Walter Sisulu University Family Medicine Department, Zithulele Hospital, Mqanduli District, 5080, South Africa.
University of California, Los Angeles, USA.
BMC Pregnancy Childbirth. 2019 Jan 11;19(1):24. doi: 10.1186/s12884-018-2164-8.
Adolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries. We examine the structural, personal, and caretaking challenges of adolescent mothers and their children in rural South Africa compared to adult mothers over the first 24 months post-birth.
A cohort of sequential births (n = 470/493) in the rural OR Tambo District was recruited and reassessed at 3, 6, 9, 12, and at 24 months post-birth, with a retention rate above 84% at all timepoints. Maternal and child outcomes were examined over time using multiple linear and logistic regressions.
Adolescent mothers reflect 17% of births (n = 76/458). Adolescent mothers were more likely to have water in their households, but less likely to live with a partner and to be seropositive for HIV than adult mothers. Risks posed by mental health symptoms, alcohol, and partner violence were similar. Adolescents exclusively breastfed for shorter time and it took longer for them to secure a child grant compared to adult mothers. Although obtaining immunizations was similar, growth was significantly slower for infants of adolescent mothers compared to adult mothers over time.
In rural South Africa, almost one in five pregnant women is an adolescent. Caretaking tasks influencing child growth, especially breastfeeding and securing the child grant appear as the greatest problems for adolescent compared to adult mothers.
青少年母亲与高收入国家和中低收入国家城市地区儿童不良结局之间存在反复关联。我们研究了与成年母亲相比，南非农村地区青少年母亲及其子女在生命的头 24 个月中面临的结构、个人和照顾方面的挑战。
在农村奥兰治自由邦地区，我们招募了一系列连续分娩的婴儿（n=470/493），并在出生后 3、6、9、12 和 24 个月时进行了重新评估，所有时间点的保留率均超过 84%。使用多线性和逻辑回归，随时间检查母婴结局。
青少年母亲占分娩的 17%（n=76/458）。与成年母亲相比，青少年母亲家中更有可能有水，但更不可能与伴侣生活在一起，也更不可能 HIV 血清阳性。心理健康症状、酒精和伴侣暴力带来的风险相似。青少年母亲母乳喂养的时间更短，与成年母亲相比，她们获得儿童补助金的时间更长。尽管获得免疫接种的情况相似，但随着时间的推移，青少年母亲的婴儿生长速度明显慢于成年母亲。
在南非农村，近五分之一的孕妇是青少年。照顾孩子的任务，尤其是母乳喂养和获得儿童补助金，似乎是青少年母亲比成年母亲面临的最大问题。
