Demographic characteristics in adult paternity for first births to adolescents under 15 years of age

Adolescent Latino Reproductive Health: A Review of the Literature

Latino adolescent reproductive health has become an increasingly important topic because of the growth in the numbers of Latino youth and because Latino youth are at high risk for negative reproductive health outcomes. Latinas now have the highest teen birth rates, and Latinos have disproportionately high rates of HIV/AIDS. These trends highlight the need for greater understanding of the sexual and reproductive health and behavior of Latino youth. This overview provides an introduction to key aspects of the Latino population. It then examines and synthesizes the existing literature by domains useful to the study of Latinos. Areas that receive in-depth coverage are socioeconomic status, family, national origin, peers and partners, and acculturation. Based on the current state of knowledge and the issues facing young Latinos, suggestions for future research and uses for existing data and past research are included.

Latino sexual styles: developing a nuanced understanding of risk

Theoreticians in adolescent sexuality have called for research that is contextual, health-focused, balanced between males and females, and from the perspective of adolescents, noting that scales developed by Buzwell and Rosenthal (1996) are promising. Cross-cultural validation of the measures in the United States. should include Latino adolescents, as they are the fastest-growing ethnic group. Contextual issues for this population include the roles of culture and the family, country of origin, and acculturation. The scales were tested with 155 Latino adolescents, Mexican-identified, and third generation plus. Scales indicated good reliability overall although several subscales were determined to best be combined as they created a single factor. Hierarchical agglomerative methods revealed a four-cluster solution with clusters conceptually mapping the original study. Clusters were significantly different on important sexual behaviors, such as virginity status, likelihood of engaging in safer sex, and number of sex partners.

Does Partner Selection Contribute to Sex Differences in Sexually Transmitted Infection Rates Among African American Adolescents in San Francisco?

INTRODUCTION

Little is known regarding whether partner characteristics explain sex differences in sexually transmitted infection (STI) rates in nonclinic-based, school-aged African American youth.

MATERIALS AND METHODS

A random digit dial household sample of 14- to 19-year-old youth in San Francisco reported the total number, age, race, and perceived history of incarceration, gang membership, and level of sexual activity of their partners. Youth were tested for gonorrhea and chlamydia.

RESULTS

Female participants were more likely than male participants to have a partner who was older or had been incarcerated and less likely to have a non-African American partner. Controlling for partner number, female's odds ratio (OR) for having an STI was 1.39 (95% confidence interval [CI] = 0.98-1.98; P = 0.07). Controlling for partner incarceration and number of partners, the borderline sex difference was eliminated (OR = 1.07; 95% CI = 0.70-1.63).

CONCLUSION

Sex differences in STI rates among African American adolescents may be determined more by the risk of the partner than the risk of the individual.

Domestic violence, single parenthood, and fathers in the setting of teenage pregnancy

PURPOSE

To explore the relative impact of demographic and early interpersonal family relationships as associations of fatherhood where the mother is a teenager, compared to where the mother is over 20 years of age.

METHOD

A prospective cross-sectional cohort study was undertaken. Institutional ethics committee approval and informed consent were obtained. Data were analyzed from interviews with consecutive males about to become fathers where the mother was aged less than 20 years (teenage) and compared to information from males about to become fathers where the mother was aged 20 years or more (control). Subjects were interviewed to obtain information covering their early life experiences, demographic information, drug use, opinion of the pregnancy, and future planning.

RESULTS

In multivariate analysis, and after controlling for family income and education, the following factors had a significant independent association with fatherhood in the setting of teenage pregnancy: a history of parental separation/divorce in early childhood, exposure to family violence in early childhood, and illicit drug use (ever or in pregnancy).

CONCLUSIONS

Fathers, in the setting of teenage pregnancy, are more likely to report adverse early family relationships, such as exposure to domestic violence or parental separation or divorce. As such, these fathers may lack a positive role model for parenting and fatherhood.

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.

Adolescent pregnancy: current trends and issues

The prevention of unintended adolescent pregnancy is an important goal of the American Academy of Pediatrics and our society. Although adolescent pregnancy and birth rates have been steadily decreasing, many adolescents still become pregnant. Since the last statement on adolescent pregnancy was issued by the Academy in 1998, efforts to prevent adolescent pregnancy have increased, and new observations, technologies, and prevention effectiveness data have emerged. The purpose of this clinical report is to review current trends and issues related to adolescent pregnancy, update practitioners on this topic, and review legal and policy implications of concern to pediatricians.

Adolescent parents and their children - The paediatrician's role

Adolescent parents and their children have a number of health issues that require attention from the health care provider. Both the adolescent and their child have health needs, and the young parent often requires significant support in their parenting role. Paediatricians should be aware of the areas in which problems can develop, including maternal nutrition and emotional health, and infant growth and development. The literature addressing these areas of concern will be reviewed and general recommendations for the care of this patient population will be provided.

Adolescent pregnancy

Teen birth rates have decreased steadily over the past decade, but the United States still has the highest birth rates among all developed countries. Young women who give birth as adolescents are likely to have poor school performance, and come from families with low socioeconomic status, a history of teen pregnancies, and low maternal education. The fathers of babies who are born to teen mothers are likely to be unsuccessful in school, have limited earnings, have high rates of substance use, and have trouble with the law. Infants who are born to teen mothers are at risk for low birth weight and physical neglect and abuse; at school age, these children are more likely than children born to adult women to have trouble with school achievement, and they are at risk for becoming teen mothers or fathers themselves. Programs that are successful in reducing teen birthrates are usually multifactorial and combine comprehensive sexuality education with youth development activities; reduction in repeat pregnancies is associated with home visits by nurses combined with long-acting contraceptive use.

The risk for infant mortality among adolescent childbearing groups

OBJECTIVE

To evaluate risk disparities and risk factors for infant mortality among adolescent childbearing age groups.

METHODS

We combined the 1995 and 1996 comprehensive U.S. birth cohorts provided by the National Center for Heath Statistics. Our analysis included 777,762 singleton, first births to women aged 12-19 years linked to 4631 infant deaths. We used both bivariate comparisons and multivariable logistic regression for our analysis, with infant mortality as our main outcome measure.

RESULTS

Rates of infant mortality are substantially higher for < or =15-year-olds (8.1/1000 live births) compared with 16-17-year-olds (6.3/1000 live births) and 18-19-year-olds (5.4/1000 live births). Even after adjusting for risk factors associated with poor outcomes, including alcohol use, tobacco use, and prenatal care use, the risk for infant mortality was 1.6 (95% confidence interval [95% CI] 1.4, 1.7) times greater for infants of mothers < or =15 years old as compared with those mothers 18-19 years old. In the < or =15-year-old group, 62% of fathers were not reported on the child's birth certificate. Not reporting the father was associated with a 24% increased risk for infant mortality after adjusting for maternal and infant risk factors.

CONCLUSIONS

Childbearing in < or =15-year-olds is associated with a substantial increased risk for infant mortality compared with childbearing in older adolescence. This study suggests that not reporting the father on a birth certificate is a potential risk marker. Risk differences among adolescent age groups may be important to consider when creating tailored intervention and prevention strategies.

Parental age difference and adverse perinatal outcomes in the United States

This study was undertaken to examine the relationship between paternal and maternal age differences and adverse perinatal outcomes in the United States. Data were obtained on singleton pregnancies delivering at >or=20 weeks gestation in the United States in 1995-97 from the National Center for Health Statistics data sets. Adverse perinatal outcomes that were evaluated included fetal death rate (>or=20 weeks), preterm delivery <37 weeks and small-for-gestational-age (SGA) births (birthweight <10th centile for gestational age and corrected for sex). Age difference was defined as paternal minus maternal age. The analysis included 8995274 pregnancies (11.3% blacks, 88.7% whites). An increase in fetal death rate, preterm delivery and SGA births was noted among white women who were older than their male partners. For black mothers older than their partners, there was an increase in fetal death rate when the women were <20 years old, but a decrease in fetal death rate when >35 years old. Neither rates of preterm delivery nor SGA births were increased much for black women with varying parental age differences. This demonstrates that race and maternal age both contribute to the effects of parental age difference on adverse perinatal outcomes.

Abused boys, battered mothers, and male involvement in teen pregnancy

BACKGROUND

The relationship between boyhood exposure to physical abuse, sexual abuse, or to a battered mother and subsequent risk of impregnating a teenage girl has not previously been examined.

METHODS

In a retrospective cohort study set in a primary care clinic for adult members of a large health maintenance organization, questionnaire responses from 4127 men were analyzed. Respondents provided the age of the youngest female whom they had impregnated, their own ages at the time, and information regarding childhood exposure to physical or sexual abuse and battered mothers. We calculated the prevalence and adjusted odds ratio (OR) for having impregnated a teenage girl according to these 3 adverse childhood experiences, regardless of the male's age at the time of impregnation. Using logistic regression, ORs were adjusted for the male's age at time of survey, race, and education.

RESULTS

Nineteen percent of the men reported that they had ever impregnated a teenage girl. During childhood, 32% of respondents had been physically abused, 15% sexually abused, and 11% had battered mothers. Compared with respondents reporting no abuse, frequent physical abuse or battering of mothers increased the risk of involvement in teen pregnancy by 70% (OR: 1.7; 95% confidence interval [CI]: 1.2-2.5) and 140% (OR: 2.4; 95% CI: 1.1-5.0), respectively. Sexual abuse as a boy at age 10 years or younger increased the risk of impregnating a teenage girl by 80% (OR: 1.8; 95% CI: 1.3-2.4); sexual abuse with violence increased the risk by 110% (OR: 2.1; 95% CI: 1.2-3.4). We found a dose-response relationship between the number of types of exposures and the risk of impregnating a teenage girl; men who reported all 3 types of exposures were more than twice as likely to have been involved than those with no exposures (OR: 2.2; 95% CI: 1.4-3.5).

CONCLUSIONS

Boyhood exposure to physical or sexual abuse or to a battered mother is associated with an increased risk of involvement in a teen pregnancy-during both adolescence and adulthood. Because these exposures are common and interrelated, boys and adult men who have had these experiences should be identified via routine screening by pediatricians and other health care providers and counseled about sexual practices and contraception. Such efforts may prevent teen pregnancy and the intergenerational transmission of child abuse and domestic violence.