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探讨青少年和年轻成年人的孕前健康:确定风险因素和干预措施,以预防不良的孕产妇、围产期和儿童健康结局-范围综述。

Exploring preconception health in adolescents and young adults: Identifying risk factors and interventions to prevent adverse maternal, perinatal, and child health outcomes-A scoping review.

机构信息

School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.

Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.

出版信息

PLoS One. 2024 Apr 17;19(4):e0300177. doi: 10.1371/journal.pone.0300177. eCollection 2024.

Abstract

BACKGROUND

Preconception health provides an opportunity to examine a woman's health status and address modifiable risk factors that can impact both a woman's and her child's health once pregnant. In this review, we aimed to investigate the preconception risk factors and interventions of early pregnancy and its impact on adverse maternal, perinatal and child health outcomes.

METHODS

We conducted a scoping review following the PRISMA-ScR guidelines to include relevant literature identified from electronic databases. We included reviews that studied preconception risk factors and interventions among adolescents and young adults, and their impact on maternal, perinatal, and child health outcomes. All identified studies were screened for eligibility, followed by data extraction, and descriptive and thematic analysis.

FINDINGS

We identified a total of 10 reviews. The findings suggest an increase in odds of maternal anaemia and maternal deaths among young mothers (up to 17 years) and low birth weight (LBW), preterm birth, stillbirths, and neonatal and perinatal mortality among babies born to mothers up to 17 years compared to those aged 19-25 years in high-income countries. It also suggested an increase in the odds of congenital anomalies among children born to mothers aged 20-24 years. Furthermore, cancer treatment during childhood or young adulthood was associated with an increased risk of preterm birth, LBW, and stillbirths. Interventions such as youth-friendly family planning services showed a significant decrease in abortion rates. Micronutrient supplementation contributed to reducing anaemia among adolescent mothers; however, human papillomavirus (HPV) and herpes simplex virus (HSV) vaccination had little to no impact on stillbirths, ectopic pregnancies, and congenital anomalies. However, one review reported an increased risk of miscarriages among young adults associated with these vaccinations.

CONCLUSION

The scoping review identified a scarcity of evidence on preconception risk factors and interventions among adolescents and young adults. This underscores the crucial need for additional research on the subject.

摘要

背景

孕前健康提供了一个机会,可以检查女性的健康状况,并解决可能影响孕妇及其子女健康的可改变的风险因素。在本综述中,我们旨在研究早孕的孕前风险因素和干预措施及其对不良母婴、围产期和儿童健康结局的影响。

方法

我们按照 PRISMA-ScR 指南进行了范围综述,以纳入从电子数据库中确定的相关文献。我们纳入了研究青少年和年轻成年人孕前风险因素和干预措施及其对母婴、围产期和儿童健康结局影响的综述。所有确定的研究都经过了资格筛选,然后进行数据提取和描述性及主题分析。

发现

我们共确定了 10 篇综述。研究结果表明,与 19-25 岁的母亲相比,年轻母亲(最多 17 岁)和低出生体重(LBW)、早产、死产以及 17 岁以下母亲所生婴儿的新生儿和围产儿死亡率增加;而且,20-24 岁母亲所生儿童的先天畸形几率也有所增加。此外,儿童期或青年期接受癌症治疗与早产、LBW 和死产的风险增加有关。诸如青年友好型计划生育服务等干预措施显著降低了流产率。微量营养素补充有助于减少青少年母亲的贫血;然而,人乳头瘤病毒(HPV)和单纯疱疹病毒(HSV)疫苗对死产、宫外孕和先天畸形几乎没有影响。但是,有一篇综述报告称,这些疫苗会增加年轻成年人流产的风险。

结论

该范围综述确定了关于青少年和年轻成年人孕前风险因素和干预措施的证据不足。这突出表明需要对该主题进行更多的研究。

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