Epidemiological assessment of the influence of socio-family factors in adolescent pregnancy

Characteristics of the Family Support Network of Pregnant Adolescents and Its Association with Gestational Weight Gain and Birth Weight of Newborns

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25–7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.

Concept analysis of family homeostasis

AIM

To report a concept analysis of family homeostasis.

BACKGROUND

As family members are a majority of informal caregivers, negative consequences from caregiving duty create a vicious cycle in the family unit resulting in ongoing health crises and care challenges.

DESIGN

Concept analysis.

DATA SOURCES

Forty empirical studies published from 1956-2012 were selected by searching five electronic bibliographical databases and by a manual search conducted from 2012-2013. Search terms included 'family homeostasis', 'homeostasis in family', 'homeostatic care' and 'family equilibrium'. Clinical experiences in nursing practice were used for constructing cases and clinical implications.

METHODS

Walker and Avant's method guided this analysis.

RESULTS

Family homeostasis is defined as the capacity and mechanisms by which equilibrium is re-established in the family after a change occurs. Five critical attributes are identified: (1) predetermined setpoint; (2) self-appraised antecedents; (3) interdependence; (4) tendency to stability; and (5) feedback mechanisms. Antecedents include any type of causative change beyond the tolerable limit, while consequences encompass intermediate and long-term outcomes as well as equilibrium itself.

CONCLUSION

Family homeostasis provides a conceptual rationale of family caregiving. While care recipients remain the primary beneficiaries of healthcare provision, homeostatic mechanisms are required to support the family caregiver's valuable contribution in the caring process to enhance family well-being. Further study should expand the definition and settings of family to reflect healthcare needs of diverse types of families and from the perspectives of different healthcare providers.

Perinatal outcomes and risk factors of Turkish adolescent mothers

STUDY OBJECTIVE

Adolescent pregnancy is considered a high risk for both the mother and infant. The aim of this study was to determine obstetric and neonatal outcomes and risk factors in adolescent pregnant women and to compare perinatal outcomes among the teen age groups and between adolescent and adult women.

DESIGN

Retrospective study including adolescent pregnant women and adult women.

SETTING

A public maternal hospital.

MAIN OUTCOME MEASURES

This retrospective cohort study included 945 teenagers who gave birth at year 2004 in a maternity hospital in Izmir. Dependent variables included perinatal and maternal outcomes. Independent variables were miscellanous socio-demographic characteristics and obstetric complications. Chi-square, Fisher exact test, and t-tests were used for the comparison of the adolescent group and adult women.

RESULTS

Overall, adolescents accounted for 11.8% of all deliveries in hospital. 99.7% of teenagers were unemployed, and 59.8% of those had no health insurance. 81.5% of the pregnant adolescents were nulliparous. 27.5% of teenagers gave birth by cesarean delivery. The rates of preterm birth and low birthweight of teen mothers were 18.2% and 12.1%, respectively. Twenty-eight percent of women had some obstetric and neonatal complications. The rate of preterm delivery was higher in adolescent mothers; however, cesarean delivery rate was higher in adult women (P = 0.000, P = 0.0002 respectively). Absence of health insurance, less education, and non-official marriage were significantly higher in pregnant women aged 17 years or younger compared with women aged 18-19 years (for all, P = 0.000). However, there was no statistically significant difference between the adolescent age groups regarding perinatal complications.

CONCLUSION

The rates of pregnancy and the rates of adverse obstetric and neonatal outcomes were considerably higher in teenagers.

Online discussions with pregnant and parenting adolescents: perspectives and possibilities

The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population. Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.