Mebrahtu Helen, Chimbindi Natsayi, Zuma Thembelihle, Dreyer Jaco, Mthiyane Nondumiso, Seeley Janet, Shahmanesh Maryam, Sherr Lorraine, Harling Guy
Institute for Global Health, University College London, London, UK.
Africa Health Research Institute, KwaZulu-Natal, South Africa.
Int J Adolesc Youth. 2024;29(1). doi: 10.1080/02673843.2024.2371414. Epub 2024 Jun 30.
Pregnancy can place adolescent girls and young women (AGYW) at risk of poor mental health. However, evidence linking youth pregnancy to mental health in resource-limited settings is limited, especially where HIV incidence is high. We analysed a population-representative cohort of AGYW aged 13-25 in rural KwaZulu-Natal to assess how adolescent pregnancy predicts subsequent mental health. Among 1851 respondents, incident pregnancy (self-reported past-12-month) rose from 0.7% at age 14 to 22.1% by 18. Probable common mental disorder (CMD; 14-item Shona Symptom Questionnaire) prevalence was 19.1%. In adjusted Poisson regression recent pregnancy was associated with slightly higher probable CMD (adjusted prevalence ratio [aPR] 1.19, 95%CI 0.96-1.49), and stronger association among 13-15 year-olds (aPR 3.25, 95%CI 1.50-7.03), but not with HIV serostatus. These findings suggest a possible incremental mental health impact of being pregnant earlier than peers, pointing to the need for age-appropriate mental health interventions for AGYW in resource-limited settings.
怀孕可能使青春期女孩和年轻女性面临心理健康不佳的风险。然而，在资源有限的环境中，将青少年怀孕与心理健康联系起来的证据有限，尤其是在艾滋病毒发病率高的地方。我们分析了夸祖鲁-纳塔尔省农村地区13至25岁的具有人群代表性的青春期女孩和年轻女性队列，以评估青少年怀孕如何预测随后的心理健康。在1851名受访者中，意外怀孕（自我报告的过去12个月内）从14岁时的0.7%上升到18岁时的22.1%。可能的常见精神障碍（CMD；14项绍纳症状问卷）患病率为19.1%。在调整后的泊松回归中，近期怀孕与略高的可能CMD相关（调整患病率比[aPR]1.19，95%CI 0.96-1.49），在13至15岁的人群中关联更强（aPR 3.25，95%CI 1.50-7.03），但与艾滋病毒血清学状态无关。这些发现表明，比同龄人更早怀孕可能对心理健康产生渐进影响，这表明在资源有限的环境中，需要为青春期女孩和年轻女性提供适合其年龄的心理健康干预措施。
