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青春期重复妊娠的危害:一项病例对照研究。

Hazards of Repeat Pregnancy during Adolescence: A Case-control Study.

作者信息

Galvão Rafael Bessa de Freitas, Figueira Camilla Olivares, Borovac-Pinheiro Anderson, Paulino Daiane Sofia de Morais, Faria-Schützer Debora Bicudo, Surita Fernanda Garanhani

机构信息

Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, SP, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2018 Aug;40(8):437-443. doi: 10.1055/s-0038-1666811. Epub 2018 Aug 24.

Abstract

OBJECTIVE

To evaluate the social, obstetric and psychological risk factors related to repeat pregnancy in teenagers.

METHODS

A case control study conducted at Centro de Atenção à Saúde Integral da Mulher (Caism, in the Portuguese acronym), in Campinas, Brazil, from 2015 to 2017. Three groups were selected: a case-group of adolescents who had repeat pregnancy and two control-groups, one consisting of adolescents who had delivered at first time and another one of adult women with more than one deliveries. Participants were asked about habits, socio-demographics characteristics, reproductive and obstetric history and assessed psychological issues.

RESULTS

Ninety women were enrolled, 30 in each study group. Adolescents with repeat pregnancy have lower self-esteem scores and more ineffective contraceptive use. When compared with teens at first delivery, they had less schooling level (odds ratio [OR] 4.03 [1.37-11.8]), more school abandon (OR 8.16 [2.36-28.2]) and drugs use (OR 4.97[1.39-17.8]). Non-white skin color (OR 6.2 [1.15-41.0]), drugs use (OR 17.5 [2.62-116.6]) and first sexual intercourse under 15y (OR 18.0[2.82-115.0]) were found as higher risk factors for repeat pregnancy when comparing adolescents and adults. Moreover, adolescents with more than one gestation had lower self-esteem and greater susceptibility to unplanned pregnancy.

CONCLUSION

There was an association between repeat pregnancy among adolescents and lower education, early onset of sexual activity, non-white skin color, low use of contraception and increased use of drugs.

摘要

目的

评估与青少年再次妊娠相关的社会、产科和心理风险因素。

方法

2015年至2017年在巴西坎皮纳斯的妇女综合健康护理中心(葡萄牙语缩写为Caism)进行了一项病例对照研究。选取了三组:有再次妊娠的青少年病例组以及两个对照组,一个对照组由首次分娩的青少年组成,另一个对照组由有多次分娩经历的成年女性组成。研究人员询问了参与者的习惯、社会人口统计学特征、生殖和产科病史,并对心理问题进行了评估。

结果

共招募了90名女性,每个研究组30名。有再次妊娠的青少年自尊得分较低,避孕措施使用效果较差。与首次分娩的青少年相比,她们的受教育程度较低(优势比[OR]为4.03[1.37 - 11.8]),更多人辍学(OR为8.16[2.36 - 28.2])且有吸毒行为(OR为4.97[1.39 - 17.8])。在比较青少年和成年人时,非白色肤色(OR为6.2[1.15 - 41.0])、吸毒行为(OR为17.5[2.62 - 116.6])以及15岁之前首次发生性行为(OR为18.0[2.82 - 115.0])被发现是再次妊娠的较高风险因素。此外,有多次妊娠的青少年自尊较低,意外怀孕的易感性更高。

结论

青少年再次妊娠与教育程度较低、性活动过早开始、非白色肤色、避孕措施使用较少以及吸毒行为增加之间存在关联。

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Hazards of Repeat Pregnancy during Adolescence: A Case-control Study.青春期重复妊娠的危害:一项病例对照研究。
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