School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
BMC Pregnancy Childbirth. 2023 Feb 3;23(1):93. doi: 10.1186/s12884-023-05361-7.
Adolescent girls and young women are vulnerable populations who are at risk of several adverse sexual and reproductive health outcomes, including unintended pregnancies, sexually transmitted infections, unsafe abortions, and death from pregnancy-related complications. In this study, we examined the correlates of repeat pregnancies among adolescent girls and young women in sub-Saharan Africa (SSA).
We extracted data from the most recent Demographic and Health Surveys (DHS) of 31 countries in SSA. Countries whose surveys were conducted from 2010 to 2020 were included in the study. A total of 108,572 adolescent girls and young women (15-24 years) were included in the study. We used a multilevel mixed-effect binary logistic regression analysis to examine the correlates of repeat pregnancies among adolescent girls and young women in SSA.
We found that adolescent girls and young women aged 20-24 [aOR = 2.36; 95%CI = 2.22, 2.51], those married [aOR = 7.52; 95%CI = 6.81, 8.30], living with a partner [aOR = 7.51; 95%CI = 6.87, 8.21], and those who had sexual intercourse before age 20 [aOR = 1.41; 95%CI = 1.33, 1.51] had higher odds of experiencing repeat pregnancies compared to those aged 15-19, those never in a union, those whose first sexual intercourse occurred at age 20 and above, respectively. Respondents exposed to listening to radio [aOR = 1.12; 95%CI = 1.06, 1.18] and those who justified intimate partner violence [aOR=1.13; 95%CI = 1.07, 1.19] had higher odds of experiencing repeat pregnancies compared to those who never listened to radio and those who did not justify intimate partner violence, respectively. Young women who had attained secondary or higher educational level [aOR = 0.83; 95%CI = 0.78, 0.90], those exposed to reading newspaper or magazine [aOR = 0.90; 95%CI = 0.82, 0.98], those residing in rural areas [aOR = 0.92; 95%CI = 0.86, 0.98], and those belonging to the richer [aOR = 0.87; 95%CI = 0.80, 0.95] and richest [aOR = 0.68; 95%CI = 0.61, 0.76] wealth quintile were less likely to experience repeat pregnancies.
The correlates of repeat pregnancies include age, age at first sexual intercourse, marital status, exposure to media, justification of intimate partner violence, wealth index, educational attainment, and place of residence. The findings underscore the need for governments and policymakers in SSA to implement policies that target the most at-risk groups: those with no formal education, the poor, and adolescent girls. Our findings also highlight the need to strengthen advocacy against the justification of intimate partner violence and intensify girl-child education.
青少年女孩和年轻女性是弱势群体，她们面临多种不良性健康和生殖健康结局的风险，包括意外怀孕、性传播感染、不安全堕胎以及与妊娠相关的并发症导致的死亡。在这项研究中，我们调查了撒哈拉以南非洲（SSA）青少年女孩和年轻女性重复怀孕的相关因素。
我们从最近的 31 个 SSA 国家的人口与健康调查（DHS）中提取数据。纳入了在 2010 年至 2020 年期间进行调查的国家。共纳入了 108572 名 15-24 岁的青少年女孩和年轻女性。我们使用多水平混合效应二项逻辑回归分析来调查 SSA 青少年女孩和年轻女性重复怀孕的相关因素。
我们发现，20-24 岁的青少年女孩和年轻女性[aOR=2.36；95%CI=2.22, 2.51]、已婚的青少年女孩和年轻女性[aOR=7.52；95%CI=6.81, 8.30]、与伴侣同居的青少年女孩和年轻女性[aOR=7.51；95%CI=6.87, 8.21]以及在 20 岁之前发生性行为的青少年女孩和年轻女性[aOR=1.41；95%CI=1.33, 1.51]，与 15-19 岁的青少年女孩和年轻女性、从未结婚的青少年女孩和年轻女性、首次性行为发生在 20 岁及以上的青少年女孩和年轻女性相比，重复怀孕的可能性更高。与从不听广播的青少年女孩和年轻女性相比，收听广播的青少年女孩和年轻女性[aOR=1.12；95%CI=1.06, 1.18]和认为亲密伴侣暴力合理的青少年女孩和年轻女性[aOR=1.13；95%CI=1.07, 1.19]重复怀孕的可能性更高。与从未接受过中学或高等教育的青少年女孩和年轻女性相比，接受过中学或高等教育的青少年女孩和年轻女性[aOR=0.83；95%CI=0.78, 0.90]、阅读报纸或杂志的青少年女孩和年轻女性[aOR=0.90；95%CI=0.82, 0.98]、居住在农村地区的青少年女孩和年轻女性[aOR=0.92；95%CI=0.86, 0.98]和属于较富裕[aOR=0.87；95%CI=0.80, 0.95]和最富裕[aOR=0.68；95%CI=0.61, 0.76]财富五分位数的青少年女孩和年轻女性重复怀孕的可能性较小。
重复怀孕的相关因素包括年龄、首次性行为年龄、婚姻状况、媒体接触、亲密伴侣暴力合理化、财富指数、教育程度和居住地。研究结果强调，需要撒哈拉以南非洲的政府和政策制定者实施针对最易受影响群体的政策：那些没有正规教育的人、贫困人口和青少年女孩。我们的研究结果还强调了需要加强反对亲密伴侣暴力合理化的宣传，并加强女童教育。
