PhD Candidate, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
International Consultant, Latin American Center for Perinatology/Women's Health and Reproductive Health of the Pan American Health Organization (CLAP/WR-PAHO/WHO), Montevideo, Uruguay.
Sex Reprod Health Matters. 2023 Dec;31(1):2175442. doi: 10.1080/26410397.2023.2175442.
Pregnancy-related complications are a substantial source of morbidity and mortality among adolescents in low- and middle-income countries. While the youngest adolescents (those aged 10-14) are considered to be at particularly high risk of adverse outcomes, there is little empirical data available on their sexual and reproductive health. Using a unique dataset of clinical records drawn from a regional network of sentinel centres providing legal abortion and comprehensive post-abortion care in 12 Latin American and Caribbean countries, we described the population of adolescents aged 10-14 seeking legal abortion and post-abortion care and calculated institutional rates of complications, using older adolescents (aged 15-19) and young adults (aged 20-24) as comparator groups. We also assessed the quality of care provided as compared to WHO recommendations. Nearly 17% (89 out of 533) of young adolescents sought care when they were already at 15 or more weeks' gestation. Young adolescents were at higher risk of pre-procedure and intra-operative complications than older adolescents and young adults, though the trend is less clear for the most severe complications. In general, the quality of care provided by centres in the network was aligned with WHO recommendations for safe abortion and comprehensive post-abortion care. Taken together, these findings provide insight into the challenges facing the global health community in assuring the sexual and reproductive health and rights of the youngest adolescents, and outline avenues for future research, advocacy, and evidence-based policymaking.
妊娠相关并发症是中低收入国家青少年发病和死亡的一个重要原因。尽管最年轻的青少年（10-14 岁）被认为处于不良后果的高风险之中，但关于他们的性健康和生殖健康的数据很少。本研究使用了一个独特的临床记录数据集，这些数据来自于一个区域网络中的监测中心，该网络在 12 个拉丁美洲和加勒比国家提供合法堕胎和全面堕胎后护理。我们描述了寻求合法堕胎和堕胎后护理的 10-14 岁青少年人群，并计算了并发症的机构发生率，将年龄较大的青少年（15-19 岁）和年轻成年人（20-24 岁）作为对照组。我们还评估了与世界卫生组织建议相比所提供的护理质量。将近 17%（533 例中的 89 例）的年轻青少年在已经怀孕 15 周或以上时寻求护理。年轻青少年在术前和手术期间发生并发症的风险高于年龄较大的青少年和年轻成年人，但最严重并发症的趋势不太明显。总体而言，网络中各中心提供的护理质量符合世界卫生组织关于安全堕胎和全面堕胎后护理的建议。总之，这些发现让人们深入了解了全球卫生界在确保最年轻青少年的性健康和生殖健康及权利方面所面临的挑战，并为未来的研究、宣传和循证决策制定提供了途径。
