Demographic characteristics of fathers of infants born to adolescent mothers in Taiwan

A review on adolescent childbearing in Taiwan: its characteristics, outcomes and risks

In Taiwan, the age-specific fertility rate for adolescent girls aged 15-19 years has remained at 14-18/1,000 births during the past two decades, which is the highest among developed countries in Asia. There was a surprisingly high age-specific fertility rate for married women aged 15-19 years at 726 per 1,000 in 1994, much higher than that of the United States. Adolescent childbearing causes many adverse outcomes including unwanted and unstable marriage, repeated childbearing during adolescence, and increased risks of having low birth weight and preterm births and neonatal mortality. Studies in Taiwan showed that adolescent childbearing is associated with their poor knowledge but open attitude and behaviour on sexuality, the inadequate contraceptive services for the adolescents in need, some risk-taking behaviors, family dysfunction and low socioeconomic status of the adolescents' families. About two-thirds of the fathers of infants born to adolescent girls were adults, even old adults with a low education level Effective strategies for adolescent childbearing prevention range from sex education, the direct provision of contraceptive supplies, and to life options programmes, especially for the adolescents with high risk of adolescent pregnancy. Reducing the incidence of adolescent childbearing by active use of contraception is more important and practical than prohibiting adolescent sexual activity.

Anxiety and depression in fathers in teenage pregnancy

OBJECTIVE

It is recognized that pregnant teenagers have higher levels of psychological symptomatology compared to older pregnant women. However, there are limited data on fathers in the setting of teenage pregnancy. The aim of this study was to compare levels of psychological symptomatology in fathers in the setting of teenage as compared to non-teenage pregnancy.

METHOD

A cross-sectional cohort study was undertaken. Data from interviews with consecutive fathers in the setting of teenage (Teenage) and non-teenage (Control) pregnancy were compared during the antenatal period. Subjects were interviewed to obtain information covering demographic and family information, the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire-28 (GHQ-28).

RESULTS

Significantly more fathers in the setting of teenage pregnancy met the case criteria for HADS-A and HADS-D subscales compared to older fathers. They had significantly higher GHQ-28 totals and all subscale scores and were more likely predictive of a young age of death compared to older fathers. However, formal contact with psychiatric services was similar between groups. Interestingly, 14% of fathers in the setting of teenage pregnancy reported losing their own father as a child. In multivariate analysis, a high HADS score was significantly associated with younger age of onset of fatherhood and exposure to domestic violence as a child, whereas having their own father alive was significantly protective against a high HADS score.

CONCLUSION

Fathers, in the setting of teenage pregnancy, have unrecognized psychological symptomatology and require services along with teenage mothers.

Determinant factors in Ecuador related to pregnancy among adolescents aged 15 or less

OBJECTIVE

Determine social factors related to pregnancy among young adolescents.

METHODS

We obtained socio-demographic data from early adolescent nulliparas aged < or = 15 years.

RESULTS

During the study period at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador 201 early adolescent nulliparous patients of low socio-economic status were surveyed and compared with 201 low socio-economic nulliparous controls aged 20 to 30. Mean age of adolescents was 14+/-0.6 years, 58.7% of them were aged 14. Age of menarche and sexual initiation was lower among adolescents (11.8+/-0.9 vs 12.8+/-2 years and 12.6+/-1.1 vs 16.2+/-5 years, respectively, p<0.05). A higher rate of adolescents initiated sexually before menarche onset (18.4% vs 5%, p<0.05). The rate of those who wanted to become pregnant, had adequate prenatal care and had knowledge of conception, used contraception or had knowledge of any contraceptive method prior to pregnancy was significantly lower in adolescents (16.9% vs 86.5%; 37.3% vs 94.5%; 18% vs 70.1%; 6.5% vs 89.5%; 42.8% vs 84.5%, respectively, p<0.05). Age of sexual partner was lower in the adolescent group (20.4+/-3.4 vs 30+/-8 years, p<0.05). Compared to controls, higher rates of adolescents were school dropouts, had problems with the law and were involved in domestic violence (87% vs 9.9%, 7.5% vs 0.5%, 44.7% vs 2.5%, respectively, p <0.05). None of the adolescents were living with mother and father in a complete family structure. Parental illiteracy was higher among adolescents (9% vs 3.5%, p < 0.05).

CONCLUSION

In this low socio-economic population, early sexual initiation, poor reproductive health knowledge and the disruption of family structure were the main social factors related to pregnancy among adolescents aged 15 or less.

Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study

OBJECTIVE

The purpose of this study was to determine obstetrical and neonatal outcome among early adolescent pregnancies (< or =15 years).

METHOD

We compared obstetrical and neonatal outcome of early adolescent nulliparas with outcome of nulliparous women aged 20-30 years.

RESULTS

Two hundred and one (201) early adolescent nulliparous patients of low socio-economic status were enrolled at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador, and matched for gestational age with 201 low socio-economic nulliparous controls aged 20-30. Mean maternal age of the adolescent group was 14.2+/-0.6 years. The incidence of cervicovaginal infections during current pregnancy was significantly higher among adolescents (trichomoniasis: 11.4% vs. 5% and candidiasis: 27.8% vs. 12.4%, p<0.05). The incidence of eclampsia was higher in adolescents (2.5% vs. 0%, p<0.05). The preterm rate in each group was 4.9%. There were no differences in labor characteristics and the rate of cesarean section, labor complications and abnormal puerperium between both studied groups. Nevertheless, mean neonatal weight was lower and the incidence of low birth weight infants (<2,500 g) and adverse neonatal outcome was significantly higher in the adolescent group (2,837.6+/-454 g vs. 3,017+/-547 g; 19.9% vs. 11.4% [OR=1.92, 95% CI: 1-3.5] and 9.5% vs. 3.5% [OR=2.9, 95% CI: 1.1-7.7] respectively, p<0.05).

CONCLUSION

Pregnancy in young adolescents (< or =15 years) of low socio-economic status did not impose adverse obstetrical outcome, however it did increase the risk for low birth weight, adverse neonatal outcome and cervicovaginal infections.