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Gardner ME, Umer A, Rudisill T, Hendricks B, Lefeber C, John C, Lilly C. Prenatal care and infant outcomes of teenage births: a Project WATCH study. BMC Pregnancy Childbirth 2023; 23:379. [PMID: 37226124 DOI: 10.1186/s12884-023-05662-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Infants of teenage births are known to have increased risk of poor infant outcomes. Adequate prenatal care (PNC) is essential to the overall health of infants and their birthing persons. While teenage births continue to be of concern in rural areas, little is known about the association between inadequate PNC and poor infant outcomes in teenage populations. PURPOSE To determine the association between inadequate PNC (< 10 visits) and poor infant outcomes neonatal intensive care unit (NICU) stay, low APGAR score, small for gestational age (SGA) and length of stay (LOS). METHODS The study used West Virginia (WV) Project WATCH population level data (May 2018-March 2022). Multiple logistic regressions and survival analysis were performed on infant outcomes; NICU stay, APGAR score, infant size, and infant length of stay (LOS) with PNC categories inadequate (< 10 PNC visits) vs adequate (10 or more) adjusting for covariates including maternal race, insurance status, parity, smoking status, substance use status, and diabetes status. RESULTS Of births to teenagers, 14% received inadequate PNC. Teens who received inadequate PNC had increased odds of infant admitted to NICU (aOR: 1.84, CI:(1.41, 2.42), p < 0.0001), low 5- minute APGAR score (aOR: 3.26, CI:(2.03,5.22), p < 0.0001), and increased LOS (Est. = -0.33, HR: 0.72, CI:(0.65,0.81), p < 0.0001). CONCLUSIONS Results demonstrated that infants of teenagers who received inadequate PNC are at increased risk of requiring a NICU stay, having a low APGAR score and requiring an increased LOS. PNC is particularly important for these groups as they are at increased risk of poor birth outcomes.
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Affiliation(s)
- Madelin E Gardner
- Department of Epidemiology/Biostatistics, School of Public Health, West Virginia University, SPH 64 Medical Center Dr, PO Box 9190, Morgantown, WV, 26505, USA.
| | - Amna Umer
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Toni Rudisill
- Department of Epidemiology/Biostatistics, School of Public Health, West Virginia University, SPH 64 Medical Center Dr, PO Box 9190, Morgantown, WV, 26505, USA
| | - Brian Hendricks
- Department of Epidemiology/Biostatistics, School of Public Health, West Virginia University, SPH 64 Medical Center Dr, PO Box 9190, Morgantown, WV, 26505, USA
| | - Candice Lefeber
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Collin John
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Christa Lilly
- Department of Epidemiology/Biostatistics, School of Public Health, West Virginia University, SPH 64 Medical Center Dr, PO Box 9190, Morgantown, WV, 26505, USA
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Abstract
Although teenage pregnancy rates have decreased over the past 30 years, many adolescents become pregnant every year. It is important for pediatricians to have the ability and the resources to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental counseling that includes the full range of pregnancy options. Counseling includes an unbiased discussion of the adolescent's options to continue or terminate the pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. It is important for pediatricians to be familiar with laws and policies impacting access to abortion care, especially for minor adolescents, as well as laws that seek to limit health care professionals' provision of unbiased pregnancy options counseling and referrals, either for abortion care or continuation of pregnancy in accordance with the adolescent's choice. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling that includes the full range of pregnancy options. Pediatricians should be aware of and oppose policies that restrict their ability to provide pregnant adolescents with unbiased counseling that includes the full range of pregnancy options. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue.
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Banerjee A, Sen S, Khan J, Pal M, Bharati P. Decadal change in the association between the status of young mother's Body Mass Index and anaemia with child low birth weight in India. BMC Pregnancy Childbirth 2022; 22:147. [PMID: 35193534 PMCID: PMC8864895 DOI: 10.1186/s12884-022-04486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/17/2022] [Indexed: 12/05/2022] Open
Abstract
Background The study aims to investigate the changes in the socio-economic and demographic status of young mothers of age 15–24 years and to examine the association between mothers’ nutrition, i.e., Body Mass Index (BMI) and anaemia with child low birth weight for almost two decades during 1998–2016 in India. Methods National Family Health Survey (NFHS) round II and IV were used. The sample of this study included 3405 currently married young mothers from NFHS II and 44,742 from NFHS IV who gave birth at least one child in the last three years preceding the surveys. Logistic regression and Blinder-Oaxaca decomposition analysis have been used in this study to examine the corresponding association between the concerned variables. Results The analysis showed that the prevalence of low birth weight (LBW) babies has decreased from 26.1 to 22.8 for the 15 to 19 age group and from 20.4 to 18.7 for the 20 to 24 age group over time. Young mothers with low BMI or severe anaemia have shown higher odds of having LBW babies. For instance, the odds of having a LBW child was 1.44 (p-value = 0.000; 95% CI: 1.05, 1.65) for mothers with low BMI and 1.55 (p-value = 0.000; 95% CI: 1.27, 1.90) with severe anaemia. Over the decade, the association of LBW babies with mothers’ nutrition has decreased. The odds of LBW with mothers with low BMI decreased from 1.63 (p-value = 0.004; 95% CI: 1.21, 2.21) to 1.41 (p-value = 0.000; 95% CI: 1.27, 1.55). Similarly, mothers with severe anaemia, the odds of LBW child decreased from 2.6 (p-value = 0.000; 95% CI: 1.75, 3.8) in 1998 to 1.3 (p-value = 0.024; 95% CI: 1.02, 1.65) in 2016. Conclusions The maternal and child health improvement in India has been moderate over the decade. Still, a significant proportion of the women are suffering from poor health and young mothers are at more risk to deliver LBW babies. It is highly recommended to integrate maternal and child health programmes with the ongoing health policies to improve the situation while taking additional care of the young pregnant mother and their nutritional health.
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Affiliation(s)
- Anuja Banerjee
- International Institute for Population Sciences, Govandi Station Road, Mumbai, 400088, India
| | - Soumendu Sen
- International Institute for Population Sciences, Govandi Station Road, Mumbai, 400088, India.
| | - Junaid Khan
- International Institute for Population Sciences, Govandi Station Road, Mumbai, 400088, India
| | - Manoranjan Pal
- Indian Statistical Institute, 203 B.T. Road, Kolkata, 700108, India
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Honorato DJP, Fulone I, Silva MT, Lopes LC. Risks of Adverse Neonatal Outcomes in Early Adolescent Pregnancy Using Group Prenatal Care as a Strategy for Public Health Policies: A Retrospective Cohort Study in Brazil. Front Public Health 2021; 9:536342. [PMID: 33898367 PMCID: PMC8062755 DOI: 10.3389/fpubh.2021.536342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care. Objective: To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services. Methods: This retrospective cohort study followed pregnant adolescents (aged 10-17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10-13 years were compared to those of adolescents aged 14-15 years and 16-17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences. Results: Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7-11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10-13 age group, 8.7% for the 14-15 age group and 12.1% for the 16-17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10-13, 14-15, and 16-17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups (p > 0.05). The infants born to mothers aged 10-13 years presented significantly (p < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range. Conclusions: Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed.
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Affiliation(s)
| | - Izabela Fulone
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
| | - Marcus Tolentino Silva
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
| | - Luciane Cruz Lopes
- Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, Brazil
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Lin L, Lu C, Chen W, Li C, Guo VY. Parity and the risks of adverse birth outcomes: a retrospective study among Chinese. BMC Pregnancy Childbirth 2021; 21:257. [PMID: 33771125 PMCID: PMC8004392 DOI: 10.1186/s12884-021-03718-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed. Methods This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25–29 years, 30–34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes. Results Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89–0.93), LBW (aRR = 0.74, 95% CI: 0.72–0.77) and SGA (aRR = 0.67, 95% CI: 0.66–0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70–0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84–0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years. Conclusion Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03718-4.
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Affiliation(s)
- Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Ciyong Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Chunrong Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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Sámano R, Chico-Barba G, Martínez-Rojano H, Hernández-Trejo M, Birch M, López-Vázquez M, García-López GE, Díaz de León J, Mendoza-González CV. Factors Associated With Weight, Length, and BMI Change in Adolescents' Offspring in Their First Year of Life. Front Pediatr 2021; 9:709933. [PMID: 34532303 PMCID: PMC8438192 DOI: 10.3389/fped.2021.709933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Young maternal age is associated with negative outcomes at birth and with offspring's growth. In low- and middle-income countries, adolescents' offspring growth little has been studied. Objective: To determine the association of maternal sociodemographic characteristics with weight, length, and BMI change in adolescents' offspring in their first year of life. Methods: This is a one-year follow-up study that included adolescent mothers and their offspring from 2010 to 2017. The infant anthropometric variables were performed at birth, 3, 6, and 12 months. Maternal health, pregnancy, and social variables were evaluated as well as birth outcomes. Crude, percentage, Z score, and percentile changes of weight, length, and BMI were evaluated from birth to 1-year-old. Statistical analyses were adjusted by maternal chronological age, socioeconomic status, breastfeeding duration, the timing of introduction of complementary feeding, among other variables. Results: We examined 186 dyads (mother-infant). The median maternal age was 15.5 years, and the mean pre-pregnancy BMI was 20. The mean gestational age was 39.1 weeks for infants, birth weight was 3,039 g, and length at birth was 49.5-cm. Maternal chronological age, the timing of introduction of complementary feeding, socioeconomic status, and maternal occupation were associated with offspring's weight gain at 12 months. Length gain was associated with exclusive breastfeeding. Socioeconomic status and occupation were associated with offspring's BMI change. When performing adjusted multivariable analyses, weight and length at birth were associated weight and BMI at 12 months. Conclusions: Weight at birth may negatively predict infant's weight and BMI changes at 12 months, while length at birth may positively predict the changes. Maternal chronological age, socioeconomic level, occupation, and the timing of the introduction of complementary feeding were associated with the weight change. Only exclusive breastfeeding was associated with length Z-score change in adolescents' offspring in their first 12-months of life.
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Affiliation(s)
- Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Programa de Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Gabriela Chico-Barba
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad Panamericana, Mexico City, Mexico
| | - Hugo Martínez-Rojano
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City, Mexico.,Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos, Mexico City, Mexico
| | - María Hernández-Trejo
- Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Mery Birch
- Licenciatura en Nutrición, Universidad del Valle de México, Mexico City, Mexico
| | | | | | - Jesús Díaz de León
- Licenciatura en Nutrición, Universidad del Valle de México, Mexico City, Mexico
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Macedo TC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, Laganà AS, Bianco B. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol 2020; 248:177-186. [DOI: 10.1016/j.ejogrb.2020.03.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
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Attitudes of Teenage Mothers towards Pregnancy and Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041411. [PMID: 32098226 PMCID: PMC7068586 DOI: 10.3390/ijerph17041411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/15/2020] [Accepted: 02/20/2020] [Indexed: 12/04/2022]
Abstract
The problem of early motherhood is still a serious medical and social problem in many countries around the world. The aim of this study was to analyze the attitudes of teenage mothers towards pregnancy and childbirth. A retrospective cross-sectional study was conducted with the use of an original questionnaire containing a test to measure attitudes on a five-point Likert scale and a Life Orientation Test-Revised (LOT-R) to assess dispositional optimism. The study involved 308 teenage mothers between 13 and 19 years of age. Attitudes of teenage mothers towards pregnancy and childbirth were more often positive (90.6%) than negative (9.4%). Sociodemographic features determining the attitudes of teenage mothers towards both their pregnancy and childbirth included their age, marital status, current occupation, and main source of income. The type of attitude adopted by teenage mothers towards pregnancy and childbirth was significantly related to the level of their dispositional optimism.
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What Are the Maternal and Neonatal Outcomes of Adolescent Pregnancy in Women Referring to Ayatollah Mousavi Hospital in Zanjan? A Comparative Cross-sectional Study. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2019. [DOI: 10.52547/pcnm.9.3.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Research has documented a negative association between women's educational attainment and early sexual intercourse, union formation, and pregnancy. However, the implications that school progression relative to age may have for the timing and order of such transitions are poorly understood. In this article, I argue that educational attainment has different implications depending on a student's progression through school grades relative to her age. Using month of birth and age-at-school-entry policies to estimate the effect of advanced school progression by age, I show that it accelerates the occurrence of family formation and sexual onset among teenage women in Mexico. Focusing on girls aged 15-17 interviewed by a national survey, I find that those who progress through school ahead of their birth cohort have a higher probability of having had sex, been pregnant, and cohabited by the time of interview. I argue that this pattern of behaviors is explained by experiences that lead them to accelerate their transition to adulthood compared with same-age students with fewer completed school grades, such as exposure to relatively older peers in school and completing academic milestones earlier in life. Among girls who got pregnant, those with an advanced school progression by age are more likely to engage in drug use, alcohol consumption, and smoking before conception; more likely to have pregnancy-related health complications; and less likely to attend prenatal care visits. Thus, an advanced school progression by age has substantial implications for the health and well-being of young women, with potential intergenerational consequences.
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Karataşlı V, Kanmaz AG, İnan AH, Budak A, Beyan E. Maternal and neonatal outcomes of adolescent pregnancy. J Gynecol Obstet Hum Reprod 2019; 48:347-350. [PMID: 30794955 DOI: 10.1016/j.jogoh.2019.02.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/29/2019] [Accepted: 02/19/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To examine the maternal and neonatal outcomes of adolescent pregnancies. METHODS Deliveries that occurred in a high-volume tertiary center between January 2013 and December 2016 were retrospectively analyzed. We studied pregnant women who were under 19 years of age at the time at which they gave birth, and who underwent regular follow-up. Pregnancies associated with chromosomal abnormalities, early pregnancy losses (before 20 weeks), and ectopic pregnancies were excluded. RESULTS In all, 101 pregnant women aged <15 years and 3611 aged 15-19 years were enrolled. The control group contained 13,501 randomly selected pregnant women aged 25-30 years. The median gestational week at delivery was lower in adolescents. Adolescent pregnancies were associated with higher rates of threatened abortion and pre-eclampsia. Gestational diabetes mellitus was less common, whereas the risk for cesarean section was higher, in adolescents. In addition, women aged <15 years were at higher risk for preterm delivery. The rates of <3rd percentile birth weight percentiles by gestational age were 6.9%, 5.1%, 4.2% and <10th percentile were 16.8%, 14.5%, 11% in the three groups, respectively. The 5 min Apgar scores were lower for the babies of adolescents, and the requirement of newborn intensive care was higher for the infants of mothers aged <15 years. CONCLUSION Adolescent pregnancy is a significant issue worldwide. Adverse outcomes differ among study populations, but both preterm delivery and low birth weight are of concern, as are a higher cesarean rate.
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Affiliation(s)
- Volkan Karataşlı
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey.
| | - Ahkam Göksel Kanmaz
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | | | - Adnan Budak
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | - Emrah Beyan
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
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Wilson-Mitchell K, Marowitz A, Lori JR. Midwives’ Perceptions of Barriers to Respectful Maternity Care for Adolescent Mothers in Jamaica: A Qualitative Study. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.1.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background:Few studies have examined respectful maternity care (RMC) of adolescent mothers in the Caribbean. The researchers’ objective was to explore the perceptions of midwives who provide care for adolescent mothers in Jamaica. Design: A pilot qualitative study was conducted in 2015. Participants were 12 community or nurse-midwives who practiced in rural and urban regions of Jamaica attended a nursing and midwifery conference.Method:Semistructured focus groups and interviews of Jamaican midwives were conducted. The World Health Organization (WHO) definitions of respectful care in relationship to sexual and reproductive health rights, and data were examined using a poststructural feminist version of Denzin’s interpretive interactionism theory. Braun and Clark’s method of reiterative content analysis was employed. Findings:Participants shared their work experience with adolescent mothers and explained that restrictive public and institutional policies culture, personal beliefs, and the location of care delivery hindered them from providing respectful care which allows for shared decision-making, informed consent, and allowing for a desired labour companion. They perceived their roles as advocates, educators, expert helpers, and worker activists. Conclusions:Out of hospital environments appeared to facilitate the advocacy role. Policies and attitudes had the potential to hinder or to promote RMC. These findings may be used to inform a national midwifery survey, educational modules, health systems change to allow for less restrictive policies and spaces.
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Usynina AA, Postoev V, Odland JØ, Grjibovski AM. Adverse Pregnancy Outcomes among Adolescents in Northwest Russia: A Population Registry-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E261. [PMID: 29401677 PMCID: PMC5858330 DOI: 10.3390/ijerph15020261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 11/17/2022]
Abstract
This study aimed to assess whether adolescents have an increased risk of adverse pregnancy outcomes (APO) compared to adult women. We used data on 43,327 births from the population-based Arkhangelsk County Birth Registry, Northwest Russia, for 2012-2014. The perinatal outcomes included stillbirth, preterm birth (<37 and <32 weeks), low and very low birthweight, 5 min Apgar score <7 and <4, perinatal infections, and the need for neonatal transfer to a higher-level hospital. Multivariable logistic regression was applied to assess the associations between age and APO. Altogether, 4.7% of deliveries occurred in adolescents. Both folic acid intake and multivitamin intake during pregnancy were more prevalent in adults. Adolescents were more likely to be underweight, to smoke, and to have infections of the kidney and the genital tract compared to adult women. Compared to adults, adolescents were at lower risk of low birthweight, a 5 min Apgar score <7, and need for neonatal transfer. Adolescents had no increased risk of other APO studied in the adjusted analysis, suggesting that a constellation of other factors, but not young age per se, is associated with APO in the study setting.
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Affiliation(s)
- Anna A Usynina
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø 9037, Norway.
- Department of Neonatology and Perinatology, Northern State Medical University, 51 Troitsky Ave., Arkhangelsk 163000, Russia.
| | - Vitaly Postoev
- Department of Public Health, Health Care and Social Work, Northern State Medical University, 51 Troitsky Ave., Arkhangelsk 163000, Russia.
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø 9037, Norway.
| | - Andrej M Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, 51 Troitsky Ave., Arkhangelsk 163000, Russia.
- Department of Public Health and Healthcare, Hygiene and Bioethics, North-Eastern Federal University, 58 Belinsky Str., Yakutsk 677000, Russia.
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Huang K, Li H, Zhang B, Zheng T, Li Y, Zhou A, Du X, Pan X, Yang J, Wu C, Jiang M, Peng Y, Huang Z, Xia W, Xu S. Prenatal cadmium exposure and preterm low birth weight in China. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:491-496. [PMID: 27436694 DOI: 10.1038/jes.2016.41] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 05/17/2016] [Indexed: 06/06/2023]
Abstract
Early studies have investigated the effect of prenatal cadmium (Cd) exposure on birth outcomes, such as preterm birth and low birth weight, although the results of these studies are inconsistent. The aim of the present study was to investigate the association between prenatal exposure to Cd and the risk of preterm low birth weight (PLBW). A total of 408 mother-infant pairs (102 PLBW cases and 306 pair matched controls) were selected from the participants enrolled in the Healthy Baby Cohort (HBC) study between 2012 and 2014 in Hubei province, China. Concentrations of Cd in maternal urine collected before delivery were measured by inductively coupled plasma mass spectrometry and adjusted by creatinine. A significant association was observed between higher maternal urinary Cd levels and risk of PLBW (adjusted odds ratio (OR)=1.75 for the medium tertile, 95% confidence interval (CI): 0.88, 3.47; adjusted OR=2.51 for the highest tertile, 95% CI: 1.24, 5.07; P trend=0.03). The association was more pronounced among female infants than male infants. Our study suggested that prenatal exposure to Cd at the current level encountered in China may potentially increase the risk of delivering PLBW infants, particularly for female infants.
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Affiliation(s)
- Kai Huang
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Han Li
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Bin Zhang
- Wuhan Medical and Health Center for Women and Children, Wuhan, People's Republic of China
| | - Tongzhang Zheng
- Department of Epidemiology, Brown Universtiy, Providence, Rhode Island 02903, USA
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Aifen Zhou
- Wuhan Medical and Health Center for Women and Children, Wuhan, People's Republic of China
| | - Xiaofu Du
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People's Republic of China
| | - Xinyun Pan
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jie Yang
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Chuansha Wu
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Minmin Jiang
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yang Peng
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zheng Huang
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection (HUST) and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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15
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Hornberger LL, Breuner CC, Alderman EM, Garofalo R, Grubb LK, Powers ME, Upadhya KK, Wallace SB. Options Counseling for the Pregnant Adolescent Patient. Pediatrics 2017; 140:peds.2017-2274. [PMID: 28827379 DOI: 10.1542/peds.2017-2274] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Each year, more than 500 000 girls and young women younger than 20 years become pregnant. It is important for pediatricians to have the ability and the resources in their offices to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental pregnancy options counseling. Counseling includes an unbiased discussion of the adolescent's legal options to either continue or terminate her pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue.
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Affiliation(s)
| | - Cora C. Breuner
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Elizabeth M. Alderman
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Robert Garofalo
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Laura K. Grubb
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Makia E. Powers
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Krishna Kumari Upadhya
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
| | - Stephenie B. Wallace
- Division of Adolescent Medicine, Children’s Mercy Hospital and Clinics, Kansas City, Missouri
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Association between prenatal care utilization and risk of preterm birth among Chinese women. ACTA ACUST UNITED AC 2017; 37:605-611. [PMID: 28786063 DOI: 10.1007/s11596-017-1779-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/31/2017] [Indexed: 10/18/2022]
Abstract
It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32-1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.
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Taylor YJ, Laditka SB, Laditka JN, Brunner Huber LR, Racine EF. Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries. Health Care Women Int 2016; 38:207-221. [PMID: 27797654 DOI: 10.1080/07399332.2016.1254219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.
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Affiliation(s)
- Yhenneko J Taylor
- a Center for Outcomes Research and Evaluation, Carolinas HealthCare System , Charlotte , North Carolina , USA
| | - Sarah B Laditka
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - James N Laditka
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Larissa R Brunner Huber
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Elizabeth F Racine
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
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18
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Tibingana-Ahimbisibwe B, Katabira C, Mpalampa L, Harrison RA. The effectiveness of adolescent-specific prenatal interventions on improving attendance and reducing harm during and after birth: a systematic review. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0063/ijamh-2016-0063.xml. [PMID: 27542198 DOI: 10.1515/ijamh-2016-0063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adolescent pregnancy has been associated with poor pregnancy outcomes including pre-term birth (PTB), low birth weight (LBW) and perinatal death. OBJECTIVE To systematically review the effect of adolescent-specific interventions on reducing PTB, LBW, and perinatal death and increasing prenatal care attendance. SEARCH STRATEGY Possible studies for inclusion were identified by a comprehensive search of OvidSP MEDLINE (limits: humans, 1990-present), EMBASE (limits: humans, 1990-2015), Popline and Global Health Database from the World Health Organisation (WHO) and PubMed International scientific databases, and references of identified articles were searched from 1990 to present. SELECTION CRITERIA All types of controlled studies of prenatal interventions were exclusive to adolescents and at least one of the outcomes of interest. DATA COLLECTION AND ANALYSIS Investigators identified relevant studies and entered the data in a pro forma. Data were summarised as forest plots and narrative synthesis. MAIN RESULTS Twenty-two studies (three randomised controlled trials (RCTs), four prospective cohort studies, nine retrospective cohort studies, five case controls and one natural experiment) were included with all but one study being carried out in higher-income countries. Seven of the 16 studies reporting on PTB found a statistically significant reduction in PTB rates between adolescent-specific prenatal care (intervention) and non-age specific prenatal care odds ratio (OR) and 95% confidence intervals (CIs) ranged from OR: 0.15 (95% CI: 0.03-0.83) to OR: 0.59 (95% CI: 0.45-0.78). Nine of the 12 studies reported statistically significant higher mean prenatal attendance rates among the intervention group compared to controls (ranging from a mean number of visits of 14.3 vs. 10.7 p<0.001 to 10.8 vs. 7.6 visits p<0.001). The type and construct of the interventions, their implementation and local population differed sufficiently that a statistical synthesis was deemed inappropriate. CONCLUSION There is some evidence that adolescent-specific programs can increase prenatal attendance and reduce the risk of PTB and low birth rate but their effect on perinatal death is uncertain. There is a distinct lack of evidence of the effectiveness of these interventions for adolescents living in low-middle income countries, despite having the majority of adolescent pregnancies, and associated risk of harm. No high-quality intervention studies were identified. Robust, cluster-based RCTs are an urgent necessity to quantify the impact of these interventions and to identify factors contributing to their success.
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Affiliation(s)
| | | | | | - Roger A Harrison
- Centre for Epidemiology in the Institute for Population Health, The University of Manchester, Manchester, UK
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19
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Owili PO, Muga MA, Chou YJ, Hsu YHE, Huang N, Chien LY. Relationship between women's characteristics and continuum of care for maternal health in Kenya: Complex survey analysis using structural equation modeling. Women Health 2016; 57:942-961. [PMID: 27613111 DOI: 10.1080/03630242.2016.1222327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study was to understand and estimate the complex relationships in the continuum of care for maternal health to provide information to improve maternal and newborn health outcomes. Women (n = 4,082) aged 15-49 years in the 2008/2009 Kenya Demographic and Health Survey data were used to explore the complex relationships in the continuum of care for maternal health (i.e., before, during, and after delivery) using structural equation modeling. Results showed that the use of antenatal care was significantly positively related to the use of delivery care (β = 0.06; adjusted odds ratio [AOR] = 1.06; 95% confidence interval [CI]: 1.02-1.10) but not postnatal care, while delivery care was associated with postnatal care (β = 0.68; AOR = 1.97; 95% CI: 1.75-2.22). Socioeconomic status was significantly related to all elements in the continuum of care for maternal health; barriers to delivery of care and personal characteristics were only associated with the use of delivery care (β = 0.34; AOR = 1.40; 95% CI: 1.30-1.52) and postnatal care (β = 0.03; AOR = 1.03; 95% CI: 1.01-1.05), respectively. The three periods of maternal health care were related to each other. Developing a referral system of continuity of care is critical in the Sustainable Development Goals era.
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Affiliation(s)
- Patrick Opiyo Owili
- a International Health Program, Institute of Public Health, School of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Miriam Adoyo Muga
- b Institute of Community Health and Development , Great Lakes University of Kisumu , Kisumu , Kenya
| | - Yiing-Jenq Chou
- c Institute of Public Health, School of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Yi-Hsin Elsa Hsu
- d School of Health Care Administration , Taipei Medical University , Taipei , Taiwan
| | - Nicole Huang
- e Institute of Hospital and Health Care Administration , National Yang-Ming University , Taipei , Taiwan
| | - Li-Yin Chien
- f Institute of Clinical and Community Health Nursing , National Yang-Ming University , Taipei , Taiwan
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20
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Minjares-Granillo RO, Reza-López SA, Caballero-Valdez S, Levario-Carrillo M, Chávez-Corral DV. Maternal and Perinatal Outcomes Among Adolescents and Mature Women: A Hospital-Based Study in the North of Mexico. J Pediatr Adolesc Gynecol 2016; 29:304-11. [PMID: 26620384 DOI: 10.1016/j.jpag.2015.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/05/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVE To compare maternal and newborn pregnancy outcomes from adolescents and mature women. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study was carried out in a public hospital, including women with singleton pregnancies, who were classified according to their age, as follows: group 1: younger than 16 years old (n = 37), group 2: 16-19 years old (n = 288), and group 3: 20-34 years old (n = 632). INTERVENTIONS AND MAIN OUTCOME MEASURES Information on clinical characteristics, gynecological and obstetric history, pregnancy complications, and perinatal outcomes was obtained through interviews and from clinical records. RESULTS Thirty-four percent of deliveries were from adolescents. Mature women were more likely to have prepregnancy overweight or obesity than adolescents (odds ratio [OR] = 2.4, 95% confidence interval [CI], 1.7-3.4). The frequency of maternal complications during pregnancy or delivery was not different between groups. Birth asphyxia was more frequent in group 2 (P = .02). Women with inadequate prenatal care had an increased risk of preterm deliveries (OR = 1.64; 95% CI, 1.06-2.54) and of having newborns with low birth weight (OR = 2.02; 95% CI, 1.22-3.35). Weight of newborns from noncomplicated pregnancies was lower in group 1 (P = .02), after adjustment for prepregnancy body mass index, gestational weight gain, preterm delivery, and newborn sex. CONCLUSION The frequency of maternal and perinatal complications was similar in adolescents and mature women. Birth weight was decreased in noncomplicated pregnancies of adolescents younger than 16 years of age. Adequate prenatal care might be helpful in prevention of some adverse perinatal outcomes.
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Affiliation(s)
- Ramón O Minjares-Granillo
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario, Campus II, Chihuahua, Chihuahua, México
| | - Sandra A Reza-López
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario, Campus II, Chihuahua, Chihuahua, México
| | - Selene Caballero-Valdez
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario, Campus II, Chihuahua, Chihuahua, México
| | - Margarita Levario-Carrillo
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario, Campus II, Chihuahua, Chihuahua, México
| | - Dora Virginia Chávez-Corral
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Circuito Universitario, Campus II, Chihuahua, Chihuahua, México.
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Allen J, Gibbons K, Beckmann M, Tracy M, Stapleton H, Kildea S. Does model of maternity care make a difference to birth outcomes for young women? A retrospective cohort study. Int J Nurs Stud 2015; 52:1332-42. [DOI: 10.1016/j.ijnurstu.2015.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
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Barczyk AN, Duzinski SV, Brown JM, Lawson KA. Perceptions of injury prevention and familial adjustment among mothers of teen parents. JOURNAL OF SAFETY RESEARCH 2015; 52:15-21. [PMID: 25662878 DOI: 10.1016/j.jsr.2014.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 10/03/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Injury is a leading cause of death for infants and children. Teen mothering has been shown to put children at increased risk of injury. The mothers of teen parents often play a predominant role in the lives and caregiving of the children born to their children. METHOD This article presents the findings of three focus groups conducted with 21 mothers of teen parents. Grounded theory methodology was used to explore family dynamics and how they relate to injury prevention beliefs and practices regarding infants and children. RESULTS Our findings revealed the difficulty mothers of teen parents and the teens themselves have in adjusting to the knowledge of the pregnancy. Unique barriers to injury prevention were also uncovered. CONCLUSIONS Our findings provide evidence for the need of a multigenerational approach to programs aimed at improving the safety and well-being of children in this context.
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Affiliation(s)
- Amanda N Barczyk
- Trauma Services Research Department at Dell Children's Medical Center of Central Texas, 4900 Mueller Blvd., Austin, TX 78723, USA.
| | - Sarah V Duzinski
- Trauma Services Research Department at Dell Children's Medical Center of Central Texas, 4900 Mueller Blvd., Austin, TX 78723, USA.
| | - Juliette M Brown
- Trauma Services Injury Prevention Department at Dell Children's Medical Center of Central Texas, 4900 Mueller Blvd., Austin, TX 78723, USA.
| | - Karla A Lawson
- Trauma Services Research Department at Dell Children's Medical Center of Central Texas, 4900 Mueller Blvd., Austin, TX 78723, USA.
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Weng YH, Yang CY, Chiu YW. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age. PLoS One 2014; 9:e114843. [PMID: 25494176 PMCID: PMC4262474 DOI: 10.1371/journal.pone.0114843] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 11/14/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although a number of studies have investigated correlations of maternal age with birth outcomes, an extensive assessment using age as a continuous variable is lacking. In the current study, we estimated age-specific risks of adverse birth outcomes in childbearing women. METHOD National population-based data containing maternal and neonatal information were derived from the Health Promotion Administration, Taiwan. A composite adverse birth outcome was defined as at least anyone of stillbirth, preterm birth, low birth weight, macrosomia, neonatal death, congenital anomaly, and small for gestational age (SGA). Singletons were further analyzed for outcomes of live birth in relation to each year of maternal age. A log-binomial model was used to adjust for possible confounders of maternal and neonatal factors. RESULTS In total, 2,123,751 births between 2001 and 2010 were utilized in the analysis. The risk of a composite adverse birth outcome was significantly higher at extreme maternal ages. In specific, risks of stillbirth, neonatal death, preterm birth, congenital anomaly, and low birth weight were higher at the extremes of maternal age. Furthermore, risk of macrosomia rose proportionally with an increasing maternal age. In contrast, risk of SGA declined proportionally with an increasing maternal age. The log-binomial model showed greater risks at the maternal ages of <26 and > 30 years for a composite adverse birth outcome. CONCLUSIONS Infants born to teenagers and women at advanced age possess greater risks for stillbirth, preterm birth, neonatal death, congenital anomaly, and low birth weight. Pregnancies at advanced age carry an additional risk for macrosomia, while teenage pregnancies carry an additional risk for SGA. The data suggest that the optimal maternal ages to minimize adverse birth outcomes are 26∼30 years.
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Affiliation(s)
- Yi-Hao Weng
- Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Wen Chiu
- Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Health Policy and Care Research Center, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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24
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Maternal adjustment and maternal attitudes in adolescent and adult pregnant women. J Pediatr Adolesc Gynecol 2014; 27:194-201. [PMID: 24656707 DOI: 10.1016/j.jpag.2013.09.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. DESIGN, SETTING, AND PARTICIPANTS A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. MAIN OUTCOME MEASURES Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. CONCLUSION Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.
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Karabulut A, Ozkan S, Bozkurt AI, Karahan T, Kayan S. Perinatal outcomes and risk factors in adolescent and advanced age pregnancies: comparison with normal reproductive age women. J OBSTET GYNAECOL 2014; 33:346-50. [PMID: 23654312 DOI: 10.3109/01443615.2013.767786] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of the study was to analyse and compare demographic characteristics and clinical outcomes of pregnancies in adolescent, advanced age and normal reproductive age women. All completed pregnancies in a 6-month period, registered by the family practitioners in Denizli province, were included into the study. A face-to-face questionnaire was used to gather information. Participants were asked for demographic information, pregnancy outcome and obstetric history, obstetric and neonatal problems. Overall 5,882 pregnancies in different age groups: 296 (5%) adolescent (< 20-years-old); 4,957 (84.3%) normal reproductive age (20-35-years-old) and 629 (10.7%) advanced age (> 35-years-old ) (group III), were included into the study. Adolescent women had a lower educational status (p < 0.01), and family played a major role in decision of marriage (p < 0.01). Birth weight of the baby was lower in adolescents (p < 0.01). While adolescents tended to deliver vaginally (OR = 1.9, p < 0.01), elderly women were more prone to operative delivery (OR = 1.2, p < 0.05). Risk of caesarean section rate was higher in elderly nulliparous women (OR = 2.2, p 0.01). The number of spontaneous and induced abortions were increased with age (p < 0.01). Antenatal problems were seen least frequently in normal reproductive age women. Both antenatal (OR = 1.7, p < 0.01) and neonatal problems (OR = 1.5, p < 0.05), were significantly higher in advanced age pregnancy. It was concluded that with sufficient antenatal care, adolescent pregnancy is not associated with an increase in adverse pregnancy outcome, except low birth weights. Advanced maternal age is more likely to be associated with increased obstetric, maternal and neonatal complications.
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Affiliation(s)
- A Karabulut
- Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.
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Redshaw M, Miller YD, Hennegan J. Young women's experiences as consumers of maternity care in Queensland. Birth 2014; 41:56-63. [PMID: 24571204 DOI: 10.1111/birt.12084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Young motherhood is commonly associated with vulnerabilities, stereotyping of young women's behavior, and poor outcomes for them and their children. The objective was to understand how maternity care is experienced by this group in the transition to parenthood. METHODS Data from a large-scale 2010 survey of women's experience of maternity care were analyzed using qualitative methods with open text responses. RESULTS Overall, 7,193 women responded to the survey: 237 were aged 20 years or less. Most (83%) of these young women provided open text responses. The main themes were: "being a consumer," "the quality of care," "needing support," and "pride in parenthood" whereas subthemes included "being young" and "how staff made me feel," "testimonials for staff," "not being left," and "it is all worthwhile." CONCLUSION Many young women responding described a positive experience. For many first-time mothers this feeling marked a change in their identity. Nevertheless, staff perceptions and attitudes affected how they saw themselves and what they took away from their experience of maternity care. A key message for other women is offered, supporting and reinforcing their role as active and involved consumers who, in engaging with services, have to stand up for themselves and make their needs and wishes known.
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Affiliation(s)
- Maggie Redshaw
- Policy Research Unit for Maternal Health and Care, National Perinatal and Epidemiological Unit, University of Oxford, Oxford, UK; Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Brisbane, Qld, Australia
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Allen J, Stapleton H, Tracy S, Kildea S. Is a randomised controlled trial of a maternity care intervention for pregnant adolescents possible? An Australian feasibility study. BMC Med Res Methodol 2013; 13:138. [PMID: 24225138 PMCID: PMC4226005 DOI: 10.1186/1471-2288-13-138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 11/11/2013] [Indexed: 12/02/2022] Open
Abstract
Background The way in which maternity care is provided affects perinatal outcomes for pregnant adolescents; including the likelihood of preterm birth. The study purpose was to assess the feasibility of recruiting pregnant adolescents into a randomised controlled trial, in order to inform the design of an adequately powered trial which could test the effect of caseload midwifery on preterm birth for pregnant adolescents. Methods We recruited pregnant adolescents into a feasibility study of a prospective, un-blinded, two-arm, randomised controlled trial of caseload midwifery compared to standard care. We recorded and analysed recruitment data in order to provide estimates to be used in the design of a larger study. Results The proportion of women aged 15–17 years who were eligible for the study was 34% (n=10), however the proportion who agreed to be randomised was only 11% (n = 1). Barriers to recruitment were restrictive eligibility criteria, unwillingness of hospital staff to assist with recruitment, and unwillingness of pregnant adolescents to have their choice of maternity carer removed through randomisation. Conclusions A randomised controlled trial of caseload midwifery care for pregnant adolescents would not be feasible in this setting without modifications to the research protocol. The recruitment plan should maximise opportunities for participation by increasing the upper age limit and enabling women to be recruited at a later gestation. Strategies to engage the support of hospital-employed staff are essential and would require substantial, and ongoing, work. A Zelen method of post-randomisation consent, monetary incentives and ‘peer recruiters’ could also be considered.
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Affiliation(s)
- Jyai Allen
- Midwifery Research Unit, Mater Research, Aubigny Place, Raymond Terrace, South Brisbane, Queensland, Australia.
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Leppälahti S, Gissler M, Mentula M, Heikinheimo O. Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open 2013; 3:e003225. [PMID: 23959755 PMCID: PMC3753503 DOI: 10.1136/bmjopen-2013-003225] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/29/2013] [Accepted: 07/24/2013] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To assess obstetric outcomes in teenage pregnancies in a country with a low teenage delivery rate and comprehensive high-quality prenatal care. DESIGN Retrospective population-based register study. SETTING Finland. PARTICIPANTS All nulliparous teenagers (13-15 years (n=84), 16-17 years (n=1234), 18-19 years (n=5987)) and controls (25-year-old to 29-year-old women (n=51 142)) with singleton deliveries in 2006-2011. MAIN OUTCOME MEASURES Risk of adverse obstetric outcomes adjusted for demographic factors and clinically relevant pregnancy complications, with main focus on maternal pregnancy complications. RESULTS Teenage mothers were more likely than controls to live in rural areas (16% (n=1168) vs 11.8% (n=6035)), smoke (36.4% (n=2661) vs 7% (n=3580)) and misuse alcohol or drugs (1.1% (n=82) vs 0.2% (n=96); p<0.001 for all). Teenagers made a good mean number of antenatal clinic visits (16.4 vs 16.5), but were more likely to have attended fewer than half of the recommended visits (3% (n=210) vs 1.4% (n=716)). Teenagers faced increased risks of several obstetric complications, for example, anaemia (adjusted OR 1.8, 95% CI 1.6 to 2.1), proteinuria (1.8, 1.2 to 2.6), urinary tract infection (UTI; 2.9, 1.8 to 4.8), pyelonephritis (6.3, 3.8 to 10.4) and eclampsia (3.2, 1.4 to 7.3), the risks increasing with descending age for most outcomes. Elevated risks of pre-eclampsia (3.7, 1.5 to 9.0) and preterm delivery (2.5, 1.2 to 5.3) were also found among 13-year-olds to 15-year-olds. However, teenage mothers were more likely to have vaginal delivery (1.9, 1.7 to 2.0) without complications. Inadequate prenatal care among teenagers was a risk factor of eclampsia (12.6, 2.6 to 62.6), UTI (5.8, 1.7 to 19.7) and adverse neonatal outcomes. CONCLUSIONS Pregnant teenagers tended to be socioeconomically disadvantaged versus controls and faced higher risks of various pregnancy complications. Special attention should be paid to enrolling teenagers into adequate prenatal care in early pregnancy.
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Affiliation(s)
- Suvi Leppälahti
- Department of Obstetrics and Gynecology/Kätilöopisto Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland
| | - Maarit Mentula
- Department of Obstetrics and Gynecology/Kätilöopisto Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology/Kätilöopisto Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Corrêa-Faria P, Martins-Júnior PA, Vieira-Andrade RG, Marques LS, Ramos-Jorge ML. Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study. Braz Oral Res 2013; 27:363-8. [PMID: 23689469 DOI: 10.1590/s1806-83242013005000017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 02/20/2013] [Indexed: 11/21/2022] Open
Abstract
The present study was designed to evaluate associations between developmental defects of enamel (DDE) in the primary dentition and aspects related to mothers and preschoolers in the city of Diamantina, Brazil. A case-control study was carried out involving children aged three to five years. The case group was composed of 104 children with at least one dental surface affected by DDE. The control group comprised 105 children without DDE, matched for gender and age. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel Index. Information was collected through interviews investigating socio-demographic aspects, gestation, birth weight, prematurity and breastfeeding. Simple and multiple regression analyses were performed, providing unadjusted and adjusted prevalence ratios (Poisson regression). DDE were more prevalent among children who had not been breastfed (PR=1.57; 95% CI: 1.1-2.2) and those whose mothers were under 24 years of age at the birth of the child (PR=1.41; 95% CI: 1.1-1.9). The prevalence of DDE in the primary dentition was higher among children who had not been breastfed and those whose mothers were under 24 years of age at the birth of the child.
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Affiliation(s)
- Patrícia Corrêa-Faria
- Department of Pediatric Dentistry, School of Dentistry, Univ Federal dos Vales do Jequitinhonha e Mucuri-UFVJM, Diamantina, MG, Brazil.
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Wallace ME, Harville EW. Predictors of healthy birth outcome in adolescents: a positive deviance approach. J Pediatr Adolesc Gynecol 2012; 25:314-21. [PMID: 22831902 PMCID: PMC3444618 DOI: 10.1016/j.jpag.2012.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 05/08/2012] [Accepted: 05/17/2012] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE Pregnant adolescents experience elevated rates of adverse birth outcomes compared to older mothers. Positive deviance inquiry is the identification of uncommon behaviors and traits that result in better health outcomes for individuals in a population that shares similar risks. The purpose of our study was to utilize a positive deviance framework to identify sociodemographic and behavioral characteristics associated with a healthy birth outcome among adolescents. DESIGN This is a retrospective cohort study design. SETTING We performed a secondary data analysis of vital records data from the State of Louisiana between January 1, 1995 and December 31, 2007. PARTICIPANTS Data included birth certificates from 35,013 Louisiana mothers age ≤19. MAIN OUTCOME MEASURE A healthy birth was defined as having an infant of weight between 2500 g and 4000 g, delivered vaginally without induction or instrumented delivery and in the absence of pregnancy, obstetric, or neonatal complications and anomalies. RESULTS Twenty-one percent of the study population was classified as positive deviants with healthy births. Multivariate log-linear regression was used to model predictors of healthy birth. Adolescents who were older, non-black, multiparous, non-smoking, married, gained a medium amount of weight, had a longer inter-pregnancy interval or received adequate prenatal care were most likely to experience a healthy pregnancy and birth. Ethnicity, alcohol use, father's information on the birth certificate and paternal characteristics did not significantly predict a positive birth outcome. CONCLUSION Characterizing positive deviant adolescents may help identify special populations for targeted intervention and important modifiable behaviors for the promotion of better birth outcomes in all young mothers.
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Affiliation(s)
- Maeve E Wallace
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112-2715, USA.
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Contreras Campos ME, Rodríguez-Cervantes N, Reza-López S, Ávila-Esparza M, Chávez-Corral DV, Levario-Carrillo M. Body composition and newborn birthweight in pregnancies of adolescent and mature women. MATERNAL AND CHILD NUTRITION 2012; 11:164-72. [PMID: 22913432 DOI: 10.1111/j.1740-8709.2012.00434.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Teenage pregnancy has been associated with adverse effects for the mother and the newborn (NB). In order to compare body composition (BC) between adolescents (Ad) and mature women (MW) during pregnancy and to determine the difference in birthweight and perinatal morbidity, pregnant Ad (n=40) and MW (n=227) were studied. BC changes between the second and third trimesters were determined by multifrequency bioelectrical impedance analysis, and birthweight and NB morbidity were evaluated. During the second and third trimesters of the pregnancy, fat mass was lower in the Ad group [16 kg (13-19)] than in the MW group [22 kg (17-27)] (P<0.01; median and quartiles 1-3). Fat-free mass increased by 3.09 kg (2.29-4.20) and 2.20 kg (1.0-3.59) (P≤0.01), and total body water increased by 2.77 L (0.84-4.49) vs. 2.04 L (0.55-3.89) (P=0.36), in the Ad and MW groups, respectively (median and quartiles 1-3). Birthweight was not significantly different between NBs of Ad (3223 ± 399 g) and NBs of MW (3312 ± 427 g, P=0.22). The youngest Ad (<18 year old, n=8) had NB with lower birthweight than MW (3031 ± 503 g, P=0.06). NBs of Ad mothers showed a non-significant trend towards a higher rate of morbidity relative to the NBs of MW. In conclusion, the BC of Ad differs from that of MW during pregnancy. In addition, the NB infants of Ad mothers tended to have a lower birthweight than those from MW, a result that suggests that the Ad should be in strict prenatal control.
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Affiliation(s)
- María Elena Contreras Campos
- Unidad de Investigación Médica en Epidemiología Clínica, Instituto Mexicano del Seguro Social (IMSS), Chihuahua, México Programa de Especialidad en Medicina Familiar Universidad Nacional Autónoma de México/IMSS, Unidad de Medicina Familiar Plus 33, Chihuahua, México Facultad de Medicina, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México Hospital de Ginecología y Obstetricia Número 15, IMSS, Chihuahua, México
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