Department of Public Health and Clinical Medicine, Epidemiology and Public Health, Umeå University, Umeå, Sweden.
Rev Panam Salud Publica. 2009 Sep;26(3):221-8. doi: 10.1590/s1020-49892009000900006.
To examine risk factors for pregnancy among adolescent girls in the Amazon basin of Ecuador.
A matched case-control study with cases and controls identified within a community-based demographic and health survey was conducted in Orellana, Ecuador, from May to November 2006. A questionnaire focused on socioeconomic status, family structure, education, reproductive health, and childhood-adolescent trauma was applied. Conditional logistic regression was used to adjust for potential confounders.
Respondents included 140 cases and 262 controls. Factors associated with increased risk of adolescent pregnancies through multivariate analysis were: sexual abuse during childhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08-8.68); early sexual debut (OR 8.51, 95% CI 1.12-64.90); experiencing periods without mother and father (OR 10.67, 95% CI 2.67-42.63); and living in a very poor household (OR 15.23, 95% CI 1.43-162.45). Another two factors were statistically associated in the bivariate analysis: being married or in a consensual union (OR 44.34, 95% CI 17.85-142.16) and not being enrolled in school at the time of the interview (OR 6.31, 95% CI 3.70-11.27). For a subsample of sexually initiated adolescents, "non-use of contraception during first sexual intercourse" was also found to be a risk factor (OR 4.30, 95% CI 1.33-13.90).
The study found that early sexual debut, non-use of contraception during first sexual intercourse, living in a very poor household, having suffered from sexual abuse during childhood-adolescence, and family disruption (living extended periods of life without both parents) were associated with adolescent pregnancy in Orellana.
探讨厄瓜多尔亚马逊流域少女妊娠的相关风险因素。
2006 年 5 月至 11 月，在厄瓜多尔奥雷利亚纳，对基于社区的人口和健康调查中确定的病例和对照进行了匹配病例对照研究。应用了一份以社会经济地位、家庭结构、教育、生殖健康和儿童青少年创伤为重点的调查问卷。采用条件逻辑回归对潜在混杂因素进行调整。
共有 140 名病例和 262 名对照者纳入研究。多变量分析显示，以下因素与少女妊娠风险增加相关：儿童青少年时期的性虐待（比值比（OR）3.06，95%置信区间（CI）1.08-8.68）；性初潮过早（OR 8.51，95% CI 1.12-64.90）；经历过父母不在身边的时期（OR 10.67，95% CI 2.67-42.63）；和生活在非常贫困的家庭（OR 15.23，95% CI 1.43-162.45）。在单变量分析中，还有另外两个因素具有统计学相关性：已婚或事实婚姻（OR 44.34，95% CI 17.85-142.16）和访谈时未在校就读（OR 6.31，95% CI 3.70-11.27）。对于性活跃的青少年亚组，“首次性行为时未使用避孕措施”也被发现是一个风险因素（OR 4.30，95% CI 1.33-13.90）。
本研究发现，奥雷利亚纳的少女妊娠与性初潮过早、首次性行为时未使用避孕措施、生活在非常贫困的家庭、儿童青少年时期遭受性虐待以及家庭破裂（生活中长时间没有父母双方的陪伴）有关。
