Lüdecke Lara Teresa, Ekman Björn, Arunda Malachi Ochieng, Bulamba Robert, Daama Alex, Ekström Anna Mia, Kyasanku Emmanuel, Larsson Elin C, Nkale James, Sundewall Jesper
Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Reprod Health. 2025 May 22;22(1):89. doi: 10.1186/s12978-025-02045-7.
The response to the COVID-19 pandemic involved various lockdown measures, including school closures, which significantly impacted young populations, particularly in low-and middle-income countries (LMICs). Given the well-known protective effect of regular school attendance on sexual and reproductive health and rights (SRHR), reports of disrupted education, compromised SRHR, and an increase in unintended pregnancies among adolescent girls and young women (AGYW 10-24 years) have caused major concerns. We conducted a scoping review to compile the available evidence of the impact of COVID-19 lockdown measures on unintended pregnancies among AGYW aged 10-24 in LMICs.
The scoping review followed the five-stage framework by Arksey and O´Malley. A systematic search on two comprehensive databases, using search terms related to COVID-19 and unintended pregnancies, was conducted along with grey literature searches of articles in English language published between 2019 and 2024. The systematic review software Covidence was used for publication screening, selection and data extraction.
After deduplication, 241 publications were screened, and 72 full-text publications were assessed for eligibility. 13 publications from the database searches, citation searching and grey literature, were included. The scoping review included seven studies that applied quantitative methods, four that used qualitative approaches and the remaining two mixed methods. Five out of 13 publications were set in Uganda, two in Kenya and two in Nigeria, while six other countries were represented once. All included studies reported increases in pregnancies among AGYW during the COVID-19 period. School dropout among girls following a pregnancy was reported to have increased. Factors associated with unintended pregnancy were school closures, limited access to SRHR services including contraceptives, and increasing sexual encounters.
School closures and other lockdown measures during the COVID-19 pandemic led to an increase in unintended pregnancies among AGYW in LMICs. The long-term consequences for these young individuals, their communities and to the broader society are still to be measured and available evidence is limited, few studies have applied robust study designs, and several relied on small sample sizes. Further research is needed to build a stronger evidence base for health and socio-economic impacts of school closures and lockdowns among young people.
对新冠疫情的应对措施包括各种封锁举措，其中学校关闭对年轻人群体产生了重大影响，在低收入和中等收入国家（LMICs）尤为如此。鉴于正常上学对性与生殖健康及权利（SRHR）具有众所周知的保护作用，教育中断、SRHR受损以及10至24岁少女和年轻女性（AGYW）意外怀孕增加的报告引发了重大担忧。我们开展了一项范围综述，以汇总新冠疫情封锁措施对LMICs中10至24岁AGYW意外怀孕影响的现有证据。
范围综述遵循了阿克西和奥马利的五阶段框架。使用与新冠疫情和意外怀孕相关的检索词，在两个综合数据库中进行了系统检索，并对2019年至2024年期间发表的英文文章进行了灰色文献检索。使用系统综述软件Covidence进行文献筛选、选择和数据提取。
在去重后，筛选了241篇出版物，并评估了72篇全文出版物的 eligibility。纳入了来自数据库检索、引文检索和灰色文献的13篇出版物。范围综述包括七项采用定量方法的研究、四项采用定性方法的研究以及其余两项混合方法的研究。13篇出版物中有五篇来自乌干达，两篇来自肯尼亚，两篇来自尼日利亚，其他六个国家各有一篇。所有纳入研究均报告称，在新冠疫情期间，AGYW的怀孕率有所上升。据报道，怀孕后女孩的辍学率有所增加。与意外怀孕相关的因素包括学校关闭、获得包括避孕药具在内的SRHR服务的机会有限以及性接触增加。
新冠疫情期间的学校关闭和其他封锁措施导致LMICs中AGYW的意外怀孕率上升。这些年轻人及其社区以及更广泛社会的长期后果仍有待衡量，现有证据有限，很少有研究采用有力的研究设计，且有几项研究依赖小样本量。需要进一步研究，以建立更有力的证据基础，证明学校关闭和封锁对年轻人健康和社会经济的影响。
