State University of Ceará, Fortaleza, CE, Brazil.
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
BMC Pregnancy Childbirth. 2021 Sep 8;21(1):616. doi: 10.1186/s12884-021-04088-7.
Adolescent motherhood (AM) remains a public health problem, especially in low and middle income countries, where approximately 95% of these births occur. Evidence from studies with population representativeness about events associated with AM is limited. We assessed the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes.
A population-based cross-sectional study on maternal and child health of women aged 10 to 49 years, living in the state of Ceará, in northeastern Brazil was carried out to assess the prevalence of AM, as well as its association with Socioeconomic Factors and Obstetric Outcomes. The definition of adolescence used in the study was the one utilized by the WHO. In addition to the interview, data were double-checked according to the information in the government's pregnancy health booklet. Sample-adjusted logistic models to determine the association of socioeconomic factors and AM, as well as the association of AM with obstetric outcomes, with a causal approach to multivariate analyses, were used.
The prevalence of adolescent motherhood was 18.6%. Poverty and household crowding were associated with greater chances of AM (p values of 0.038 and < 0.001, respectively), as well as not being in a stable relationship (OR 2.26 (95%CI: 1.67, 3.07), p < 0.001). AM showed a greater chance of not using community health services (p < 0.001), had fewer prenatal consultations (β - 0.432 (95%CI: - 0.75, - 0.10)) and started prenatal care at a later date (β 0.38 (95%CI: 0.21, 0.55), p < 0.001)). AM are also less likely to be tested for HIV and more likely to have urinary tract infections.
Interventions aimed at socially-vulnerable adolescents are suggested. However, if pregnant, adolescents should receive proactive and differentiated prenatal care.
少女妈妈（AM）仍然是一个公共卫生问题，尤其是在中低收入国家，这些国家大约 95%的分娩都发生在这里。关于与 AM 相关事件的具有代表性的研究证据有限。我们评估了 AM 的流行率，以及其与社会经济因素和产科结局的关联。
在巴西东北部塞阿拉州进行了一项基于人群的母婴健康横断面研究，以评估 AM 的流行率，以及其与社会经济因素和产科结局的关联。研究中使用的青春期定义是世界卫生组织使用的定义。除了访谈外，还根据政府妊娠健康手册中的信息对数据进行了双重检查。使用调整后的样本逻辑模型来确定社会经济因素与 AM 的关联，以及 AM 与产科结局的关联，采用多变量分析的因果方法。
少女妈妈的患病率为 18.6%。贫困和家庭拥挤与 AM 的几率增加有关（p 值分别为 0.038 和<0.001），以及没有稳定的关系（OR 2.26（95%CI：1.67，3.07），p<0.001）。AM 更有可能不使用社区卫生服务（p<0.001），产前咨询次数较少（β-0.432（95%CI：-0.75，-0.10）），并且开始产前护理的时间较晚（β0.38（95%CI：0.21，0.55），p<0.001）。AM 进行 HIV 检测的可能性也较低，而尿路感染的可能性则较高。
建议针对社会弱势群体的青少年进行干预。但是，如果怀孕了，青少年应该接受积极主动和有区别的产前护理。
