covering adolescents aged 10-19 years without language restrictions that evaluated the use of LARC compared with non-LARC in terms of effectiveness and the public health costs of unintended pregnancy. The search for articles included the databases MEDLINE/PubMed, Cochrane Library, Embase, and Lilacs, using the entry terms "Adolescent" and "Long-Acting Reversible Contraception." We evaluated the risk of bias and the certainty of the evidence for each outcome of interest. The search retrieved a total of 1,169 articles and, after the title and abstract, we identified 40 articles for full-text analysis. Out of the 40 studies evaluated, 4 articles met the eligibility criteria for cost evaluation, and 1 met the eligibility criteria for effectiveness as an outcome. In conclusion, LARC emerges as the most effective and cost-effective contraceptive method. The cost of utilizing LARC, especially the copper IUD, is significantly lower than the costs attributable to unintended pregnancies in adolescence. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy is a significant public health issue in Mexico; its prevalence oscillates around 20% of all pregnancies. Concurrently, alcohol, tobacco, and illicit drug use have become more common in this age group. Methods: To estimate the prevalence of substance exposure in a population of pregnant teenagers, we conducted a prospective, observational, and cross-sectional study. The protocol was approved by the institutional review board. On informed consent, we asked 420 consecutive pregnant youngsters cared for at the outpatient obstetric service of a tertiary public regional women's and children's hospital in Nuevo León, in northeast Mexico, to answer a previously validated questionnaire to estimate the prevalence of alcohol, tobacco, or illicit drugs use during pregnancy. Results: Of the 420 participants, 317 (75.5%) consumed at least one substance during pregnancy. Alcohol, either alone or in combination, was consumed by 300 (71.7%) participants. Tobacco was used by 117 (27.8%) participants, almost always in combination with other substances, while marijuana and other illicit drugs were consumed by 92 (21.9%) participants. Approximately one-fourth of the participants, 102 (24.1%) reported no substance use during pregnancy. Conclusions: In this series, the reported prevalence of alcohol, tobacco, and illicit drugs consumption during pregnancy, explored with a validated instrument, is higher than that previously reported in our country. This fact offers a worrying picture of another set of factors adding to the burden of teenage pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the feasibility of implementing the nursing intervention Breastfeeding Counseling (5244) in first‐time adolescent mothers and its effect on the knowledge and maintenance of exclusive breastfeeding in the first 6 months of life. Methods: Randomized, controlled feasibility study with 166 first‐time mothers between 14 and 19 years of age, from 20 to 30 weeks of gestation, assigned to an experimental group (nursing intervention: breastfeeding counseling) or a control group (usual education plus nursing intervention not related to breastfeeding). The rate of abandonment of exclusive breastfeeding and the level of knowledge about breastfeeding were evaluated. Findings: The inclusion was 91.7% (166/181), dropout during the intervention was 39.75% (n = 66), and loss in the follow‐up was 8.43% (n = 14). Compliance with the intervention protocol was 100%. The pregnant women and family members were satisfied with the intervention and perceived the health benefits for the mothers and their children. Outcome measures in the experimental group did not reveal a significant effect on breastfeeding abandonment rates at 2, 4, and 6 months postpartum, but they did manage to improve and maintain the level of knowledge about breastfeeding. Conclusions: It was found that it is feasible to implement the nursing intervention: "Breastfeeding counseling" in prenatal classes, achieving an increase in the level of knowledge about breastfeeding in adolescent mothers, but without a reduction in the rate of abandonment of breastfeeding. Nursing professionals need to know and address barriers to exclusive breastfeeding in adolescents. Implications for nursing practice: The nursing intervention "Breastfeeding counseling (5244)" and the outcome "Knowledge: Breastfeeding (1800)" supported the processes of education and knowledge assessment on breastfeeding in pregnant adolescents, which should be instituted in perinatal nursing care. [ABSTRACT FROM AUTHOR]

Unplanned teenage pregnancy is quite common in Brazil and often stems from a lack of sexual education. Consequently, this can lead to consecutive pregnancies among young girls who are unaware of information about contraceptive methods. Thus, this project aimed to support, clarify doubts, and disseminate information about the use of contraceptive methods for pregnant adolescents and those in the postpartum period. It is an experiential report conducted by eight medical students from the Federal University of Pernambuco (UFPE) on the interventions carried out at the Hospital das Clínicas - UFPE and the Family Health Units of Mangueira, Coqueiral II, São Miguel, and Bongi, all in Recife-PE (Brazil). The project consisted of two stages, one involving theoretical training for teachers and students and another involving practical application, which had to be adapted due to the absence of all patients in the scheduled group discussions, thus resorting to individual conversations. The project approached 74 pregnant and postpartum teenage girls, either remotely or in person, and 30 agreed to participate. The conversations involved informative topics about sexual education, and it was noted that 93.3% of the participants were interested in using contraception in the postpartum period, with 83.3% of them having already used contraceptives in the past and 53.3% knowing more than one method provided by the Unified Health System (SUS). After adapting the approach, the project had satisfactory adherence and could be a precursor to interventions regarding family planning during prenatal care for pregnant adolescents. [ABSTRACT FROM AUTHOR]

Adolescence is the transition phase to adulthood when physical, mental, and behavioral changes occur. The study evaluated the fertility rate of women aged 15 to 19 years living in the health macroregions of the state of Pará and their sociodemographic parameters, pregnancy and childbirth, from 2010 to 2020. The study is descriptive and analytical and uses data from SINASC/DATASUS. In 2014, the highest fertility rate (106.5%) was in Health Macroregion III. Single mothers or mothers in consensual unions, brown color/race, and between 8 and 11 years of study were the predominant ones. They had four to six prenatal care appointments between 37 and 41 weeks. Early pregnancy in adolescents exposes them to social and health risks such as school dropout, lack of support network in baby care, disadvantage in the labor market, and mental health problems. [ABSTRACT FROM AUTHOR]

Objective: To describe the activities of popular care in the face of emotional situations in the family unit of hypertensive adolescent pregnant women who consulted a health service provider institute in the municipality of Sincelejo (Sucre - Colombia) 2017-2018. Method: Qualitative ethnographic study, with the participation of 13 people to whom in-depth semi-structured surveys were applied. Results: Various popular care activities related to the emotional situation (feelings of anger, sadness, crying, fear, joy, tranquility, worry and despair) emerged, such as listening to music, attending religious events and talking with family members. Conclusions: The popular care activities carried out by pregnant adolescents based on emotional situations, allowed them to achieve well-being and satisfaction in their cultural environment. Therefore, it is essential to know popular care to provide humanized nursing care in a dynamic way when offering care at the home and at the hospital level. [ABSTRACT FROM AUTHOR]

Objective: describe the perception of nurses in primary care about prenatal care aimed at pregnant adolescents. Methods: This is a descriptive, cross-sectional study of a qualitative, developed in the Basic Health Units of Guamá in Belém -- Pará, from May to April 2021. Results: Fifteen nurses participated, guided by a semi-structured form, with the data analyzed using the Laurence Bardin technique, resulting in six categories about the perception of prenatal care with adolescents. We conclude that nurses are aware of the positive impact that nursing care has on the conduct of pregnancy and the formation of autonomy for adolescents. Conclusion: The perception of the positive impact of nursing care on prenatal care for pregnant teenagers is perceived, however, it needs structural improvements in care, continued training of professionals and early capture of pregnant teenagers. [ABSTRACT FROM AUTHOR]

Objective: Emergency contraception (EC) is an effective and safe method for preventing unplanned pregnancy after unprotected sexual intercourse among adolescents but is infrequently prescribed by pediatricians. Because of the scarcity of data on the discomfort with EC prescription among physicians in Brazil, this study aimed to identify associated factors with discomfort with EC prescription among pediatricians in the state of Amazonas. Methods: A web-based, cross-sectional study including sociodemographic data, knowledge, attitudes, and discomfort with EC prescription was used. Multivariate logistic regression and artificial intelligence methods such as decision tree and random forest analysis were used to identify factors associated with discomfort with EC prescriptions. Results: Among 151 physicians who responded to the survey, 53.0% were uncomfortable with prescribing EC, whereas only 33.1% had already prescribed it. Inexperience was significantly associated with discomfort with EC prescription (odds ratio 4.47, 95% confidence interval 1.71–11.66). Previous EC prescription was protective against discomfort with EC prescription in the three models. Conclusions: EC is still infrequently prescribed by pediatricians because of inexperience and misconceptions. Training these professionals needs to be implemented as part of public health policies to reduce unplanned adolescent pregnancy. [ABSTRACT FROM AUTHOR]

Ambivalence toward pregnancy is an important predictor of early pregnancy as documented in diverse Western societies. Inuit women from Nunavik, a northern region of Quebec, Canada, experience a high rate of early pregnancy, yet no study has explored their attitudes toward pregnancy. Grounded in a participatory approach, this study aimed to explore ambivalence toward pregnancy, among other pregnancy-related attitudes, and identify themes underlying ambivalence among young Inuit women from Nunavik. We conducted semi-structured interviews with 15 women aged 16 to 20 years, who became pregnant during the year preceding the interview. We used an inductive approach to analyse the data. Eleven participants were identified as ambivalent toward pregnancy while three were characterised as having a favourable attitude, and one as unfavourable. Four themes related to ambivalence were identified: the value of childbearing/motherhood; the use of contraceptives; the likelihood of becoming pregnant; and the ideal age to become pregnant. A better understanding of young women's attitudes toward pregnancy could contribute to the development of culturally relevant programmes to more effectively support adolescents, pregnant adolescents and young mothers, and to lead to better care. [ABSTRACT FROM AUTHOR]

Background: the beginning of sexual activity exposes adolescents to a series of risks that compromise their sexual and reproductive health, as well as their psychological and social development. Objective: to describe the application and results of an educational intervention on pregnancy in adolescence. Methods: an educational intervention study was carried out in adolescents from 12 to 18 years of age (N=107), belonging to the health area of the Francisco Peña Peña Polyclinic, Nuevitas municipality, Camagüey, from 2020 to 2021. The research was organized in three stages: diagnosis, intervention and evaluation. The studied variables were about the knowledge about the right age to start sexual relations; optimal age for pregnancy; contraceptive methods; and maternal and child complications of pregnancy in adolescence. Results: the intervention was able to raise knowledge about the appropriate age for the start of sexual intercourse, which ranged from 34.6% to 96.3%. About the optimal age to carry a pregnancy, 90.6% of adolescents were better oriented after applying the strategy. Once the study was completed, the level of knowledge in general rose to 85%. Conclusion: The educational intervention was effective in increasing knowledge about pregnancy in adolescence, and about the maternal and child complications that it entails in this stage of life. [ABSTRACT FROM AUTHOR]

Repeat adolescent pregnancy is a public health problem worldwide. Different interventions aimed at increasing the use of contraception and preventing repeat pregnancies have been implemented and their effectiveness has been evaluated. This systematic review evaluates the results of the efficacy of diverse interventions for contraceptive use and prevention of repeat pregnancies in adolescents. A search was conducted for articles published from 1985 to 2018 in the PubMed, Scopus, EBSCOhost, Web of Science, and ProQuest databases, including interventions with adolescents 15 to 19 years of age who were pregnant, postpartum or had a history of pregnancy. Significant results were found for an increase in contraceptive use and prevention of repeat adolescent pregnancy, leading to the conclusion that there are reports of high methodological quality multicomponent interventions for the prevention of repeat adolescent pregnancy that could be tested in other socio-economic and cultural contexts. [ABSTRACT FROM AUTHOR]

Objective: to determine the relationship of family support and other sociodemographic factors with the state of pregnancy in adolescent women between 13 and 19 years of age in Colombia. Material and Methods: an observational, cross-sectional study was carried out with analytical intent based on the results of the 2015 National Survey of Demography and Health. Expansion factors were used to estimate and describe the population characteristics. To determine the statistical relationship of family support with pregnancy adjusted for other sociodemographic factors, a binomial regression with logarithmic link model was performed. Results: 86.2% of the adolescents were not pregnant. Family support RP: 0.26, being under 15 years old RP: 0.34, having sex with a condom RP: 0.11, having information on safe sexual practices RP: 0.68 and having higher education RP: 0.51 were factors associated with pregnancy status. Discussion: it is important to implement and transform intersectoral policies and strategies that emphasize the inclusion of the family as a guideline for adolescents, in addition, to guide the topics of sexual health education according to age groups according to the level of maturity and autonomy that the teenager has. [ABSTRACT FROM AUTHOR]

Bacteriuria during pregnancy is a frequent and important cause of morbidity and complications. Data on its occurrence in pregnant adolescents are still scarce. A cross-sectional study was conducted at a tertiary teaching hospital in São Paulo, Brazil. All adolescents (≤18 years) who came for prenatal care between January 2010 and January 2016 were included. Sociodemographic characteristics, medical history, obstetric history, and the results of laboratory tests were selected. A urine sample was aseptically collected from each patient to undergo microscopic and culture analysis. A total of 388 pregnant adolescents averaging 15.30 ± 1.24 years of age were included. The frequency of bacteriuria in this group was 17.01% (66/388). The lack of sports practice (OR = 8.65; 95% CI, 1.09–68.39), the fact that pregnancy was desired (OR = 2.17; 95% CI, 1.08–4.34), and the use of hormonal methods of contraception (OR = 2.46; 95% CI, 1.04–5.84) turned out to be independent risk factors for bacteriuria. Protective factors were identified as late coitarche (OR = 0.75; 95% CI, 0.57–0.98) and a urine culture analysis at a later gestational age (OR = 0.94; 95% CI, 0.90–0.98). The most often isolated pathogens were Escherichia coli (49%) and Streptococcus agalactiae (18%). Bacteriuria among pregnant adolescents is a relatively common condition. The infection risk of the urinary tract was increased by physical inactivity and seemingly by the influence of behavioral and sexual factors. Such results can help to identify patients at risk, favoring the early diagnosis of urinary tract infections and optimizing prenatal care. [ABSTRACT FROM AUTHOR]

Background: Pregnancy in adolescence presents biological, economic, epidemiological and social vulnerabilities, making adherence to self-care practices fundamental to the well-being of the mother-child binomial. Objective: Analyze the influence of sociodemographic and clinical variables and the guidance received on adherence to best practices in prenatal care. Method: This is a descriptive quantitative study conducted with 30 pregnant adolescents who underwent prenatal follow-up in an outpatient clinic. Results: Mean age of participants was 15.7 years; they had their first sexual intercourse at age 13.7 and 7.5 years of formal education. Most participants had no paid occupation. They had a steady partner and, despite not having planned their pregnancies, they were desired. The worst self-care adherence score was observed in the weight control and nutrition domain, and the best in the risk behavior domain. Conclusion: Although there was no statistically significant correlation between the sociodemographic and clinical variables, adherence scores are higher when pregnant adolescents report having a steady partner, having planned their pregnancies, and having received guidance. [ABSTRACT FROM AUTHOR]

Objective  This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design  Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results  Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion  Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points Infant mortality risk was highest for adolescents <15 years old across racial/ethnic groups. Racial/ethnic disparities in timing of death were present even among the youngest adolescents. Infants of NHB adolescents had greatest risk of mortality, especially as age increased. Preterm birth influenced infant mortality risk, especially among NHB adolescents. [ABSTRACT FROM AUTHOR]

Background: Many low-and-middle-income countries, including South Africa, have high rates of teenage pregnancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. At the same time, South Africa's education department, in the interest of learners, promotes adolescents' early return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option.Methods: Recognising his this policy tension, we aimed to explore how policies are interpreted and implemented by the health and education sectors through interviews with key informants who produce, interpret and implement these policies. Using an interview guide developed for this study, we conducted in-depth interviews with 24 health policy makers, managers in both sectors, school principals and nursing staff who manage adolescent mothers (aged 16-19) and their babies. Data was analysed using thematic analysis.Results: Informants from both sectors expressed discomfort at pregnant learners remaining in school late in pregnancy and were uncertain about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breastfeeding was not common. While health professionals highlighted the benefits of extended breastfeeding for infants and mothers, they recognised the potential conflict between the need for the mother to return to school and the recommendation for longer breastfeeding. Additionally, the need for ongoing support of young mothers and their families was highlighted.Conclusions: Our findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breastfeeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents' mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage to facilitate the interests of both the mother and infant: some exclusive infant feeding together with a supported return to school for the adolescent mother. [ABSTRACT FROM AUTHOR]

Objective: to know the practice of breastfeeding among adolescent mothers in Rio Branco, Acre. Method: exploratory, cross-sectional study with a quantitative approach, developed with 30 teenage mothers. Data collection took place between May and June 2021, through a semi-structured interview. Data were organized into tables and analyzed by the Statistical Package for the Social Sciences (SPSS) version 20.0 with frequency distribution of the variables. Results: most had seven to nine prenatal consultations and were instructed on the importance of breastfeeding. They received support to breastfeed (90%), mainly by the family (93.3%). They found no difficulties in breastfeeding (53.3%). Among the participants who had problems when breastfeeding, 57.1% stopped the practice. They pointed out that breast milk is important for the child (23.3%) and that it prevents diseases (20%). Conclusion: adolescent mothers received guidance on breastfeeding from health professionals, as well as were supported by their family members to maintain breastfeeding, which addressed possible difficulties in this process. [ABSTRACT FROM AUTHOR]

The objective of this study was to verify the existence of a relationship between premature births and early pregnancies in the municipality of Ponte Nova - MG. For this, secondary data from SINASC was used, consisting of the number of babies born alive to teenage mothers, based on the total records of live births from the years 2008/2018. A total of 2.958 adolescent mothers were observed, analyzing term and preterm births, it was found that most adolescents became pregnant between the ages of 15 and 19, in addition to not having a partner, low education and being predominantly black and brown, demonstrating a family, emotional, economic and social vulnerability. Furthermore, it was observed that the number of prenatal consultations was lower in mothers of premature babies, as for the type of delivery, vaginal was the most common. Using Pearson's correlation coefficient, the existence of a correlation between teenage pregnancy and prematurity was found to be highly significant given 0.82. Therefore, the present study proved to be necessary, since it evidenced the need to evaluate, discuss and propose intervention measures regarding the early pregnancy of adolescents. [ABSTRACT FROM AUTHOR]

Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy -- dependent variable; sociodemographic, clinical and obstetric -- independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher's exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance. [ABSTRACT FROM AUTHOR]

Objective: to identify the factors associated with need for intensive care unit admission of Brazilian pregnant adolescents with COVID-19. Method: population-based non-concurrent cohort study using secondary databases. Brazilian pregnant adolescents who had laboratory confirmation of SARS-CoV-2 by RT-PCR, between March 14, 2020 and April 11, 2021 were included in the study. Statistical analysis using the Poisson multiple regression model, estimating the relative risk and respective 95% confidence intervals, with values of p <0.05 considered significant. Results: in total, 282 pregnant women were included in the study, with median age of 17 years, most with brown skin, in the third trimester of pregnancy, and living in urban or peri-urban areas. The intensive care unit admission rate was 14.5%, associated with living in the Southeast region of Brazil (RR=5.03, 95%CI=1.78-14.24, p=0.002), oxygen saturation below 95% (RR=2.62, 95%CI=1.17-5.87, p=0.019), and having some comorbidity (RR=2.05, 95%CI=1.01-4.16, p=0.047). Conclusion: the intensive care unit admission rate was high among Brazilian pregnant adolescents and was associated with living in the Southeast region of Brazil, having some comorbidity and/or presenting low oxygen saturation. [ABSTRACT FROM AUTHOR]

This study examined the association between community violence exposure (CVE), sex without contraception, and adolescent pregnancy in Chicago. A self-administered, online survey was conducted among 15- to 19-year-old girls from the South and West sides of Chicago from October to March 2018. Participants were recruited via community organization partnerships and social media advertising. The survey included questions about CVE, sexual behaviors, and covariates that are known to contribute to sexual risk taking. CVE was measured via a validated index of seven questions that measured individual experiences with violence. Multivariable and logistic regression analyses were performed to examine the association between CVE, penile–vaginal intercourse without contraception, and ever being pregnant. The final sample included 644 girls. Levels of CVE were high: 62.87% of girls reported that a close friend or relative died because of violence and 41.60% were a victim of violence. Nearly half (48.69%) of girls had penile–vaginal intercourse and 6.01% had been pregnant. For each standard deviation increase in CVE score, the odds of penile–vaginal intercourse without contraception (odds ratio [OR] = 1.69, 95% confidence interval [CI] = [1.27, 2.25]) and the odds of ever being pregnant (OR = 1.87, 95% CI = [1.36, 2.57]) increased. These results remained significant when adjusting for demographic, psychosocial, institutional, and interpersonal factors. Findings suggest that girls in Chicago who are exposed to higher levels of community violence have an increased likelihood of experiencing penile–vaginal intercourse without contraception and teenage pregnancy, even when adjusting for other predictors to teenage pregnancy. [ABSTRACT FROM AUTHOR]

Background: Adolescent mothers have lower rates of initiation, continuation, and exclusivity of breastfeeding, and even more so in the first pregnancy. Current interventions target adult women, and little evidence is available for breastfeeding promotion among adolescents. Methods: This is a pilot study protocol with a parallel, single-blind, randomized, and controlled trial design, to evaluate the feasibility of the intervention "Lactation Counseling" in first-time adolescent mothers to maintain exclusive breastfeeding in the first 6 months of life. The control group will receive routine education in prenatal care and prenatal and childbirth classes, the experimental group will receive additionally the intervention "Lactation Counseling", for 4 weeks, both conducted by trained nurses. Feasibility outcome includes recruitment and dropout rates, and, pilot outcomes will be the exclusive breastfeeding rate and the breastfeeding knowledge. Measurements will be taken at baseline, post-intervention, and 2, 4, and 6 months after childbirth. Discussion: Exclusive breastfeeding rates could be increased in adolescent mothers through nursing counseling interventions that are previously structured and evaluated from their feasibility. This study will allow the evaluation of the feasibility of an intervention in low-income, Latin American population adolescents. Trial registration: ClinicalTrials.gov NCT04655846, Registered 7 December 2020. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the prevalence of severe fear of childbirth (FOC) in a sample of nulliparous pregnant adolescents in a tertiary referral hospital in Turkey and compare the severity of FOC with the low-risk nulliparous pregnant women. Also, we aimed to identify potential risk factors that may predict the occurrence of high FOC. Material and Methods: In this cross-sectional study, a total of 55 singleton pregnant adolescents aged 13-19 years at the time of pregnancy occurrence were included in the study group and 68 low-risk singleton pregnant women aged between 20-30 years were included in the control group. Results: The sum of moderate and severe depression patients were significantly higher in the adolescent pregnancy (AP) group (n=12, 21.8%) than the non-AP group (n=4, 5.8%, p=0.008). In the AP group, 12 young women scored Wijma Delivery Expectancy/Experience Questionnaire version A (WDEQ-A) ≥85, ending in a prevalence of 21.8% with severe FOC, and 13 women in the non-AP group scored WDEQ-A≥85 ending in a prevalence of 18.8% with severe FOC, and there was no statistically significant difference when compared (p=0.681). A positive and statistically significant relationship was observed between the total scores of the WDEQ-A and Beck Depression Inventory (BDI) scales (r=0.286, p=0.001). Conclusion: We found a high prevalence of FOC among Turkish nulliparous adolescent and non-adolescent pregnant women, approximately one in every 5 patients had a severe level of FOC. Also, we detected a significant correlation between the WDEQ-A scores and the BDI scores. [ABSTRACT FROM AUTHOR]

Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. Main Outcome Measures: Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcomes of adolescent versus adult women during pregnancy and puerperium admitted to a dedicated intensive care unit (ICU) in Manaus, Amazonas, Brazil. Methods: In a retrospective cohort study, we retrieved data from the medical charts of 557 adolescent (<20 years) and adult (≥20 years) women. The association between demographic and clinical variables and the outcomes were compared in univariate and multivariate analyses. Results: The maternal severity index (MSI) of adult women was significantly higher than in adolescents. In univariate log‐binomial regression analysis, pneumothorax and circulatory dysfunction were positively associated with the composite primary outcome of death or transfer (for more complex care), whereas eclampsia was negatively associated. Being an adolescent was not associated with this outcome, not even when adjusting for potential confounders. Conversely, being an adolescent was associated with fewer complications (secondary outcome) even after adjusting for potential confounders (type of admission, eclampsia, pre‐eclampsia, surgical site infection, abdominal hemorrhage, drug abuse, metabolic syndrome, malnutrition, pneumothorax, or circulatory dysfunction). Conclusion: In Manaus, Amazonas, Brazil, adult women admitted to the ICU because of gestational or birth complications had worse outcomes compared with adolescents. Synopsis: In this cohort, adult women admitted to the intensive care unit for gestational or birth complications had worse outcomes compared with adolescents. [ABSTRACT FROM AUTHOR]

Background: Adolescent pregnancy carries a high risk of severe health issues for both the mother and the newborn. Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America. Most of the risk factors are met in indigenous communities, which is an underrepresented and poorly studied population. We aimed to assess the determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle. Methods: Through a case–control study, female adolescents aged 13 to 19 years old from seven indigenous communities of the Peruvian central jungle were interviewed. Adolescents with (cases) and with no (controls) pregnancy history, such as current pregnancy, children and abortion, fulfilled our eligible criteria. Our instrument explored: sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. We performed a penalized maximum likelihood logistic regression analysis to obtain Odds Ratios (OR) and their 95% confidence intervals (95% CI). Results: We enrolled 34 cases and 107 controls. Overall, 53.9% were 15 to 19 years old. We found a significant association of being 15–19 years old (OR = 6.88, 95% CI 2.38–19.86, p < 0.0001) and an elementary school level of instruction (OR = 5.59, 95% CI 1.95–16.06, p = 0.001) with the risk of adolescent pregnancy. A marginal statistical significance between having five to six siblings and adolescent pregnancy was also reported (OR = 2.70, 95% CI 0.85–8.61, p = 0.094). Furthermore, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy (OR = 0.17, 95% CI 0.06–0.47, p = 0.001). Conclusion: Our results suggest that public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health topics with adolescents. Plain language summary: Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America and rural areas. Indigenous communities are mainly located in rural areas and are exposed to multiple risk factors of adolescent pregnancy. We aimed to find the factors that have an influence on adolescent pregnancy in indigenous communities from the Peruvian central jungle. We conducted a case–control study identifying female indigenous adolescents from the Peruvian central jungle with or without pregnancy history. Our survey explored sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. Being 15 to 19 years old, having an elementary educational level, and five to six siblings increased the risk of adolescent pregnancy. On the other hand, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy. Furthermore, eight out of ten adolescents opposed to sexual intercourse at an early age. Public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health with adolescents. [ABSTRACT FROM AUTHOR]

The United Kingdom has one of the highest teenage birth rates among countries in western Europe. Government initiatives such as the Teenage Pregnancy Strategy introduced by the labor government in 1999 to reduce the teenage pregnancy rate by half in ten years could be responsible for the steady decline in teenage conception and childbirth for the past two decades. However, to sustain this decrease it is crucial to consider the broader socioeconomic and environmental determinants of teenage pregnancy at the population level. A selected literature search was conducted in this respect to highlight the factors that could be neglected by recent interventions on teenage pregnancy and childbirth in the United Kingdom. [ABSTRACT FROM AUTHOR]

Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and childbirth in adolescent mothers in Brazil (age groups: 12-16 years and 17-19 years). Methods: hospital-based cross-sectional study substantiated by Nascer no Brasil", (Born in Brazil) data. The study encompassed puerperal adolescent mothers from all regions in the country, and their newborns. Chi-square test was used to compare adolescents in the 12-16 years old age group and those in the 17-19 years old age group. Results: pregnant women in the 12-16 years old age group mostly lived in the Northeast of Brazil (p=0.014); most of them did not have a partner (p<0.001), unplanned pregnancy (p<0.001), they had inadequate schooling for their age (p=0.033), had less than six prenatal consultations (p=0.021), were subjected to episiotomy (p=0.042) and accounted for the largest number of premature babies (p=0.014). Conclusions: puerperal women in the 12-16 years old age group presented vulnerability in their socioeconomic conditions, inadequate assistance at the prenatal and childbirth care, as well as their babies showed neonatal complications that pointed towards these adolescent mothers' need of multidisciplinary care. [ABSTRACT FROM AUTHOR]

Few studies examining predictors of twinning consider younger mothers who do not use assisted reproductive technologies (ART). Higher parity is associated with greater odds of having a twin birth, but it is unclear whether this association is present among young women. We tested the hypothesis that the rates and odds of twinning would increase with parity among teenage and young adult mothers who did not use ART. We conducted a retrospective, population-based cohort study using 2009–2018 United States National Vital Statistics data on 11,383,370 (58.94% first, 41.06% repeat) births to adolescent and adult women aged 15-24 years. None. Rates and odds of twinning by parity among teenage (15-19 years) and young adult (20-24 years) mothers. The adjusted twin birth rate among first-time teenage mothers was 13.28 per 1000 births compared to 16.62 twins per 1,000 births among repeat teenage mothers. This difference by parity was present but smaller among mothers aged 20-24 (18.31 vs 21.44 twins per 1000 births for first-time and repeat young adult mothers, respectively). Repeat young mothers, particularly teenage mothers, are a high-risk group in terms of infant and maternal health outcomes; their higher rate of twinning puts them at an additional risk for adverse birth outcomes. Practitioners may counsel young mothers at risk for subsequent unintended pregnancy on elevated risk of twinning. [ABSTRACT FROM AUTHOR]

Although most studies show that adolescent pregnant women are at a higher risk for adverse birth outcomes, there has been limited research examining this relationship in Canada. This systematic review and meta-analysis investigated the prevalence of low birthweight (LBW), preterm birth (PTB), and stillbirth in Canadian adolescent women compared to adult women. Studies were included if they were primary research and included a sample of adolescent mothers (≤19 years) and adult mothers (≥20 years) who gave birth to singleton infants in Canada. Birth outcomes must have been measured consistently in at least 3 studies for inclusion. Comprehensive electronic literature searches were conducted from database inception until August 2020 in 5 databases. Random effects meta-analysis models were used to estimate pooled odds ratios (pOR) for LBW, PTB, and stillbirth between adolescent and adult pregnant women. Outcomes reported included PTB (8 studies), LBW (6 studies), and stillbirth (3 studies). Compared to adult mothers, adolescent mothers had a 56% increase in the prevalence of LBW (pOR 1.56, 95% confidence interval [CI] 1.24, 1.97), a 23% increase in PTB (pOR 1.23, 95% CI 1.06, 1.42), a 20% increase in stillbirth (pOR 1.20, 95% CI 1.05, 1.37). Heterogeneity, as assessed by I2, was high for LBW and PTB and was low for stillbirth. A subgroup analysis did not remove the high heterogeneity, and some studies did not adjust for confounding variables and were missing information on sociodemographic and behavioral factors. Future research is needed to investigate the mechanisms surrounding these differences by maternal age. [ABSTRACT FROM AUTHOR]

To understand the pregnancy and childbirth experiences and preferences of adolescent mothers with a history of childhood trauma in order to develop trauma-informed care practice recommendations for this unique group. Mixed methods convergent parallel design involving completion of the Adverse Childhood Experiences (ACE) questionnaire, a survey of care experiences and preferences during pregnancy and delivery, and a one-on-one interview. hHospital-based medical home program for pregnant and parenting adolescents. Adolescent and young adult mothers aged 12-22 years, receiving care between June 2018 and June 2019. A total of 29 adolescent mothers completed the questionnaire, out of a potential 38 in the program (76.3% participation). Five went on to complete an interview. The average age was 17.9 years (standard deviation 1.8 years). The mean ACE score was 5.1 out of 10, indicating childhood exposure to an average of 5 different types of potential trauma. A total of 19 participants (65.5%) reported being triggered during pregnancy or postpartum. Trauma memories were elicited during vaginal examinations in the clinic (27.6%) and in the hospital (27.6%), abdominal examinations (13.8%), measurement of vital signs (17.2%), and labor (17.2%). Ten participants (34.5%) felt that the providers delivering their baby knew how to help them cope with trauma memories. Themes that emerged included the following: acknowledgment of trauma by provider, avoiding re-telling of story, building a relationship with provider, choice and control in care, and providing coping strategies. A majority of adolescent mothers in our sample experienced trauma memories during pregnancy and postpartum medical interactions. Priorities for trauma-informed care in this population are described. [ABSTRACT FROM AUTHOR]

Background: Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives. Methods: Qualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers. Results: Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices. Conclusion: Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents. [ABSTRACT FROM AUTHOR]

Objective: To systematize good prenatal care practices in a referral center for pregnant teenagers in Campinas, São Paulo, Brazil, from the perspective of healthcare professionals. Material and methods: Qualitative study conducted between June and July 2017 using semi-structured interviews and a focus group with 10 healthcare professionals providing care to pregnant teenagers in a public hospital in the region of Campinas, São Paulo, Brazil. Data were examined using the thematic content analysis technique, which gave rise to new analytical categories. Triangulation of the results was used for validation. The theoretical and practical applicability of the main findings was identified. Results: The study looked into three categories arising from the discourse of the professionals and the evidence found in the literature: 1) comprehensive analysis of pregnant teenagers; 2) professional experiences related to the care of pregnant teenagers reflecting service quality; and 3) strengths and improvement opportunities potentially replicable as a care model. Good practices in prenatal care are those which prioritize comprehensive care for pregnant teenagers, are coordinated by a multidisciplinary team and result in a multidimensional approach, valuing the complexity of motherhood in the teenage years. Conclusion: It is advisable to develop education strategies, strengthen group care and involve the teenager's support network as part of sexual and reproductive health services in order to promote a positive experience during prenatal care when the process of becoming a mother takes place during adolescence. [ABSTRACT FROM AUTHOR]

Objective. To determine under-5 children's state of health, well-being, Early Childhood Development (ECD) and its association with mother age. Materials and methods. Using the National Survey of Girls, Boys and Women (ENIM, in Spanish) 2015, we compared sociodemographic characteristics and indicators of well-being, child development, nutrition, health, and child protection by age of the mother. We adjusted a logistic regression model to know the characteristics associated with an appropriate early child development. Results. The children of adolescent mothers are less likely to have an adequate ECD. Children with support for learning are about three times more likely to develop properly, while being a boy or having a mother with depressive symptomatology reduces this likelihood. Conclusions. It is important to design public policies based on modifiable conditions focused on support for learning, prevention and care of depressive symptoms to reduce development risks and increase care for the children of mothers in disadvantaged conditions. [ABSTRACT FROM AUTHOR]

Background: Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives.Methods: Qualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers.Results: Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices.Conclusion: Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Long-acting reversible contraception (LARC) methods are safe for adolescents and provide the greatest assurance against rapid repeated pregnancy when inserted during the immediate postpartum (IPP) and immediate post-abortion (IPA) period. Despite increasing enthusiasm for IPP/IPA LARC insertion, adolescents' preferences and experiences have seldom been examined. The objective of this review was to examine the attitudes of adolescents (aged 10-19 years) towards IPP/IPA LARC, their experiences and perceptions around having an LARC device fitted IPP/IPA and the factors involved in decision-making to use, not use or discontinue IPP/IPA LARC.Material and Methods: In January 2021, we searched seven bibliographic databases for original research articles published in English, from the year 2000. Studies of any design focused on IPP/IPA LARC were eligible for inclusion. Three of the authors assessed articles for eligibility and extracted data relevant to the outcomes of the review. Joanna Briggs Institute Critical Appraisal Tools were used to assess methodological quality. Key themes emerging from the data were synthesized and reported narratively.Results: We identified 10 relevant articles, four of which were entirely adolescent-focused. Only three addressed IPA LARC. IPP availability was important for ensuring access to LARC postpartum. Attitudes towards LARC IPP were associated with adolescents' sociodemographic characteristics and positive perceptions related to the long duration of action. Determinants of discontinuation and nonuse included poor-quality contraceptive counseling, intolerable side effects and subsequent distress, misconceptions about LARC safety IPP and the influence of partners and community on autonomy. No factors involved in IPA LARC decision-making were available. Limited evidence demonstrated that adolescents may favor contraceptive implants over intrauterine devices, and in certain contexts may face greater barriers to IPA LARC access than adult women do.Conclusions: Immediate insertion of LARC postpartum appears acceptable to adolescents who do not experience side effects and those with the opportunity to make autonomous contraception decisions. This important topic has been addressed in few studies involving an entirely adolescent population. Very limited evidence is available on IPA LARC. Further research on adolescents' lived experiences of IPP/IPA LARC access and use is necessary to inform the provision of person-centered care when assisting adolescents' contraceptive choice following pregnancy. [ABSTRACT FROM AUTHOR]

To verify the association between mood and anxiety disorders, and suicide risk during pregnancy and their relationship with premature birth in a population of pregnant adolescents attending prenatal care in the public health system of Pelotas, a southern city in Brazil. This was a cohort study with all pregnant adolescents attending antenatal public services in the urban area of Pelotas between October 2009 and May 2011. The first assessment occurred between the 20th and 22 nd week of pregnancy and the second occurred one month after delivery. We used the Mini International Neuropsychiatric Interview (MINI) to assess mood and anxiety disorders and suicide risk. A total of 645 pregnant women aged between 12 and 19 years old were interviewed. An anxiety disorder was present in 9.1% of the pregnant adolescent, and 28.5% had a mood disorder. The prevalence of suicide risk was 12.6%, and 15.3% of the babies were born premature. A multivariate analysis adjusted for maternal education, number of previous pregnancies and previous preterm birth indicated that adolescents who had suicide risk during pregnancy were approximately twice as likely to give birth prematurely when compared to those who were not diagnosed with suicide risk (PR 1.79; CI 1.06–3.03). Our findings suggest that pregnant adolescents who were at risk of suicide during pregnancy were more likely to have premature babies. It is important to pay attention to the mental health of this specific population to prevent obstetric complications and consequently improve the health of the children. [ABSTRACT FROM AUTHOR]

Aim. Adolescent pregnancy is a problem in Latin America that requires the implementation of effective interventions. This study describes the adaptation process of Computer Assisted Motivational Intervention (CAMI) for increasing contraceptive use and reducing subsequent pregnancies in the context of adolescent mothers in Northern Mexico. Methods. The McKleroy Intervention Adaptation Model was applied: 1) assessment of the local context; 2) evaluation of the intervention with experts; 3) preparation of the content, activities and materials; 4) pilot testing of the adapted version; and 5) implementation, with an exploratory and descriptive design. Results. The CAMI-Spa version was obtained with modifications and a favorable trend in scores on contraceptive variables (pretest vs. posttest) as attitude [120.67(SD ± 12.36) vs. 138.40(SD ± 7.20)], knowledge [28.00(SD ± 8.76) vs 44.00(SD ± 8.49)], processes of change [78.67(SD ± 20.83) vs 108.60(SD ± 9.21)] and self-efficacy [43.00(SD ± 10.37) vs 56.80(SD ± 17.38)]. Conclusion. The use of an intervention adaptation model allowed for the adjustment of the intervention to the context of Mexican adolescent mothers without affecting its key components, which could ensure the effect on increased contraceptive use. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: to identify adolescents' knowledge of safe sexual practices and to identify adolescents' information needs about sexually transmitted infections and pregnancy. Method: cross-sectional study conducted with 499 adolescents in public school, from February to April 2017, by using a self-applied and structured questionnaire. Results: the best known method was the male condom (94.4%); among male adolescents, 22.7% considered condom use unnecessary in all sexual relations (p<0.01) and 24.6% stated that oral contraceptives protected against sexually transmitted infections (p=0.04). Conclusion: the adolescents presented previous and eventually superficial conceptions regarding the prevention of STI and pregnancy. Female participants presented greater knowledge about contraceptive methods, sexually transmitted infections and safe sex practices. The identification of disabilities in the knowledge presented by the group recommends activities related to sexual education in schools. [ABSTRACT FROM AUTHOR]

Background: Trans masculine people are more likely than cisgender peers to have a teen or unintended pregnancy, though little is known about the origins of these disparities. Aims: This study aimed to describe teen and unintended pregnancy experiences among trans masculine people in order to elucidate risk factors and pregnancy-related needs. Methods: As a part of the United States-based SexuaL Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) study, in-depth, semi-structured interviews were conducted between March 2017 and August 2018 with 10 trans masculine people, ages 20–59 years, who experienced a teen or unintended pregnancy. Audio-recorded interviews were professionally transcribed, then analyzed using immersion/crystallization and thematic analysis approaches. The themes were contextualized using sociodemographic survey data. Results: The four themes that were developed from participants’ narratives highlighted: 1) how trans masculine people navigated having a pregnant body (e.g., heightened gender dysphoria due to being pregnant); 2) the importance of the cultural environment in shaping experiences as a trans masculine pregnant person (e.g., pregnancy and gender-related job discrimination); 3) the development of the pregnancy over time (e.g., decision-making processes); and 4) how pregnancy (and gender identity) affected relationships with other people (e.g., adverse family of origin experiences). Discussion: This study identified a number of risk factors for teen and unintended pregnancies among trans masculine people including physical and sexual abuse as well as ineffective use of contraception. This research also identifies unique needs of this population, including: relieving gender dysphoria, combating discrimination, and ensuring people feel visible and welcome, particularly in reproductive healthcare spaces. Public health practitioners, healthcare providers, and support networks (e.g., chosen family) can be key sources of support. Attention to risk factors, unique needs, and sources of support will improve reproductive healthcare and pregnancy experiences for trans masculine people. [ABSTRACT FROM AUTHOR]

Objective: To compare the levels of anxiety and stress in two population groups of adolescent women and their relation to pregnancy. Methodology: Descriptive cross-sectional study, which included 125 pregnant adolescents treated at the Luz Castro de Gutiérrez Hospital, and 124 non-pregnant teenage students belonging to the Jorge Eliécer Gaitán school, both located in the city of Medellín (Colombia). The participants answered the Hamilton Anxiety Rating Scale (HAM-A) and the Holmes and Rahe Stress Scale to assess psychosocial stress. Results: The median age was 17 years (interquartile range or IQR = 2) in pregnant women and 13.5 (IQR = 2) in students. In pregnant women, the prevalence of anxiety was 68% and stress was 73.6%, while in the non-pregnant group the prevalence of anxiety was 64% (OR = 1.2. 95% CI 0.20-2.09. P = 0.5) and the stress rate was 40% (OR = 4.18; 95% CI 2.37-7.41; p = <0.01). An association was found between having a positive test for anxiety and bad family relationships, alcohol consumption and the beginning of sexual life, while there was an association between having a positive test for stress and being under 15 years old, having bad family relationships, bad relationships with a partner, consumption of alcohol, beginning of sexual life and relatives with mental illnesses. Conclusions: No higher prevalence of anxiety is found in adolescent mothers treated at the Hospital General de Medellín compared to non-pregnant girls from Colegio Jorge Eliécer Gaitán in Medellín (Colombia). A higher stress disorder was found among pregnant teens. Poor family relationships, alcohol consumption and the onset of sexual life were evidenced as associated factors, both for anxiety and for stress. [ABSTRACT FROM AUTHOR]

Background: Adolescent pregnancy is a public health concern worldwide, particularly in low-income settings. Adolescent mothers face higher risks during pregnancy and delivery compared to adult mothers and yet, may also experience worse quality of obstetrical care. This study evaluates adherence to meeting Brazilian recommendations for prenatal care by comparing first-time adolescent versus adult mothers in a rural, low-income setting. Methods: Using data from the Adolescence and Motherhood Research (AMOR) project, we evaluated adherence to national recommendations as documented in the prenatal cards of 39 adolescents (13– 18 years) and 37 adults (23– 28 years) from a low-income area in northeast Brazil. Recommendations included ≥ 6 prenatal consultations, gestational age ≤ 12 weeks at the first visit, participation in 3 educational activities, 2 serology for syphilis (VDRL) and HIV, 1 Toxoplasmosis serology, 2 urine tests, 2 blood glucose and 2 hemoglobin/hematocrit (Hb/Ht) exams. Chi-square tests were used to compare the proportions of adolescents and adults with a record of these procedures in the prenatal cards. Results: Compared to adult women, the adolescent group had lower attainment of almost all recommended components of prenatal care compared to the adult group, with statistically significant differences for 2 blood glucose tests (46.2% vs 78.4%; p=0.004), 2 VDRL tests (30.8% vs 54.1%; p=0.040), 2 Hb/Ht exams (35.9% vs 83.8%; p< 0.001), and at least 6 consultations (84.6% vs 100%; p=0.013). Conclusion: Despite greater health risks of adolescent fertility, the prenatal cards of adolescent mothers presented a poorer record of adherence to recommendations for adequate prenatal care compared to adult mothers from a low-income setting of Brazil. Health policies for both health professionals and the target population are needed to ensure adequacy of prenatal care and appropriate risk reduction for this vulnerable population. [ABSTRACT FROM AUTHOR]

Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation. [ABSTRACT FROM AUTHOR]