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Objective. To determine the association between teenage pregnancy and socioeconomic factors and to estimate social inequalities among adolescents in Mexico in 2015. Methods. A study involving women from 15 to 19 years of age was conducted using data from birth records for 2015. The fertility rate was determined and disaggregated by quintiles for each socioeconomic variable. Absolute and relative measures of inequality were estimated; negative binomial regression analysis was used to obtain risk ratios and 95% confidence intervals. Results. The fertility rate was 73.21 births per 1000 women between the ages of 15 and 19 years in Mexico. Coahuila was the state with the highest birth rate (99.3 per 1000 adolescents). A statistically significant association was found between fertility rate and the gap in access to health services, especially in quintile 5 (risk ratio [RR] = 45.68), whereas a greater association with the gap in education was found in quintile 4 (RR = 27.36). No significant differences were found in terms of the gap in access to social security. Conclusions. Marginalization and poverty are significantly associated with teenage pregnancy and fertility rate. However, wide inequalities exist among the different social groups, making it necessary to implement actions geared towards promoting measures to improve the social, political, and economic environment. [ABSTRACT FROM AUTHOR]

Objective. To determine the impact of the Family Health Units Strategy for Primary Health Care in reducing adolescent pregnancy in Paraguay. Methods. Ecological study that included 18 health regions. Two stages were established (2000-2008 and 2008-2015). The adolescent pregnancy rate was established based on the newborns of adolescent mothers (<20 years) and the total of live births, and the population coverage of primary health care based on the total number of individuals living in areas where the strategy of primary health care was implemented and the total number of inhabitants of the district, for a given year. The Pearson correlation coefficient was used. Results. During the first stage, the percentage variation of the adolescent pregnancy rate in the country was positive at 11.5%, and in stage 2 it was negative at 14.9%. An inverse linear relationship was found between the variables explored (r = -0.654). Conclusions. After the implementation of the primary health care strategy, there has been a trend towards a decrease in adolescent pregnancy, which can be considered a positive impact even though the result may be influenced by other factors not considered in the study. [ABSTRACT FROM AUTHOR]

Objective. Identify difficulties in adolescents' access to contraceptive care and information, based on perceptions and experiences of health workers in Huechuraba, in the Metropolitan Region of Chile. Methods. This qualitative, descriptive study incorporated principles of participatory action research, involving health care teams in the survey and data analysis, and generating proposals for improvement. Seventeen (17) semi-structured individual interviews and one group interview were conducted with professionals and technical personnel involved in adolescent care in the commune's health centers. Results. Health workers perceived that adolescents were having difficulties reaching the centers due to cultural factors, lack of information, lack of health activities in the community, while administrative requirements and procedures hindered access to care. Shortcomings were evident in the management and interpretation of fertility regulation standards and of current legislation, and in the absence of explanatory frameworks recognizing adolescents' gender, sexual, and reproductive rights. Conclusions. Adolescents and their needs have a low profile and there are conflicts between theory and practice regarding access to contraception and counseling, with a lack of definitions or agreements that take into account social and cultural contexts. It is urgent to provide health workers with training on gender and sexual and reproductive rights, together with opportunities for reflection in order to generate coordinated and effective approaches. Efforts are required to disseminate the program and organize activities in community spaces, together with other community sectors. [ABSTRACT FROM AUTHOR]

Objective. To identify risk factors for adolescent pregnancy among female students in Bogotá, Colombia. Methods. This was a retrospective study of cases and controls matched by age, identified by means of a survey on the sexual behavior of adolescent students in Bogotá (Encuesta sobre el Comportamiento Sexual de los Adolescentes Escolarizados en Bogotá) conducted in the first semester of 2010. All 272 cases and 544 randomly-selected controls were taken from 39 044 total records. Variables considered were sociodemographics, household structure, and family environment; sexual relationships and pregnancy; and knowledge of sexual and reproductive health. Matching and conditional logistic regression were used to adjust for possible confounding factors. Results. The factors associated with increased risk of adolescent pregnancy based on multivariate analyses were: attending public school (odds ratio [OR] = 2.25; 95% confidence interval [95% CI]: 1.45-3.51); history of siblings with adolescent pregnancy (OR = 1.98; 95% CI: 1.55-2.76); early first sexual intercourse (12 years of age or less) (OR = 2.34; 95% CI: 1.01-5.40); having a self-reported low- or average-level of contraceptive knowledge (OR = 3.92; 95% CI: 1.96-7.83); previous pregnancy (OR = 14.09; 95% CI: 8.74- 22.70); and not living with both parents (OR 3.58; 95% CI: 2.10-6.16). Conclusions. Factors related to individual, family, and social environments that influence the incidence of adolescent pregnancy must be considered and addressed when designing interventions. The existing sex education curriculum is an important component in preventing adolescent pregnancy, however, parent/caregiver participation is required for success. [ABSTRACT FROM AUTHOR]

Objective. To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil. Methods. A national cross-sectional study was conducted among parturient women aged 15–24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnaires collected demographic, behavioral, and clinical data. Results. A total of 2 071 (86.3%) of the 2 400 parturient women invited to participate were included in the study. Mean age was 20.2 years (standard deviation [SD]: 2.7) and mean years of formal education was 8 (SD: 2.4). Preterm labor occurred in 450 women (21.7%). The highest proportion of premature labor (36.1%) was found in the North region and the lowest proportion (6.9%) was found in the South region. In the final multivariate logistic regression model, living in the North region (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.28– 1.59); having monthly income less than twice the Brazilian minimum wage (OR: 1.27, 95%CI: 1.01–1.60); having suffered domestic violence (OR: 2.27, 95% CI: 1.23–4.18); and having had inadequate prenatal care (OR: 3.17, 95% CI: 2.54–3.97) remained significant correlates of preterm labor in this population. Conclusions. Results show a high prevalence of preterm labor among young women in Brazil. Preterm labor has multifactorial etiologies. More public health resources must be directed toward accelerating understanding of this complex process. [ABSTRACT FROM AUTHOR]

Objective. To study the prevalence of, severity of, and risk factors for depressive symptoms in a probabilistic sample of Mexican adolescent mothers. Methods. A sample of adolescents aged 13-19 years, drawn from a national survey, was interviewed in relation to severity of depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D) 16-23 and CES-D ≥. 24] and pregnancy or parenting status. Results. Depressive symptoms (CES-D 16-23) ranged from 2.3% in the first postpartum semester to 32.5% in the second trimester of pregnancy; high depressive symptoms (CES-D ≥. 24) ranged from 3.0% in the second postpartum semester to 24.7% in mothers of an infant more than 1 year old. Significant differences between groups were in mothers in the second gestation trimester, who had significantly more symptoms than those who had never been pregnant and those in the first postpartum semester. In those with high symptomatology, no significant differences were observed between groups. A multinomial logistic regression model used to estimate the likelihood of depression found increased risk of depressive symptoms (CES-D 16-23) in those without a partner in the first, second, or third trimester of pregnancy; in the second postpartum semester; and with a child over the age of 1 year. Increased risk of high symptomatology (CES-D ≥. 24) was found in those not in school or with a child over the age of 1 year. Conclusions. Depressive symptoms entail an enormous burden of disease for the mother and mental health risks to the infant; mothers should therefore be targeted in prevention and intervention actions. [ABSTRACT FROM AUTHOR]

Objective. To examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. Methods. Data were taken from the Santiago Longitudinal Study conducted in January 2008-November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low- to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklist's Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. Results. Seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex was inversely associated with withdrawn-depressed symptoms (Odds Ratio [OR] = 0.84, Confidence Interval [CI] = 0.72-0.97), but positively associated with somatic complaints (OR = 1.20, CI = 1.04-1.38) and rule breaking behavior (OR = 1.21, CI = 1.08-1.36), after adjusting for demographic and other individual and parenting variables. The majority (80%) of the youth who had had sex reported using protection at the time of last intercourse. Conclusions. Findings highlight the role that mental health problems--some of them not commonly associated with onset of sexual activity--may play in a youth's decision to have sex. The potential protective effects of several parenting and family characteristics disappeared with youth age and youth behavioral problems. [ABSTRACT FROM AUTHOR]

Objective. To examine risk factors for pregnancy among adolescent girls in the Amazon basin of Ecuador. Methods. A matched case-control study with cases and controls identified within a community- based demographic and health survey was conducted in Orellana, Ecuador, from May to November 2006. A questionnaire focused on socioeconomic status, family structure, education, reproductive health, and childhood-adolescent trauma was applied. Conditional logistic regression was used to adjust for potential confounders. Results. Respondents included 140 cases and 262 controls. Factors associated with increased risk of adolescent pregnancies through multivariate analysis were: sexual abuse during childhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08-8.68); early sexual debut (OR 8.51, 95% CI 1.12-64.90); experiencing periods without mother and father (OR 10.67, 95% CI 2.67-42.63); and living in a very poor household (OR 15.23, 95% CI 1.43-162.45). Another two factors were statistically associated in the bivariate analysis: being married or in a consensual union (OR 44.34, 95% CI 17.85-142.16) and not being enrolled in school at the time of the interview (OR 6.31, 95% CI 3.70-11.27). For a subsample of sexually initiated adolescents, "non-use of contraception during first sexual intercourse" was also found to be a risk factor (OR 4.30, 95% CI 1.33-13.90). Conclusion. The study found that early sexual debut, non-use of contraception during first sexual intercourse, living in a very poor household, having suffered from sexual abuse during childhood-adolescence, and family disruption (living extended periods of life without both parents) were associated with adolescent pregnancy in Orellana. [ABSTRACT FROM AUTHOR]

Objective. To contribute to a better understanding of the problems of pregnancy among adolescent women, including proximate and socioeconomic determining factors, in two large, culturally different cities in Colombia: Santa Fe de Bogotá and Cali. Methods. This longitudinal study combined quantitative and qualitative research methods, using information generated by a survey of adolescents conducted in 2003. The survey included 550 adolescents in Bogotá and 550 adolescents in Cali, from all socioeconomic strata. To analyze the determinants, discrete-time proportional hazards models were used. For the qualitative study, 72 in-depth interviews and four focus groups were done. With the information organized by subjects and categories that were defined in relation to the purposes of the study, categories were identified that arose from the patterns and recurrences in the data, in order to see sociocultural trends by sex, stratum, and city. Results. The patterns of sexual activity, union (married or unmarried relationship), and maternity differ considerably among the socioeconomic strata, in both of the cities. The adolescent women in the low stratum begin having sexual relations, form unions, and become mothers earlier in life and with greater frequency than do adolescent women in the medium or high strata. The main determinant of the reproductive behavior of adolescent women is the set of contextual and socioeconomic factors in the home, mainly the family context (environment and supervision) and the educational climate (the average number of years of formal education of the family members over the age of 15). Conclusions. Sex education has been provided in the schools in Colombia since 1993, but our results clearly indicate that it has had only a limited impact on the reproductive behavior of adolescent women. [ABSTRACT FROM AUTHOR]