School importance and dropout among pregnant adolescents

Teenage childbearing and school dropout in a sample of 18,791 single mothers in Cameroon

Background

Adolescent childbearing increases the risk of adverse health and social consequences including school dropout (SDO). However, it remains unclear why some teenage mothers drop out of school and others do not, especially in sub-Saharan Africa settings. We aimed to investigate the background and behavioral characteristics of single mothers, associated with school dropout in a sample of 18,791 Cameroonian girls, who had their first child during adolescence.

Methods

We used data from a national registry of single mothers, collected during the years 2005–2008 and 2010–2011. Both bivariate analysis and logistic binary regression models were used to explore the relationship between adolescence motherhood and SDO controlling for a range of socio-economic, family, sexual and health seeking behavior characteristics.

Results

Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. The multivariable regression model showed that SDO was more common in those who were evicted from their parental home (aOR: 1.85; 95% CI: 1.69–2.04), those who declared having other single mothers in their family (aOR: 1.16; 95% CI 1.08–1.25) and in mothers who had their first child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout.

Conclusions

Strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.

There is compelling, worldwide evidence that pregnancy and birth during teenage years are significant contributors to high school dropout rates, especially in developing countries. Research has also shown that education continuity of teenage mothers can lessen the long term negative social consequences of teenage pregnancies and childbearing. In this study, we investigated the factors associated with school dropout in a sample of Cameroonian teenage mothers.

The information collected included socio-economic, family, sexual characteristics, and health-seeking behavior.

Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. School dropout was more common in those who were evicted from their parental home, those who declared having other single mothers in their family and in mothers who had their 1st child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout.

In conclusion, strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.

Does motherhood affect the quality of life of adolescents?

STUDY OBJECTIVE

Assess the quality of life (QOL) of female adolescents with children compared to those without children.

DESIGN

Cross-sectional.

SETTING

Public university-affiliated family planning clinic, São Paulo, Brazil.

PARTICIPANTS

91 female adolescents (16-19 years) of low socio-economic status with and without children.

INTERVENTIONS

The Portuguese version of the WHOQOL-BREF questionnaire was used.

OUTCOME MEASURES

Mean scores of the 4 main domains were compared between adolescents with and without children.

RESULTS

Both mothers (N = 40) and nonmothers (N = 51) had low mean scores (<75%) in most of the QOL domains. Compared to adolescents without children, adolescent mothers scored significantly lower in the physical (52.1 vs 59.4, P = .0137) and social (66.9 vs 77.3, P = .0182) domains.

CONCLUSION

Adolescent mothers have a significantly lower quality of life in the physical and in the social relationships domains than nonmothers.

Career aspirations and pregnancy intentions in pregnant teens

STUDY OBJECTIVE

To quantify the association between career aspirations and pregnancy intention in a cohort of pregnant adolescents seeking prenatal care.

DESIGN

Pregnant adolescents presenting for their first prenatal visit between March 2002 and February 2005 participated in a 30-minute interview as part of a larger cohort study addressing pregnancy attitudes and outcomes. Pregnancy intention was assessed through direct questioning and career aspirations were assessed by categorizing career goal responses into three categories: those requiring less than a college education, those requiring at least a college education, and undecided. Associations between pregnancy intention and career aspirations were quantified using cross tabulations and multivariable logistic regression.

SETTING

Hospital based prenatal clinic.

PARTICIPANTS

Women aged 12 to 19 seeking prenatal care.

MAIN OUTCOME MEASURE

Pregnancy intention.

RESULTS

Of the 257 pregnant adolescents included in the study, 20% were 12-15 years old, 39% were 16-17 years old and 41% were 18-19 years old. The majority (85%) of the adolescents reported their pregnancies were unintended; 59% reported a career that requires at least a college education; 28% reported a career that requires less than a college education; and, 13% were undecided. Intended pregnancy was observed in 15% of those with career aspirations not requiring college and 17% of those with career aspirations and requiring college.

CONCLUSIONS

The majority of adolescents in this study reported their pregnancy was unintended, had career aspirations requiring at least a college education, and reported plans to go back to school after the baby was born. Understanding pregnant adolescents' career aspirations may help inform pregnancy prevention and parenting support programs.

Childhood trauma and psychiatric disorders as correlates of school dropout in a national sample of young adults

The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S.-born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys, a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2,532 young adults, aged 21-29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relation between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout.

Assessing reasons for school/college dropout among young adults and implications for awareness about STDs and HIV/AIDS: findings from a population-based study in Karachi, Pakistan

BACKGROUND

Dropping out of school/college not only impedes economic prosperity but may also result in poor knowledge and awareness about sexually transmitted diseases (STDs).

PURPOSE

This study investigated, among young adults in Karachi, Pakistan, the risk factors associated with involuntary school/college dropout and the implications for awareness about HIV/AIDS and STDs.

METHOD

A population-based, cross-sectional study of 1,650 young males and females, aged 17-21 years and living in Karachi, was conducted using a structured questionnaire. Bivariate and multivariate analyses were performed separately for males and females.

RESULTS

Females were twice as likely to drop out of school/college as males. Furthermore, migrant residential status, living in an extended family and lower socio-economic status were identified as risk factors for school/college dropout both for males and females. In the total sample, only 17% of males and 13% of females had heard of STDs (p = 0.020). Furthermore, 26.8% of males and 20.5% of females had not heard of HIV/AIDS (p = 0.003). The females exhibited a higher level of awareness on these matters than the males, irrespective of whether they had dropped out of school or not. While the males who dropped out were considerably less aware than those who remained at school, there was no such difference among females.

CONCLUSION

Young adults from poor families are at increased risk of dropping out of school/college. Among the dropouts, males were clearly at risk of ignorance about STDs while females were somewhat better informed.

Self-reported substance use and sexual behaviors among adolescents in a rural state

BACKGROUND

Research finds a strong association between substance use and risky sexual behavior but more needs to be known about this relationship. Few studies have examined this relationship among rural sixth- to eighth-grade students. As such, the purposes of this study were to provide a descriptive profile of rural sixth- to eighth-grade students' substance use behavior and sexual activity and to examine the relationship between substance use behaviors and sexual activity.

METHODS

Participants consisted of a convenience sample of 10,273 middle school students (sixth to eighth grade) attending 10 public schools in rural Tennessee. The middle school Youth Risk Behavior Survey was administered to these students during April and May 2004.

RESULTS

Analysis found that a large percentage of students had tried cigarettes, alcohol, and inhalants. Additionally, it was found that sexual intercourse had been initiated by 18.8% of females and 25.4% of males. Of those students who reported ever having had sexual intercourse, 75% had reported the use of cigarettes and alcohol. In addition, approximately 50% of those students reported marijuana and inhalant use.

CONCLUSIONS

The results suggest that substance use behavior has a relationship with the likelihood of initiating sexual activity. Additional longitudinal research with this population will be needed for explaining whether these select substance use behaviors are probable risk factors predisposing young rural adolescents to report engaging in sexual behaviors or a result of other factors.

The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females

OBJECTIVE

To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors.

METHODS

A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae.

RESULTS

In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance.

CONCLUSION

This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.

Twelve-year follow-up study of the impact of nutritional status at the onset of elementary school on later educational situation of Chilean school-age children

OBJECTIVE

To determine the impact of nutritional status in a multicausal approach of socio-economic, socio-cultural, family, intellectual, educational and demographic variables at the onset of elementary school in 1987 on the educational situation of these children in 1998, when they should have graduated from high school.

SETTING

Chile's Metropolitan Region.

DESIGN

Prospective, observational and 12-year follow-up study.

METHODS

A representative sample of 813 elementary first grade school-age children was randomly chosen in 1987. The sample was assessed in two cross-sectional studies. The first cross-sectional study was carried out in at the onset of elementary school in 1987 and the second was carried out in 1998, 12-years later, when they should be graduating from high school. In 1998, 632 adolescent students were located and their educational situation was registered (dropout, delayed, graduated and not located). At the onset of elementary school were determined the nutritional status, socio-economic status (SES), family characteristics, intellectual ability (IA), scholastic achievement (SA) and demographic variables. Statistical analysis included variance tests and Scheffe's test was used for comparison of means. Pearson correlation coefficients and logistic regression were used to establish the most important independent variables at the onset of elementary school in 1987 that affect the educational situation 1998. Data were analysed using the statistical analysis system (SAS).

RESULTS

Logistic regression revealed that SES, IA, SA and head circumference-for-age Z score at the onset of elementary school in 1987 were the independent variables with the greatest explanatory power in the educational situation of school-age children in 1998.

CONCLUSIONS

These parameters at an early school age are good predictors of the educational situation later and these results can be useful for nutrition and educational planning in early childhood.

School trajectory and teenage pregnancy in three Brazilian state capitals

This paper describes the relationship between school trajectory and incidence of teenage pregnancy. A cross-sectional residence-based questionnaire was applied, interviewing 4,634 youth ages 18 to 24 years, selected through a stratified three-stage sample. For the present study, young people ages 20 to 24 years (65.6%) were chosen, with teenage pregnancy rates of 29.5% for females and 21.4% for males (in relation to their partners). Sexual debut was reported by 87% of women and 95.3% of men. The majority of young people reported irregular school trajectory, with 39% enrolled in school at the time of the study. Nearly half of those who had interrupted their studies at least once reported a teenage pregnancy. The main reasons for interrupting their studies were pregnancy and children for women and work for men. School dropout due to teenage pregnancy was mentioned by 40.1% of women for whom the outcome of pregnancy was a child. However, 20.5% had already dropped out of school before becoming pregnant.

Are pregnant adolescents stigmatized by pregnancy?

PURPOSE

To identify prevalence and correlates, including substance use and exposure to violence, of feeling stigmatized by being pregnant as an adolescent.

METHODS

A total of 925 low-income African-American, Mexican-American, and Caucasian pregnant adolescents aged </= 18 years were interviewed on the postpartum ward of a university hospital within 48 hours of delivery. Correlates of stigma were identified among self-reported behaviors such as substance use, exposure to violence, family support and criticism, as well as reproductive and sociodemographic characteristics.

RESULTS

Two out of five adolescents (39.1%) reported feeling stigmatized by their pregnancy. As compared with their nonstigmatized peers, stigmatized adolescents were more likely to report having seriously considered abortion, being afraid to tell parents about pregnancy, feeling that parents/teachers thought pregnancy a mistake, and feeling abandoned by the fathers of their babies. Stepwise logistic regression revealed the following correlates independently associated with feeling stigmatized: white race/ethnicity, not being legally/common-law married or engaged to the baby's father, feelings of social isolation, aspirations to complete college, experiencing verbal abuse or being fearful of being hurt by other teenagers, and experiencing family criticism. In contrast, greater self-esteem and having dropped out of school before conception were protective of reporting feelings of stigma.

CONCLUSIONS

Significant proportions of pregnant adolescents feel stigmatized by pregnancy and are at increased risk of social isolation and abuse. These young women may need special attention during and after pregnancy to develop concrete strategies to care for themselves and their children to complete their education and avoid becoming clinically depressed.

Another Look Inside the Gap: Ecological Contributions to the Transmission of Attachment in a Sample of Adolescent Mother-Infant Dyads

Ecological contributions to attachment transmission were studied in a sample of 64 adolescent mother-infant dyads. Maternal sensitivity was assessed when infants were 6 and 10 months old, and infant security was assessed at 15 and 18 months. Maternal attachment state of mind was measured with the Adult Attachment Interview (AAI) after the 1st assessment. Ecological variables considered were maternal education and depression, paternal support, and infant maternal grandmother support. Results indicated that when the contribution of ecological variables was statistically controlled for, sensitivity was a significant mediator and state of mind no longer contributed to infant security. Sensitivity also mediated an association between maternal education and infant attachment, suggesting that attachment transmission is embedded in a more global process of infant attachment development.

Health risks and psychosocial outcomes of early childbearing: a review of the literature

This article presents a review of the literature on the obstetric, medical, and neonatal health risks as well as psychosocial outcomes associated with early childbearing. An important concern in adolescent pregnancies is the increased risk for infant morbidity and mortality as a result of higher incidence of preterm births and low-birthweight infants. Implications for prenatal and postpartum nursing care are discussed. Promising new models to improve care of young mothers and their children, such as home visitation by public health nurses, are presented and features of successful intervention programs outlined.