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IntroductionAdverse sexual and reproductive health (SRH) outcomes, such as unplanned pregnancies and HIV infection, disproportionately affect adolescent girls and young women (AGYW; aged 15-24 years) in east Africa. Increasing uptake of preventive SRH services via innovative, youth-centred interventions is imperative to addressing disparities in SRH outcomes.Methods and analysisFrom 2018 to 2019, we used human-centred design to co-develop a theoretically driven HIV and pregnancy prevention intervention for AGYW at private drug shops called Accredited Drug Dispensing Outlets (ADDOs) in Tanzania. The result, Malkia Klabu (Queen Club), was a customer loyalty programme designed to strengthen ADDOs' role as SRH providers while encouraging uptake of critical SRH prevention products among AGYW. Malkia Klabu members had access to free contraceptives and oral HIV self-test (HIVST) kits and earned punches on a loyalty card for other shop purchases; punches were redeemable for small prizes. Our pilot among 40 shops showed that intervention ADDOs had higher AGYW patronage and distributed more HIVST kits and contraceptives to AGYW relative to business-as-usual (ie, client purchasing) comparison shops. We will conduct a cluster-randomised controlled trial (c-RCT) among 120-140 ADDOs in 40 health catchment areas in Shinyanga and Mwanza Regions (Lake Zone), Tanzania. ADDO shop recruitment includes a 1-month run-in with a tablet-based electronic inventory management system for tracking shop transactions, followed by enrolment, randomisation and a 24-month trial period. Our c-RCT evaluating the human-centred design-derived intervention will assess population impact on the primary outcomes of HIV diagnoses and antenatal care registrations, measured with routine health facility data. We will also assess secondary outcomes focusing on mechanisms of action, evaluate programme exposure and AGYW behaviour change in interviews with AGYW, and assess shop-level implementation strategies and fidelity.Ethics and disseminationEthical approval was granted from both the University of California, San Francisco and the Tanzanian National Institute for Medical Research. Study progress and final outcomes will be posted annually to the National Clinical Trials website; study dissemination will occur at conferences, peer-reviewed manuscripts and local convenings of stakeholders.Trial registration numberNCT05357144.

IntroductionIn South Asia, younger women have high rates of unmet need for family planning and low empowerment. Life skills interventions can equip young women with agency, but the effectiveness of these interventions in reproductive and sexual autonomy and contraception has not been examined.Methods and analysisA two-arm, parallel, cluster randomised controlled trial will evaluate the impact of TARANG (Transforming Actions for Reaching and Nurturing Gender Equity and Empowerment), a life skills and reproductive health empowerment group-based intervention for newly married women, compared with usual services in the community in rural and tribal Rajasthan, India. TARANG will also provide light-touch sessions to husbands and mothers-in-law of newly married women. We will test the impact of TARANG in 80 village clusters among 800 eligible households comprising newly married women aged 18-25 years who are at risk of pregnancy but do not want a pregnancy within 1 year at the time of enrolment, their husbands and mothers-in-law who consent to participate. Women in the intervention villages will receive 14 sessions over a 6-month period, while husbands and mothers-in-law will receive 1 and 4 sessions (respectively) each. Three rounds of surveys will be collected over 18 months. Control villages will receive the intervention after the endline surveys. Primary outcomes include rate of unintended pregnancy and modern contraceptive use. We plan to start recruitment of participants and data collection in April 2024. We will estimate unadjusted and adjusted intention-to-treat effects using survival analysis and mixed models.Ethics and disseminationStudy protocols have been reviewed and approved by the human subjects review boards at the University of California, San Francisco, and the Centre for Media Studies, India (IRB00006230) and ACE Independent Ethics Committee, Bangalore (NET0062022). Results will be disseminated in international peer-reviewed journals and conferences, to stakeholders including local government and non-governmental organisations, and directly to the communities and individuals that participated in the intervention.Trial registration numberNCT06024616.

ObjectivesTo explore the relevance of pregnancy intention as a screen for contraceptive needs among postpartum individuals.Study designWe surveyed 234 postpartum individuals to assess the alignment between pregnancy intentions in the next year and current desire to prevent pregnancy.ResultsMost individuals (87%) desired pregnancy prevention now, including 73% of individuals who desired or were ambivalent about pregnancy in the next year.ConclusionA majority of individuals considering pregnancy in the next year desired pregnancy prevention now. Directly assessing current desire to prevent pregnancy may be more specific for contraceptive needs in postpartum individuals.ImplicationsOur ability to ensure that all individuals who want to prevent pregnancy have access to contraception depends on the use of effective screening questions. These findings prompt consideration of broader clinical implementation of screening for desire to prevent pregnancy in lieu of questions about pregnancy intention in the next year.

Background: Disparities in sexual health outcomes persist among American Indian and Alaska Native (AIAN) youth due to intersectional challenges accessing youth-friendly health services. AIAN youth have an increased prevalence of STIs and teen pregnancy. To address disparities in sexual health outcomes, the Ask Auntie/Ask Your Relative (AYR) Q&A service has been used by AIAN youth and young adults for over seven years as a trusted resource for information on sensitive health topics. There is a continued need to better understand the health-seeking behaviors of AIAN youth, especially those related to healthy relationships and sexual health, to improve the alignment of health resources to their needs. Methods: This mixed-method study began with two phases. Phase 1 involved an analysis of all AYR data using Google Analytics and basic frequency counts. Phase 2 reviewed all questions and answers related to sexual health and healthy relationships (N = 240) using thematic analysis, NVivo 12.0, and intersectionality, guided by the social determinants of health. All AYR answers were coded based on type, name/location, number of times viewed, and examples. The final step of the analytic process was to utilize an intersectional approach and socioecological model (Individual, Community, Tribe/Nation, and World) to create a visual model with results. Results: Phase 1—Since We R Native began tracking AYR data, the service has been utilized by 2.37 M users, with 1.16 M unique pageviews. The average time on the page was 4 min and 46 s. The number of AYR questions submitted varied by year, and were most frequent in 2016, then decreased in subsequent years. In Phase 2, the main themes identified in AYR questions were (1) Reaching Out for Help, (2) Identity and Physical Development, and (3) Healthy Relationships. Analysis of the Q&A answers identified 244 resources, and of these, 100 were Native-specific. The context-specific resources represented 21 uniquely coded health topics, ranging from women's health to behavioral health. Conclusions: The broad range of healthy relationship and sexual health questions submitted to the AYR service reflects the types of health information that AIAN young adults want to know about. Resources provided in response to their questions connected Q&A viewers to a wide variety of organizations and programs designed to support AIAN young adults in their health and wellness journey. Findings from this study may be useful for creating additional culturally tailored resources. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS CONCLUSIONS Despite overall declines in risky teen sexual activity, racial and ethnic disparities persist. This study compared abstinence‐only and comprehensive teen pregnancy prevention (TPP) programs to explore the effects of the programs on teen sexual activity‐related outcomes that may differ by race/ethnicity.Program evaluation data were collected from 7th‐grade students in comprehensive (N = 3244) and abstinence‐only (N = 3172) TPP programs. Differences between outcomes by TPP program were analyzed using chi‐square tests and logistic regression for each racial/ethnic group.Black and Hispanic students were significantly less likely to indicate positive attitudes, intentions, and behaviors at baseline. Only white students significantly improved in both programs from pre‐ to post‐assessment. Native American students in the abstinence‐only program were significantly less likely than Native American students in the comprehensive sexuality programming to improve from pre‐ to post‐assessment regarding male sexuality, refusal skills, sex and teen norms, and sexual abstinence.The findings suggest that youth of diverse racial/ethnic backgrounds do not enter TPP programs with similar attitudes, intentions, or behavior regarding appropriate sexual behavior and that the impact of such programs also may vary by race and ethnicity. [ABSTRACT FROM AUTHOR]

This qualitative research design applying multiple case study aims to explore, discover, and comprehend the journey encountered by the early adult senior high school student-parents of Dagohoy National High School, Dagohoy, Talaingod Davao del Norte. In this study, three (3) participants were chosen to participate in an in-depth interview. Thematic analysis was used in analyzing the data. This study revealed the unique characteristics of each case. From the stories of failures and moments of triumph, six (6) major themes emerged. Three (3) themes also in surviving the challenges, from the thoughts of inspiration, another three themes emerged. Because not all the respondents had a support structure, the survey's results indicated that they frequently dealt with family difficulties and concerns about managing their finances and taking care of their children. Due to their twin responsibilities, which cause them to frequently overlook the importance of their health, a relationship ranks top among their priorities, while health comes in last. This research urges the school to strengthen the conduct of guidance programs such as teenage pregnancy awareness orientation for students and responsible parenting to those student-parents to help them pursue and finish their studies and recommends Department of Education allocate a budget for the Alternative Delivery Mode teachers, a particular teacher item, that focuses only on working students, student-parents, or any similar situations that hinder the students from attending classes daily. [ABSTRACT FROM AUTHOR]

Cultural practices help constitute a 'normal' way of life within a specific community and set the standard that members of the community are expected to adhere to. Some of these practices may have a short- and long-term influence on young people in ways supportive of teenage motherhood. This study explored cultural practices and beliefs in a study area in Ghana that encourage teenage girls into motherhood unintendedly. An exploratory design was used. Thirty teenage mothers and twenty-two opinion leaders participated in fieldwork conducted between October 2018 and February 2019. Data were analysed using an inductive approach. Four themes became apparent: fear of being cursed for having an abortion; sleeping arrangements; funerals and wakes; and practices of cohabitation in the study area. Cultural practices contribute to teenage motherhood in the Adaklu District of Ghana. Programmes, interventions and policies should be designed to take into consideration the needs, contexts, and backgrounds of teenagers. Future programmes to enhance teenagers ability to avoid teenage pregnancy and motherhood should consider factors such as the family, the person, the community, institutions, and national and international influences. [ABSTRACT FROM AUTHOR]

Background/Aims: Adolescent pregnancies are prevalent in Indonesia. This study aimed to explore perceptions from healthcare workers and pregnant adolescents of maternity services for pregnant adolescents. Methods: This qualitative exploratory study involved two policymakers, 10 midwives, five doctors, and 10 pregnant adolescents. Data were collected through structured interviews in public health centre consultation rooms. The data were analysed thematically to explore factors that promoted or hindered use of maternity services for pregnant adolescents. Results: The identified barriers included a lack of tailored directives, challenges in engaging adolescents, insufficient numbers of skilled healthcare professionals, adolescents' fears and compromised confidentiality. Opportunities for improvement included enhancing service quality through strategic planning and specialised training for midwives and psychologists. Conclusions: The study underscores the need to improve maternity services offered for pregnant adolescents by creating a conducive working environment and sensitising healthcare workers and the community to adolescent mothers' needs. Implications for practice: There is a need for guidelines in Indonesia specifically on providing care for pregnant adolescents. Healthcare professionals require specialised training and facilities should be made adolescent friendly. [ABSTRACT FROM AUTHOR]

Popular media often contain storylines focused on pregnancy and infertility. These storylines have the potential to perpetuate stigmatization related to these issues. According to the differential susceptibility to media effects model (DSMM), lay infertility beliefs could serve as either predictors or outcomes of pregnancy-focused media viewership, with moral sanction theory and cultivation theory supporting competing hypotheses. Further, viewership could impact fertility awareness, meaning knowledge of physiological and medical factors related to fertility. The current study tested how viewership of 16 & Pregnant and Teen Mom is related to infertility beliefs and fertility awareness in an online survey. Participants (N = 990) were on average 39.5 years old, 53.9% female, 77.9% white, and 38.9% had more than a high school degree. Structural equation modeling revealed that infertility beliefs served as predictors, but not outcomes, of viewership. Participants with the stigmatizing belief that infertility is caused by being immoral, ungodly, or unmotherly/unfatherly were drawn to 16 & Pregnant and Teen Mom. However, the outcome of viewership was improved knowledge of the biological/medical aspects of fertility. Although scholars have cited concerns about 16 & Pregnant and Teen Mom, findings suggest that viewing these programs could have educational benefits beyond reducing teen pregnancy. [ABSTRACT FROM AUTHOR]

Background: Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high rates of unemployment, reduced access to education, and poorer health, with significantly increased risk of poverty compared with the general population. In pregnancy, there appears to be a gap in the literature surrounding the experiences and outcomes of pregnant people within these ethnic groups. Objectives: The aim of this study was therefore to scope published research, specifically questioning "What is the experience of Roma Gypsy and Traveller pregnant people who access maternity care?" and "What are the obstetric outcomes within these groups?" Search Strategy: This review followed frameworks proposed by Arksey and O'Malley, Levac, and the Joanna Brigg's Institute. The PRISMA extension for Scoping Reviews (PRISMA‐ScR) tool was used. The search strategy and specific terms were chosen using the population–concepts–context framework. Selection Criteria: Titles and abstracts were reviewed independently by two reviewers. Inclusion and exclusion criteria were defined to set clear guidance for reviewers to identify appropriate studies. Data Collection and Analysis: Five electronic databases were searched (CINAHL, EMBASE, MEDLINE [OVID] Web of Science and SCOPUS). A charting form was developed to record key characteristics systematically and uniformly from the studies. Main Results: Five themes were identified: systemic issues, antenatal care, complications of pregnancy, birth experience, and postnatal care. Systemic issues included racism, barriers to care, and adapted antenatal care. Antenatal issues included teenage pregnancy, smoking, risk of venous thrombus embolism, dietary issues, risk of communicable diseases, domestic violence, and mental health concerns. Increased risks of congenital abnormalities, growth restriction, premature labor, and perinatal and early childhood mortality were identified. For Roma women, negative birth experiences were reported, whereas the experiences of Traveller women varied. Conclusions: The findings identified in this study serve to create a framework upon which healthcare providers can tailor the way in which pregnant people from a Roma, Gypsy, or Irish Traveller background are cared for. Using such a framework would hopefully begin to reduce the systematic marginalization and discrimination of these minorities. Synopsis: Gypsy, Roma, and Traveller pregnant people suffer poor outcomes in pregnancy. The true extent of this is not known as they are underrepresented in research. [ABSTRACT FROM AUTHOR]

System-involved youth are a vulnerable population at high-risk of experiencing numerous sexual reproductive health (SRH) outcomes. They are likely to have several risk factors for teen pregnancy and parenting including abuse and neglect histories, lack of a supportive consistent adult in their lives, and limited opportunities to experience normal romantic relationships. Issues of pubertal development are rarely addressed in this population. Data is from system-involved adolescents (n = 301) enrolled in a SRH intervention. The final analysis is restricted to those who were sexually active at baseline (n = 229). Most participants were African Americans between 13–21 years of age. More than 70% reported an early mean age of first sex. Approximately a quarter self-reported early pubertal development. Logistic regression was utilized to examine the odds of pregnancy in relation to self-reported pubertal timing. The findings support the need to develop programming for system-involved youth which address their unique needs. [ABSTRACT FROM AUTHOR]

Background: Globally, teenage pregnancy is a public health problem. Low- and middle-income countries in the Sub-Saharan region are more affected with teenage pregnancy. It is worse with teenage girls who have other vulnerabilities like living in refugee camps. However, there is little information about teenage pregnancy in refugee camps especially in resource limited areas like Northern Uganda. Objective: To determine the prevalence and the factors associated with teenage pregnancy among refugees in Palabek refugee settlement, Northern Uganda. Methods: This was a cross-sectional study conducted among teenage girls in Palabek refugee settlement in Northern Uganda. The study estimated a total sample size of 316 teenage girls and they were sampled using systematic random sampling. Data was collected using researcher administered questionnaire. Conditional logistics regression was employed to identify the associated factors for teenage pregnancy. Results: A total of 306 teenagers participated in the study with a response rate of 98.6%. The study showed that the prevalence of teenage pregnancy among teenage girls in Palabek refugee settlement, Northern Uganda was 41.2%. The factors associated with teenage pregnancy among teenage girls in Palabek refugee settlement included: being in the 15–19 years age group (AOR = 6.3, 95%CI: 1.8–22.8), not being in school (AOR = 5, 95%CI: 2.3–10.9), not being married (AOR = 0.2, 95%CI: 0.1–0.5), delayed sexual debut (AOR = 2.4, 95%CI: 1.1–5.5), having multiple sexual partners (AOR = 0.3, 95% CI: 0.1–0.7), alcohol use (AOR = 6.7, 95%CI: 2.2–18.4), being aware of sexual reproductive health services (AOR = 0.4, 95%CI: 0.2–0.9), and having divorced families (AOR = 2.4, 95% CI: 1.2–4.9). Conclusion: Study results reveal that 4 in 10 teenage girls in Palabek, Northern Uganda, are pregnant, influenced by individual, community, and health system factors. This highlights vulnerabilities in refugee camps, urging prioritization of sexual and reproductive health for adolescent girls in refugee camps. [ABSTRACT FROM AUTHOR]

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]

Introduction: The age at first birth refers to the age at which a woman has her first child. It can significantly influence the demographic behavior of women and the general community. Moreover, teenage childbearing is a serious public health and social problem. The main objective of this study was to identify factors associated with age at first birth among women in Ethiopia. Methods: Secondary data on women were obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). These population-based crosssectional data were downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 8,885 women aged 15-49 years from 305 enumeration areas. A multilevel survival analysis was employed to identify the factors associated with teenage childbearing among women in Ethiopia. Results: The majority (67.7%) of randomly sampled women were subjected to teenage childbearing. Women being rural dwellers [hazard ratio (HR) = 1.27, 95% CI: 1.05, 1.54]; women from middle-income families (HR = 1.43, 95% CI: 1.18, 1.74); and women from higher-income families (HR = 1.40, 95% CI: 1.15, 1.70) were associated with a higher risk of teenage childbearing. Conversely, contraception method users (HR = 0.87, 95% CI: 0.77, 0.99), Muslims (HR = 0.75, 95% CI: 0.64, 0.89), Orthodoxes (HR = 0.68, 95% CI: 0.57, 0.80), women with secondary education (HR = 0.53, 95% CI: 0.43, 0.65), women with higher education (HR = 0.28 (95% CI: 0.22, 0.37), and the higher age of household head (HR = 0.99, 95% CI: 0.98, 0.99) were associated with a lower risk of teenage childbearing among women in Ethiopia. Conclusion: Since the median age of women to have their first child was 18 years old, this study strongly suggests that stakeholders at the federal and regional levels must work closely toward enforcing the legal age of marriage and implementing national adolescents' and youths' targeted sexual and reproductive health programs. [ABSTRACT FROM AUTHOR]

Objective: We sought to evaluate the risk of preterm labor and hypertensive disorders in adolescent pregnancies with and without diabetes. Methods: We evaluated 1,843,139 adolescents (≤20 years old) with labor and delivery admissions in the national Kids' Inpatient Database (KID) in years 2006, 2009, 2012, 2016, and 2019. International classification of disease codes was used to identify diabetes and medical factors affecting pregnancy. Weighted logistic regression was used to evaluate the association between diabetes and complications. Results: Among admissions, 0.2% had type 1 diabetes (T1D), 0.2% had type 2 diabetes (T2D), and 0.7% had gestational diabetes (GDM); 10.1% of admissions were complicated by hypertensive disorders and 5.8% by preterm labor. Compared to adolescents without diabetes, those with diabetes had a higher prevalence of hypertensive disorders (T1D: 35.4%, T2D: 37.8%, GDM: 24.9%, None: 9.9%; p < 0.001) and preterm labor (T1D: 21.5%, T2D: 16.8%, GDM: 6.8%, none: 5.7%; p < 0.001). In adjusted models, odds of hypertensive disorders were higher in later study years (2019 vs. 2006 OR 1.85, 95% CI 1.77–1.94), among those with T1D (OR 4.32, 95% CI 3.94–4.74), with T2D (OR 4.18, 95% CI 3.79–4.61), and with GDM (OR 1.99, 95% CI 1.89–2.10). Adjusted odds of preterm labor were higher among those with T1D (OR 4.53, 95% CI 4.09–5.02), with T2D (OR 3.35, 95% CI 2.96–3.78), and with GDM (OR 1.18, 95% CI 1.08–1.28); disparities were seen by race/ethnicity, insurance, and income. Conclusions: Diabetes, which is increasing among adolescents, is a significant risk factor for preterm labor and hypertensive disorders. Though the absolute number of adolescent pregnancies is decreasing, rates of hypertensive disorders have increased. Appropriate interventions are needed to ensure healthy outcomes for adolescents who are pregnant. [ABSTRACT FROM AUTHOR]

Simple Summary: For Adolescents and Young Adults (AYAs) with gynecological cancer, preserving fertility is crucial for their Quality of Life. This systematic review explores how possible (in)fertility affects treatment choice and psychological well-being during and after treatment. The studies included were evaluated using the Mixed Methods Appraisal Tool (MMAT). A total of 15 studies were analyzed. The key findings emphasize the importance of informing all AYAs about how cancer treatment can impact fertility and discussing available fertility preservation options. This review also highlights that AYAs with gynecological cancer who do not have fertility preservation options are often overlooked. Therefore, research should focus more on this specific group. We recommend improving the Shared Decision-Making (SDM) and follow-up process for AYAs with gynecological cancer by addressing fertility-related questions and concerns, which could enhance their long-term Quality of Life. Background/Objectives: With growing survival rates for Adolescent and Young Adults (AYAs) diagnosed with gynecological cancer, the focus shifted to Quality of Life (QoL). Fertility-sparing surgery offers a viable alternative to standard, usually fertility-impairing treatments. Treatment choice remains difficult and renders perspectives of AYAs on decision-making and psychological outcomes afterwards. This review examines the impact of (in)fertility on psychological well-being both during cancer treatment, and in the long term. Methods: A systematic review of the peer-reviewed literature was conducted by searching Pubmed, Web of Science, Cochrane Trial database and PsycINFO on 30 November 2023. The review included studies with a focus on gynecological cancer, fertility and pregnancy related psychological outcomes, QoL, and psychosocial factors influencing decision-making. Case reports and reviews were excluded. Quality was assessed with the Mixed Methods Appraisal Tool (MMAT). Results: 15 studies, published between 2005 and 2023, involving 1328 participants, were included. Key findings highlight the significance of informing all AYAs about cancer treatment effects on fertility and discussing fertility preservation options. Feeling time-pressured and conflicted between choosing the best oncological outcomes and preserving fertility were common. Factors such as younger age at diagnosis, time pressure, and inadequate counseling by healthcare workers increased reproductive concerns which contributed to long term psychological distress. Research on AYAs with gynecological cancer without fertility preservation possibilities is limited and should be prioritized. Conclusions: This review shows that both Shared Decision-Making (SDM) and follow-up processes can be improved by addressing fertility-related questions and concerns, therefore increasing long-term QoL. This review is registered in PROSPERO (ID 448119). [ABSTRACT FROM AUTHOR]

Background/Objectives: Teen birth rates remain a pressing public health issue in the United States, with significant long-term health risks for both mothers and children. Previous research has primarily focused on the impact of women in elected office on reproductive health outcomes, but less is known about the influence of women candidates. This study explores the relationship between the number of women candidates in county-level elections and county-level teen birth rates, highlighting the role of women candidates as visible role models and agents of potential policy change. Methods: We utilized a dataset covering county-level elections from 2010 to 2020, along with teen birth rate data from the CDC. We employed a multilevel model to analyze the relationship between the cumulative number of women candidates and teen birth rates, controlling for socioeconomic and health-related factors, such as insurance coverage and social vulnerability. Results: The findings indicate that as the number of women candidates increased, the estimated county-level teen birth rate declined. This effect was observed across different election years, with more substantial impacts in midterm and presidential elections. The analysis also confirmed that socioeconomic conditions, such as a lack of health insurance, contribute to higher teen birth rates. Conclusions: Women candidates, even when not elected, serve as important role models and influence reproductive health outcomes in their communities. Increasing the number of women candidates at the local level may be an effective strategy for reducing teen birth rates and improving public health outcomes. [ABSTRACT FROM AUTHOR]

Background: Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions. Methods: A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022. Findings: Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as "infertility caused by FP," "freedom of sex by promoting FP," and "cultural taboos on having sex before marriage and talking about sexuality," were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. Conclusions: Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary. Plain English summary: Teenage girls becoming pregnant unexpectedly face higher health and socio-economic risks, which can affect both the lives of teenage mothers and newborns. In Kenya, the government has targeted ending teenage pregnancies by 2030, but the decrease has been limited. Although understanding teenage mothers' experiences and perspectives is important for designing appropriate interventions, only a few studies have been conducted. This study focused on 19 teenage mothers and other key participants to gain a deeper understanding of their backgrounds. Four major reasons were identified for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about birth control methods, (3) financial challenges, and (4) low access to birth control methods. At the study site, cultural norms and stereotypes were observed as barriers in promoting the use of birth control methods to teenagers. In addition, teenagers from poor backgrounds were found to be more vulnerable because they can be easily taken advantage of by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. In this study, unintended teenage pregnancies negatively influenced most participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. [ABSTRACT FROM AUTHOR]

Pregnancy complications are far more common in young women. This could inhibit their personal growth and development, take away them of their youth and education, and decline the general health of the country in the process. Focusing on this problem is an ideal matter. Education, family planning, raising community awareness, and teaching adolescents the importance of delaying marriage, reproductive health, and involvement of parents will surely help transform today's teenage girls into healthy, responsible adults who will bear a healthy future generation. The study emphasizes the lived experiences, challenges, coping mechanisms, and parent's role. Moreover, the study's findings which were based on the Thematic Analysis, were as follows: (1) Teenage Mothers have maternal adjustment difficulties, adolescent reproductive health knowledge gaps, and fear of negative evaluation. (2) Teenage Mothers struggles to discrimination, social rejection anxiety, parenting efficacy, academic disengagement, and financial stress. (3) Lastly, when talking about their coping techniques, Teenage Mothers found support system such as family functioning, where they feel positive, peer influence that uplifts them, maternal identity development through fellow teenage mothers, parent-infant attachment as a source of their motivation, and spiritual well-being where they offer, they overall life to God. [ABSTRACT FROM AUTHOR]

Postpartum depression is a significant public health issue that occurs within the first 12 weeks after childbirth. It is more prevalent among teenage mothers compared to adults. However, the findings of the existing interventional studies cannot be readily applied to teenage mothers due to their unique psychosocial concerns. Furthermore, these findings have shown inconsistencies regarding the benefit of psychological and psychosocial interventions in reducing the incidence of postpartum depression. The current review is aimed at investigating the effectiveness of psychosocial interventions in preventing postpartum depression, specifically among teenage mothers. The preferred reporting items for systematic reviews and meta-analysis manuals were utilized to identify and select relevant articles for this review. The articles were retrieved using population, intervention, control, and outcome models. The quality of each article was assessed using the Cochrane risk of bias tool. Statistical analysis was conducted using STATA version 17. The effect size of the intervention was estimated using the standard mean difference in depression scores between the intervention and control groups. Heterogeneity among the studies was assessed using the I2 statistic and Q statistic, while publication bias was evaluated through funnel plot asymmetry and Egger's test. A total of nine eligible articles were included. While psychosocial interventions have been demonstrated to decrease the incidence of postpartum depression compared to usual maternal health care, it is worth noting that the mean difference in depression scores was significant in only three of the included studies. The meta-analysis revealed that psychosocial interventions were effective at preventing postpartum depression, with a pooled effect size of − 0.5 (95% CI: − 0.95, − 0.06) during the final postpartum depression assessment. The heterogeneity was substantial, with an I2 value of 82.3%. Although publication bias was not observed, small studies had a significant effect on the pooled effect size. The findings of this review suggest that psychosocial interventions can effectively prevent PPD, particularly within the first 3 months of the postpartum period. This review highlights the scarcity of interventional studies in low-income countries, indicating the need for further research in diverse communities. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Klippel–Trénaunay syndrome can present with atypical manifestations such as a bleeding vulvar hemangioma. This case report, the first documented in Uganda, highlights the need for awareness of such presentations and underscores the importance of continuous follow‐up in female patients to manage potential complications throughout adolescence and pregnancy. Klippel–Trénaunay syndrome (KTS) is a rare congenital disorder marked by bone and soft tissue hypertrophy, port‐wine stains, and varicosities. Cases involving genital hemangiomas are rare. This report highlights a 5‐year‐old girl in Uganda with typical KTS features, including hypertrophy and port‐wine stains, along with a bleeding vulvar hemangioma, emphasizing its uncommon presentation and potential complications. Treatment involved compression bandaging and timolol 0.2% solution. This case underscores the importance of awareness of atypical manifestations of hemangiomas with KTS and continuous follow‐up for female patients, especially through adolescence and pregnancy, due to potential complications such as prepubertal per vaginal bleeding, menorrhagia, and post‐partum bleeding. [ABSTRACT FROM AUTHOR]

Prior reviews investigating the impact of pregnancy on adolescent idiopathic scoliosis (AIS) have reached different conclusions and a meta-analysis of curve progression among pregnant females with AIS and its effects on clinical outcomes has not previously been performed. A comprehensive search of major bibliographic databases (PubMed, Embase, and Scopus) was conducted for articles pertaining to spinal curve progression during pregnancy among patients with AIS. Patient demographics, scoliotic curve outcomes, and patient-reported quality of life measures were extracted. Ten studies, including 857 patients with a mean age of 28.7 years, were included. Before pregnancy, 42.1% had undergone spinal fusion and 59.0% had a thoracic curve. Based on prepregnancy and postpregnancy radiographs, the curve increased from 33.9°–38.5°, and meta-analysis revealed a curve progression of 3.6° (range = −5.85 to 1.25, P = 0.003), primarily arising from loss of correction in the unfused group (Unfused = −5.0, P = 0.040; Fused = −3.0, P = 0.070). At the same time, 45.9% patients reported increased low back pain and many reported a negative body self-image and limitations in sexual function. However, 5 studies noted that pregnancy and number of pregnancies were not associated with curve progression, and multiple studies identified similar quality of life-related changes in non-pregnant patients with AIS. Among unfused pregnant females with AIS, the spinal curvature increased significantly by 5.0° from before to after pregnancy. However, these changes may be independent of pregnancy status and occur with time. Such curve progression can contribute to a negative body self-image, low back pain, and functional limitations irrespective of pregnancy state. [ABSTRACT FROM AUTHOR]

Background: Adolescent pregnancy is associated with increased risk of both maternal and neonatal complications. Common maternal complications include anemia, hypertensive disorders, and a higher incidence of infections, including Group B Streptococcus (GBS). Additionally, adolescents are at increased risk for gestational diabetes and postpartum hemorrhage. Neonatal complications often involve low birth weight, prematurity, and an increased likelihood of neonatal intensive care unit (NICU) admission. Objectives: This study aims to assess and compare the prevalence of obstetric complications between adolescent and older pregnant women. Methods: This retrospective study investigates obstetric outcomes in adolescent pregnancies, analyzing data collected from 1 January 2016 to 30 June 2024. This study included 902 participants, of whom 224 were adolescents. The variables were categorized into maternal, birth, and neonatal characteristics. Results: Adolescent patients demonstrated a significantly higher prevalence of Group B Streptococcus (GBS) infection, affecting 25.89% of this group. Adolescent patients reported 17.86% nicotine use during pregnancy, a rate significantly higher than that of older age groups (p < 0.001). Additionally, adolescent pregnancies were associated with the highest mean blood loss during delivery, averaging 500 mL during vaginal birth and 1050 mL during cesarean section, leading to a higher incidence of blood transfusions (3.13%, p = 0.021). Newborns from adolescent pregnancies had the lowest mean birth weight (3199 g) and length (53.6 cm). Neonatal complications were more frequent in this group, affecting 20.09% of newborns, with a significantly higher rate of admission to intensive care units (2.68%, p = 0.008). These findings underscore the need for targeted interventions and more proactive management strategies to address the specific challenges faced by this population. [ABSTRACT FROM AUTHOR]

Introduction: The United States has the highest teen pregnancy rate and sexually transmitted infection rates among developed countries. One common approach that has been implemented to reduce these rates is abstinence‐only‐until‐marriage programs that advocate for delaying sexual intercourse until marriage. These programs focus on changing adolescents' beliefs toward abstinence until marriage; however, it is unclear whether adolescents' beliefs about abstinence predict their sexual behavior, including sexual risk behavior (SRB). An alternative approach may be encouraging youth to delay their sexual debut until they reach the age of maturity, but not necessarily until marriage. Methods: To address this question, we compare the longitudinal association between abstinence beliefs (i.e., abstaining completely until marriage) and beliefs about delayed sexual debut with subsequent SRB 24 months later. The harmonized data set included 4620 (58.2% female, Mage = 13.0, SDage = 0.93) participants from three randomized controlled trials attending 44 schools in the southern United States. Negative binomial regressions were employed to examine the association of abstinence until marriage beliefs and beliefs regarding delaying sex with SRB. Results: We identified that beliefs supporting delaying sex until an age of maturity were associated with lower odds of engaging in SRB, such as having multiple sex partners and frequency of condomless sex, for both sexes. However, stronger abstinence beliefs had no significant associations with all SRB outcomes. Conclusions: Findings suggest prevention programming that focuses on encouraging youth to delay sex until an appropriate age of maturity may be more effective at preventing SRB and consequent negative sexual health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Pregnant adolescents face multiple adverse experiences that vary by context due to pregnancy‐related stigma. We explored experiences of pregnancy‐related stigma and psychosocial issues among adolescents living in rural eastern Uganda. Methods: We conducted in‐depth semi‐structured interviews with 15 adolescents (15–19 years old) who were pregnant (>3 months) or had recently given birth (<3 months) at Tororo District Hospital in Uganda. All interviews were translated from Dhopadhola to English. Thematic analysis was conducted to identify major themes, which were interpreted using the Health Stigma and Discrimination Framework. Results: Six key themes were identified and were organized under the Health Stigma and Discrimination Framework. Social and gender norms for adolescent women and their lack of autonomy were identified as drivers and facilitators of pregnancy‐related stigma. Results show how stigma is experienced by adolescents through the lack of social support, multiple forms of abuse, and negative judgement. Such manifested stigma negatively impacted their psychosocial wellbeing and resulted in limited access to socioeconomic resources and educational opportunities. Conclusion: This study acknowledges the multilevel nature of pregnancy‐related stigma among adolescents in the context of existing policy and programming. Recognizing the impact of pregnancy‐related stigma on the health and wellbeing of adolescent girls necessitates prioritizing comprehensive stigma reduction interventions that address main drivers and facilitators, and that are rooted in the communities to harness support. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of levonorgestrel-releasing intrauterine device (LNG-IUD) use on the incidence of acne in adolescents and young women. Methods: A narrative review was conducted in PubMed, Embase, Cochrane, and SciELO assessing the incidence of acne in adolescents and young women using LNG-IUD (13.5, or 19.5 mg, or 52 mg). Cohort, cross-sectional studies, clinical trials, and meta-analyses were included, without a date limit. Studies that didn't evaluate women in the age of interest were excluded. Only articles in English were selected. Results: Nine articles were included in this narrative review. Only clinical trials, cohort studies, and cross-sectional studies were evaluated. Two cross-sectional studies evaluated the incidence of acne in women using any contraceptive methods, with the incidence of acne being 36% in women aged 17 to 47 using LNG-IUD in one study. In another study, acne incidence ranged from 2 to 8% in women using any contraceptive methods, with higher rates in younger women and LNG-IUD users. The incidence of acne varies and participants between 16 to 35 years were more likely to report new acne or worsening of pre-existing acne. In a prospective cohort study of women between 16 and 24 years, acne was a common adverse effect, with 44% in the first year. Conclusion: The data indicate variability in the incidence of acne among LNG-IUD users, with a higher prevalence observed in younger women. Further research should focus on the effects of LNG-IUD on acne in young populations, with rigorous study designs and consideration of previous contraceptive use. SHORT CONDENSATION: The levonorgestrel-releasing intrauterine device (LNG-IUD) is an important tool in the prevention of unplanned pregnancies in adolescents and young women. Acne is a possible adverse effect that could lead to discontinuation of the method. [ABSTRACT FROM AUTHOR]

Adolescents' sexual and reproductive health challenges are of global public health concern and good quality sexual and reproductive health (SRH) education has an important role to play in addressing these negative sexual health outcomes. Yet in most Sub-Saharan African countries including Ghana, there is limited implementation of SRH education. Several environmental factors hinder the implementation of SRH education with the attitudes expressed by religious leaders having a major impact. We conducted semi-structured interviews with 15 Christian leaders in Bolgatanga, Ghana, to explore the factors influencing their decision to adopt and implement SRH education. Findings show that although Christian leaders were aware of (unsafe) sexual practices among adolescents, they held a conservative position on SRH education. While leaders were open to educating adolescents about sexual health, most held the opinion that SRH education for adolescents should be limited to abstinence-only and not acknowledge sexual activity or promote contraceptive use. Beliefs related to sexual morality, the perceived cause(s) of teenage pregnancy, and perceived responsibility for SRH education influenced Christian leaders' thinking about SRH education. Implementing SRH education programmes to address young people's sexual behaviour will require intervention programmes to change Christian leaders' beliefs and attitudes towards SRH education. [ABSTRACT FROM AUTHOR]

Loreto, in the Peruvian Amazon, has one of the highest adolescent pregnancy rates in the country. However, underlying causes of adolescent pregnancy are not fully understood as data are limited in Indigenous and remote Amazonian communities. This study investigated adolescent reproductive health within Loreto using an ecological systems framework. Forty-one semi-structured interviews were conducted in June 2022: community leaders (n = 12) and adolescent participants between 15 and 17 years of age (pregnant girls, n = 11; never pregnant girls, n = 9; and boys, n = 9). We also conducted focus group discussions with community health workers and educators in October 2022 (three focus groups, n = 15). Adolescent reproductive health is complex with multi-layered factors that put girls at higher risk of pregnancy. We found a paradoxical relationship between expected social and gender norms and individual desires. This research provides a contextual understanding of the lived experience of adolescents and young people in the Amazon region of Peru. Our findings suggest the need for greater exploration of the contradictory ideas surrounding adolescent pregnancy and female sexuality. [ABSTRACT FROM AUTHOR]

Despite increased access to contraceptive methods (CM), the United States still has the highest rate of adolescent pregnancy among industrialized nations, and adolescents from historically marginalized groups are disproportionately affected. In this study, we sought to (1) understand if differences in CM usage were associated with differential percentages of new pregnancies among adolescents and young adult patients attending a family planning (FP) clinic at an urban community practice and (2) identify areas of improvement in our FP counseling. Mixed-methods study design consisting of (1) a 12-month retrospective chart review and (2) a self-answered cross-sectional survey of FP patients. Chi-square, Fisher's exact tests, and risk ratio were performed to analyze the percentage of new pregnancies according to CM usage. The percentage of new pregnancies was 11 among our FP patients (N = 555) during this study period. As anticipated, pregnancy was associated with no CM use, CM discontinuation, and, interestingly, multiple CM changes (P <.001). The probability of no-pregnancy significantly decreased among patients on no method, who discontinued their CM or made multiple CM changes compared to those with continuous CM use. There was no association between the percentage of new pregnancies and any particular CM type. Despite adequate access to FP patient services and high patient satisfaction levels, our findings indicate a need to adopt a more patient-centered approach in our FP counseling that addresses patient's reproductive life plans, preferences, and method side effects to increase CM uptake and satisfaction and decrease frequency of CM changes which is associated with increased risk of mistimed pregnancy during method switching. [ABSTRACT FROM AUTHOR]

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Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Uganda is burdened by high unintended and teen pregnancies, high sexually transmitted infections, and harm caused by unsafe abortion. Objectives: Explore factors influencing sexual and reproductive health and rights (SRHR) in Uganda by synthesizing evidence from qualitative studies using a scoping review. Eligibility Criteria: Original qualitative peer-reviewed research studies published between 2002 and 2023 in any language exploring factors influencing SRHR in Uganda. Sources of Evidence: Eight databases searched using qualitative/mixed methods search filters and no language limits. Charting Methods: Information extracted included author, article title, publication year, study aims, participant description, data collection type, sample size, main findings, factors at the individual, interpersonal, community, and policy levels, implications for SRHR in Uganda, and study limitations. Quality of the selected articles was assessed using the Critical Appraisal Skills Programme tool. Results: One hundred seventy-three studies met inclusion criteria. At the individual level, knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were identified as critical factors influencing health outcomes. Interpersonal factors included communication with sexual partners and relationships with family, school, and community members. Healthcare organization factors included adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors included gendered norms and male involvement in SRHR. Policy-level factors included the importance of aligning policy and practice. Conclusions: Multiple factors at individual, interpersonal, community, healthcare, cultural, and policy levels were found to influence SRHR in Uganda. The findings suggest that interventions targeting multiple levels of the socio-ecological system may be necessary to improve SRHR outcomes. This review highlights the need for a holistic approach that considers the broader socio-ecological context. Reducing identified gaps in the literature, particularly between policy and practice related to SRHR, is urgently needed in Uganda. We hope this review will inform the development of policies and interventions to improve SRHR outcomes. Plain language summary: A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda In Uganda, there are significant challenges regarding sexual and reproductive health and rights (SRHR), including high rates of unintended and teen pregnancies, sexually transmitted infections, and unsafe abortions. To better understand these issues, we conducted a comprehensive review of qualitative studies published between 2002 and 2023. Our analysis identified 173 studies that revealed various factors influencing SRHR in Uganda across different levels. At the individual level, factors such as knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were found to significantly impact health outcomes. Interpersonal relationships also played a crucial role, with communication with sexual partners and relationships with family, school, and community members being identified as important influences. Furthermore, the organization of healthcare services was found to be vital, particularly regarding adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors, including gender norms and the involvement of males in SRHR, were noted as significant contributors to SRHR outcomes. Additionally, the alignment of policy and practice was emphasized as essential for improving SRHR outcomes in Uganda. Overall, the review concluded that addressing SRHR challenges in Uganda requires interventions that target multiple levels of the socio-ecological system. A holistic approach considering individual, interpersonal, community, healthcare, cultural, and policy factors is necessary. There is an urgent need to bridge gaps between policy and practice related to SRHR. Findings could inform the development of policies and interventions aimed at improving SRHR outcomes in Uganda. [ABSTRACT FROM AUTHOR]

Background: One of the reasons for the high rates of maternal and child morbidity and mortality in Sub-Saharan Africa is the rising proportion of teenage pregnancy. Preventing teenage pregnancy is critical to meeting sustainable development goal number three which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. To support the achievement of this goal, this study aimed to assess the spatial variation and factors associated with teenage pregnancy in Ethiopia using the recent nationally representative data. Methods: A secondary data analysis of the 2019 Ethiopian mini Demographic and Health Survey was conducted with a total weighted sample of 2211 (unweighted 2100) teenagers. The Bernoulli model was fitted using SaTScan version 9.6 to identify hotspot areas and the geospatial pattern and prediction of teenage pregnancy were mapped using ArcGIS version 10.7. A multilevel logistic regression model was fitted to identify factors associated with teenage pregnancy among teenagers. Adjusted OR with 95% CI was calculated and variables having a p-value less than 0.05 were statistically significant factors of teenage pregnancy. Result: The prevalence of teenage pregnancy among adolescents aged 15–19 years in Ethiopia was 12.89% (95% CI: 11.56%, 14.36%). The SaTScan analysis identified a primary cluster in the Gambella region of Ethiopia (log-likelihood ratio = 14.02, p < 0.001). A high prevalence of teenage pregnancy was observed in Somalia, Afar, Gambella, and the southern part of the Oromia regions of Ethiopia. Age, educational status- primary and secondary, religion- protestant, having television, contraceptive knowledge, household head-female, and region- Small peripheral were significant determinants of teenage pregnancy. Conclusion: The spatial distribution of teenage pregnancy in Ethiopia was nonrandom. Age, educational status, religion, having television, contraceptive knowledge, sex of household head, and region were significant determinants of teenage pregnancy. Therefore, concerned government bodies and other stakeholders should organize periodic educational campaigns and youth-friendly reproductive health services. Collaboration between healthcare professionals, and religious and community leaders could also form a strategic partnership that makes interventions more comprehensive, culturally sensitive, and effective in reducing teenage pregnancy. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy causes serious health, social, and economic consequences, with 95% occurring in developing countries. A significant number of girls start childbearing at an early age in Ethiopia, which contributes to high infant and maternal morbidity and mortality. However, the information on teenage pregnancy and related variables is limited in the study area. Objective: To assess the prevalence of teenage pregnancy and its associated factors among teenage females in the Hula District, Sidama, Ethiopia. Methods: A community-based cross-sectional study was employed among 518 teenagers, randomly selected between 15 February and 15 March 2023. An interviewer-administered questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were applied to assess the relationship under study. Results: Living in rural areas compared to urban [adjusted odds ratio (AOR) = 3.90; 95% confidence interval (CI): 1.30-11.3], lack of awareness about family planning methods (AOR = 5.90; 95% CI: 1.60-22.24), unfamiliarity with the availability of family planning services (AOR = 3.20; 95% CI: 1.08-9.24), and inadequate communication about sexual issues with parents (AOR = 3.61; 95% CI: 1.14-11.56) were independently associated with teenage pregnancy. Conclusion: The prevalence of teenage pregnancies in the Hula District was high. Factors such as residing in rural areas, limited access to information on family planning methods and services, as well as a lack of open discussions about sexual health were associated with teenage pregnancy. [ABSTRACT FROM AUTHOR]

Conducting research studies with vulnerable populations on sensitive topics such as adolescent pregnancy can be challenging depending on methodological approaches and ethical issues that may arise before, during, and after data collection. This methodological paper was developed based on experiences and lessons learned from a critical ethnographic study conducted to determine and understand the cultural and personal meaning of unintended adolescent pregnancy in the Rwandan context and to explore the perceived consequences and management of unintended adolescent pregnancy with and for single adolescent mothers. The purpose of this methodological paper is to discuss methodological and ethical challenges encountered while conducting this research, as well as various approaches used to overcome these challenges, and to provide guidance to researchers interested in conducting research about similar or other sensitive topics. Future researchers facing similar challenges should prioritize community engagement strategies, such as building strong relationships with gatekeepers and leaders, to facilitate access to potential participants. Additionally, researchers should engage in continuous ethical reflection and adaptation throughout the study, adjusting strategies if necessary to ensure the well-being and autonomy of participants. As a result of the practical and methodological strategies provided in this reflective paper, researchers could be able to navigate practical, methodological, and ethical challenges effectively while conducting sensitive studies on topics such as adolescent pregnancy. [ABSTRACT FROM AUTHOR]

Pregnancy loss is arguably a traumatic and stressful life event that potentially impacts the emotional and behavioral health of those who experience it, especially adolescents. Research assessing this relationship has primarily focused on adult women populations. Using data from National Longitudinal Study of Adolescent to Adult Health, a cross-sectional research design was employed to investigate whether pregnancy loss outcomes are associated with depressive mood and suicidal behavior (i.e., suicidal thoughts and suicide attempt) among adolescent girls (N = 6, 913). We also investigated the mediating effect of depressive mood. Initially, an all-encompassing pregnancy loss variable was used, which included abortions and miscarriages. Acknowledging the differences between these pregnancy loss outcomes, we created separate measures for each. Using the all-encompassing pregnancy loss variable, findings from logistic regression analyses showed that pregnancy loss is positively and significantly associated with depressive mood and suicidal behaviors. Depressive mood mediated the relationship between pregnancy loss and suicidal behaviors. Miscarriage was positively and significantly associated with suicidal thoughts as well as attempting suicide. Depressive mood mediated the relationship between miscarriage and suicidal thoughts, while only partially mediating the relationship between miscarriage and suicide attempt. No significant effects were observed for abortion on outcomes of interest. Cross-sectional analyses were performed limiting our ability to make casual inferences. Pregnancy loss is associated with depressive mood and suicidal behavior, especially among adolescent girls who experience a miscarriage. Adolescent pregnancy and pregnancy loss should remain a focus of scholars and health professionals. • Pregnancy loss is associated with depressive mood and suicidal behavior. • Miscarriage is associated with depressive mood and suicidal behavior. • Depressive mood plays an important role among girls who experience pregnancy loss. • Abortion was not associated with negative emotional or suicidal outcomes. [ABSTRACT FROM AUTHOR]

Early childbearing poses several potential risks to maternal and child health. This paper empirically analyses the association between teenage pregnancy and child nutritional status, maternal and child anaemia in three countries (Nigeria, India and Bangladesh) that account for the highest proportion of teenage births and/or total number of malnourished teenage mothers and children. Data were sourced from nine waves of Demographic and Health Surveys conducted in Bangladesh, India, and Nigeria from 2005–2018, covering a sample of 27,705 children from Bangladesh, 266,308 children from India and 54,719 children from Nigeria. Our outcome measures of maternal and child nutrition include (i) a composite measure of anthropometric failure for children (CIAF), (ii) maternal anaemia, (iii) childhood anaemia, and (iv) anaemia in maternal–child pairs. Using multivariate regression analysis, we examine the associations between early childbirth, child nutrition, and maternal and child anaemia, controlling for an array of household‐level socioeconomic and demographic characteristics. Across all three countries, the prevalence of CIAF (childhood anthropometric failure) is significantly higher among children born to women aged below 17 at first birth. We further find that early pregnancy and childbearing are associated with significantly higher rates of severe/moderate anaemia among both mothers and children in Bangladesh and Nigeria. In the three countries studied, the proportions of teenage mothers with vulnerable socioeconomic status and suboptimal pre‐conception care are relatively high, which raises the risk of maternal and child morbidity as well as mortality. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15–19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS). Methods: This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS). Results: The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19. Conclusion: Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health. [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]

Background: As the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities. Methods: This cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared. Results: The cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08–75.7, p <.001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51–16.91, p <.001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52–27.36, p <.001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care. Conclusions: This research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: There still remains a significant gap in understanding the sexual and reproductive health challenges faced by adolescents, particularly in the context of early sexual activity, teenage pregnancy, and sexually transmitted diseases. This study seeks to fill this gap by exploring the initial sexual experiences of Cambodian adolescents, highlighting the complex interplay of cultural, social, and personal influences that shape their sexual health decisions and outcomes. Methodology: A descriptive qualitative research design was used. Thirty Cambodian adolescents were interviewed from March to June 202 and data were analyzed using thematic analysis. Results: Participants met their sexual partners in school and through friendships and social networking sites. Their motivations for sexual activities ranged from intrinsic desires to influences of inebriation, love, and trust. Consent was crucial but some were influenced by partners. Awareness of sexual protection varied, affecting condom use and information-seeking behaviors. After initial encounters, participants grappled with complex emotions and physical changes. Discussion: The findings suggest the need for educational interventions that address substance use; promote safe behavior, consensual conduct, open communication, and mutual respect; and provide coping strategies. [ABSTRACT FROM AUTHOR]

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

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

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The objective was to analyze the spatial distribution of pregnancy in children under 14 years and six months by Brazilian region and municipality and sociodemographic and health characteristics of pregnant women and live births. Ecological study analyzing the Live Birth Information System (SINASC) from 2011 to 2021 in three age groups (< 14 years and six months, 15-19 years, and 20 years and above) by demographic and birth variables. We applied the Global and Local Moran. A total of 127,022 live births to girls aged 10-14 years were identified during the period, most of whom were Black, 21.1% in common-law or married relationships, with a lower proportion of seven prenatal care appointments and enrollment in the first trimester, a higher proportion of low birth weight and low Apgar score, residing in the North and Northeast. The mean live birth rate for 10-to-14-year-old girls was significantly autocorrelated with space, especially in municipalities of the Midwest and North. Pregnancy from 10 to 14 years of age reveals several vulnerabilities suffered by these girls due to pregnancy at an early age, which is more common among Black women, with implications for morbimortality for them and their children and the presumed violence in these cases, including denied access to legal abortion. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to better understand the relationship between homicide and other public health outcomes, by studying their trends over time. Subject and methods: Research in both criminology and public health has long identified that crime and violence tend to cluster together with adverse phenomena in the social and health domains. However, such work has relied primarily on cross-sectional analyses. Here, we instead study trends over time. We take data from the Netherlands, between 2000 and 2020, and ask whether homicide shows similar trends over time as other public health phenomena – such as smoking behaviour, alcohol use, child mortality, adolescent pregnancies, and suicide. Results: We observe, first, that all of the phenomena – with the exception of suicide – declined over the period under study. We then employ a time series analysis to examine whether these trends arise independently, or whether they are the result of structural similarities between phenomena. Results showed that the decline in homicide rates is linked to a similar decline in adolescent pregnancies – the rates of these phenomena 'move together' during the period under study. Conclusion: This work shows that the phenomenon of homicide shares structural similarities with teenage pregnancies – a decline in one is linked to a similar decline in the other. More generally, the current work furthers our understanding of the place of homicide in the domain of (public) health. [ABSTRACT FROM AUTHOR]

Teenage pregnancy remains a prevalent concern, particularly among young females facing educational and economic disadvantages. This can be attributed to factors such as illiteracy, societal practices, and poverty encouraging girls to enter into sexual relationships at an early age. In Nigeria, more than 23% of females aged between 15-19 years are bearing children. In Nigeria, as in numerous other countries, there is a noticeable increase in teenage sexual activity. The case of underage girls, usually between the ages of thirteen to nineteen years, becoming pregnant is a serious problem that has eaten deep into the fabric of our societies, inhibiting growth in this contemporary period. This study focused on the menace of this act among the teenagers in our society, using a descriptive method to identify basic factors and their effects using primary data. Some of the root causes identified are poverty, peer pressure and media influence while the effects include school drop-out, inadequate care for the child born by teenage mother, health problems and a host of other vices. The study suggested adequate parental care, eradication of street hawking, and inculcation of moral values through religious bodies as ways of reducing teenage pregnancy in Nigeria. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)