Raneri Leslie G, Wiemann Constance M
Office of Adolescent Pregnancy Programs, Office of Population Affairs, U.S. Department of Health and Human Services, Rockville, MD, USA.
Perspect Sex Reprod Health. 2007 Mar;39(1):39-47. doi: 10.1363/3903907.
Women with multiple pregnancies in adolescence may experience medical, psychological and social complications. Improved understanding of the individual-, dyad-, family-, peer/community- and social system-level risk factors for repeat pregnancy may lead to the development of more effective prevention strategies for adolescent mothers in a variety of settings.
Between 1993 and 1996, white, black and Mexican American adolescent mothers at a labor and delivery unit in Texas were interviewed after delivery and completed written surveys prospectively for up to 48 months. Logistic regression analyses were used to determine predictors of repeat pregnancy within 24 months, using social ecological theory as a guide.
Forty-two percent of adolescent mothers experienced a repeat pregnancy within 24 months; 73% of these delivered a second child. Individual-level predictors were planning to have another baby within five years (odds ratio, 1.6) and not using long-acting contraceptives within three months of delivery (2.4). Dyad-level predictors were not being in a relationship with the father of the first child three months after delivery (2.0), being more than three years younger than the first child's father (1.6) and experiencing intimate partner violence within three months after delivery (1.9). Peer/community-level predictors were not being in school three months postpartum (1.8) and having many friends who were adolescent parents (1.5).
Adolescent mothers are at high risk for a rapid subsequent pregnancy. Interventions that address the complex and multifaceted aspects of the lives of adolescent mothers are needed to prevent repeat pregnancy.
青春期多胎妊娠女性可能会经历医学、心理和社会方面的并发症。更好地了解再次妊娠在个体、双胎、家庭、同伴/社区及社会系统层面的风险因素，可能会促使在各种环境中为青春期母亲制定更有效的预防策略。
1993年至1996年期间，对德克萨斯州一家分娩单位的白人、黑人及墨西哥裔美国青春期母亲在分娩后进行访谈，并前瞻性地完成长达48个月的书面调查。以社会生态理论为指导，采用逻辑回归分析来确定24个月内再次妊娠的预测因素。
42%的青春期母亲在24个月内再次妊娠；其中73%生育了第二个孩子。个体层面的预测因素包括计划在五年内再要一个孩子（优势比为1.6）以及在分娩后三个月内未使用长效避孕措施（2.4）。双胎层面的预测因素包括分娩后三个月未与第一个孩子的父亲保持恋爱关系（2.0）、比第一个孩子的父亲小三岁以上（1.6）以及在分娩后三个月内遭受亲密伴侣暴力（1.9）。同伴/社区层面的预测因素包括产后三个月未上学（1.8）以及有许多身为青春期父母的朋友（1.5）。
青春期母亲随后快速再次妊娠的风险很高。需要采取干预措施来解决青春期母亲生活中复杂且多方面的问题，以预防再次妊娠。
