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Batek LM, Leblanc NM, Alio AP, Stein KF, McMahon JM. Facilitators and barriers to contraception access and use for Hispanic American adolescent women: An integrative literature review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003169. [PMID: 39052657 PMCID: PMC11271872 DOI: 10.1371/journal.pgph.0003169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
STATEMENT OF THE PROBLEM Hispanic American adolescents experience high rates of pregnancy with profound consequences. Compared with White teens, Hispanic teens use contraception less frequently and often choose less effective forms of contraception. Access to contraception is a primary barrier to use which contributes to relatively high and disparate rates of pregnancy in Hispanic teens. This integrative review identifies facilitators and barriers of contraception access and use for Hispanic women, 13-17 years of age, living in the U.S. METHODOLOGY Following the Whittemore and Knafl (2005) methodology and PRISMA guidelines, peer reviewed studies were retrieved from PUBMED, CINAHL and EMBASE. The Mixed Methods Appraisal Tool was used to assess the study quality and thematic analysis was used to categorize barriers and facilitators. FINDINGS Of 131 studies retrieved, 16 met inclusion criteria. Individual, interpersonal and healthcare provider factors were identified as primary categories of barriers and facilitators with structural issues comprising an additional barrier category. Individual level barriers were disproportionately represented and further categorized into themes: beliefs/misconceptions, dislike of contraception, pregnancy risk perception, lack of knowledge, and lack of control. Barriers related to cultural and religious influences were identified in individual, interpersonal and structural levels. The most frequently reported facilitators were perceived parent comfort discussing sexual health and past experience of pregnancy. DISCUSSION Limitations in this review may stem from heterogeneity in the acculturation and geography of participants and analysis by a single reviewer. Implications include considering the range of information sources and the influence they have on risk perception and risk mitigation for this population. CONCLUSION & SIGNIFICANCE Adolescents describe many modifiable influences on contraception access and use. Misperceptions related to contraception, stemming from beliefs and perceptions, can be corrected through increased access to reliable sources of sex education, parental support, and direct access to nurses and healthcare providers. Awareness of these influences can inform further research and intervention development to address these health disparities.
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Affiliation(s)
- Lindsay M. Batek
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Natalie M. Leblanc
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Amina P. Alio
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Karen F. Stein
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| | - James M. McMahon
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
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Mebrahtu H, Chimbindi N, Zuma T, Dreyer J, Mthiyane N, Seeley J, Shahmanesh M, Sherr L, Harling G. Incident pregnancy and mental health among adolescent girls and young women in rural KwaZulu-Natal, South Africa: an observational cohort study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2024; 29:2371414. [PMID: 39035705 PMCID: PMC11259029 DOI: 10.1080/02673843.2024.2371414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
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.
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Affiliation(s)
- Helen Mebrahtu
- Institute for Global Health, University College London, London, UK
| | - Natsayi Chimbindi
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Thembelihle Zuma
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
- Division of Infection and Immunity, University College London, London, UK
| | - Jaco Dreyer
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Nondumiso Mthiyane
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Maryam Shahmanesh
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Guy Harling
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, South Africa
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Pszczołowska M, Walczak K, Miśków W, Mroziak M, Kozłowski G, Beszłej JA, Leszek J. Association between Female Reproductive Factors and Risk of Dementia. J Clin Med 2024; 13:2983. [PMID: 38792524 PMCID: PMC11122498 DOI: 10.3390/jcm13102983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Women have an over 50% greater risk of dementia than men, which is a main topic of much research. This review aims to investigate the impact of a woman's reproductive history on dementia risk. The consequences of stillbirth are long-term health and psychosocial problems for women. Because of the awareness of an endangered pregnancy, many parents experience deep anxiety and stress in subsequent pregnancies. There are contradictory conclusions from research about abortion and the risk of dementia correlation. When it comes to the late age of first birth, which is said to be above 35 years old, it was observed that older mothers have a decreased risk of dementia compared to those who gave birth in their 20s; however, being a child of the older mother is connected with a higher risk of developing dementia. Using hormonal contraception can result in decreased risk of dementia as estrogen stimulates microglia-related Aβ removal and reduces tau hyperphosphorylation. The influence of postmenopausal hormonal therapy and the duration of the reproductive period on developing dementia remains unclear. Although female disorders like endometriosis and polycystic ovary syndrome are reported to increase the risk of dementia, the research on this topic is very limited, especially when it comes to endometriosis, and needs further investigation. Interestingly, there is no conclusion on whether hypertensive disorders of pregnancy increase the risk of dementia, but most articles seem to confirm this theory.
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Affiliation(s)
| | - Kamil Walczak
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Weronika Miśków
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Magdalena Mroziak
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Gracjan Kozłowski
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Jan Aleksander Beszłej
- Clinic of Psychiatry, Department of Psychiatry, Medical Department, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Jerzy Leszek
- Clinic of Psychiatry, Department of Psychiatry, Medical Department, Wrocław Medical University, 50-367 Wrocław, Poland
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Associations between parenthood and dementia in men and women: biology or confounding? BMC Neurol 2023; 23:90. [PMID: 36859243 PMCID: PMC9976501 DOI: 10.1186/s12883-023-03108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/27/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND High parity and extremes of age at first birth have been linked with increased dementia risk in women, with exposure to pregnancy-associated physiological changes proposed as an explanation. However, confounding by socioeconomic and lifestyle factors could also produce such associations, whereby men would share similar patterns of association. We investigated whether these associations hold for both sexes. METHODS In a cohort study including all women (N = 2,222,638) and men (N = 2,141,002) ≥ 40 years of age in 1994-2017 in Denmark, we used Cox regression to evaluate associations between number of children, age at first birth, and dementia risk separately for women and men. RESULTS During follow-up, 81,413 women and 53,568 men (median age at diagnosis, 83.3 and 80.3 years, respectively) developed dementia. Compared with having one child, having two or more children was associated with modest decreases in overall dementia risk in both sexes (hazard ratio [HR] range 0.82-0.91, Pdifference men vs. women = 0.07). Although the associations between childlessness and overall dementia risk differed statistically for men and women, the association magnitudes differed only slightly (HRmen 1.04, 95% confidence interval [CI] 1.01-1.06; HRwomen 0.99, 95% CI 0.97-1.01; P = 0.002). Associations between age at becoming a parent and overall dementia were also similar for women and men, with the exception of older (≥ 40 years) first-time parents (HRmen 1.00, 95% CI 0.96-1.05; HRwomen 0.92, 95% CI 0.86-0.98; P = 0.01). With few exceptions, sub-analyses by dementia subtype and timing of onset also revealed similar patterns and effect magnitudes for women and men. CONCLUSIONS Associations between number of children, age at becoming a parent, and dementia risk were similar for both sexes. Lifestyle and socioeconomic factors are more likely to explain the observed associations than normal pregnancy-related physiological changes.
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Russotti J, Font SA, Toth SL, Noll JG. Developmental pathways from child maltreatment to adolescent pregnancy: A multiple mediational model. Dev Psychopathol 2023; 35:142-156. [PMID: 35074030 PMCID: PMC9309193 DOI: 10.1017/s0954579421001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adolescent pregnancy (AP) is a significant public health issue. Child maltreatment (CM) represents an established risk factor, yet little is known about the explanatory mechanisms linking the phenomena. Informed by developmental theory, this study prospectively tested seven multi-level, indirect pathways that could plausibly explain the relationship between CM and AP: (1) substance use (polysubstance use and frequency); (2) sexual risk behavior; (3) depressive symptoms; (4) posttraumatic stress disorder symptoms; (5) cognitive dysregulation; (6) pregnancy desire and difficulty expectancies; and (7) age at menarche. Data came from a prospective, longitudinal cohort study of 469 ethnically diverse, nulliparous adolescent females, designed to examine the impact of substantiated CM on reproductive outcomes such as pregnancy and childbirth (265 maltreated and 204 demographically matched comparison adolescents). A multiple-mediator structural equation model was conducted to simultaneously test multiple indirect effects while accounting for confounding variables. Maltreatment had an indirect effect on pregnancy via substance use and higher pregnancy desire/lower perceived difficulty. Findings represent a step towards elucidating pathways linking CM with AP. Recommendations are offered to prevent pregnancy by addressing the pregnancy-specific mechanisms that are part of the maltreatment sequelae.
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, Rochester, USA
| | - Sarah A Font
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, Rochester, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, USA
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Maslowsky J, Stritzel H, Gershoff ET. Post-Pregnancy Factors Predicting Teen Mothers' Educational Attainment by Age 30 in Two National Cohorts. YOUTH & SOCIETY 2022; 54:1377-1401. [PMID: 38107471 PMCID: PMC10723653 DOI: 10.1177/0044118x211026941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Women who begin childbearing as teenagers attain lower levels of education than women who delay childbearing until age 20 and later. Little is known about post-pregnancy factors that predict educational attainment among teen mothers. The current study examined whether teen mothers' environment and experiences 2 years after their first birth contribute to their educational outcomes by age 30, net of selection factors associated with teenage childbearing. Data were from two cohorts, the National Longitudinal Surveys of Youth 1979 (N = 241) and 1997 (N = 378). Multinomial logistic regression modeling was used to assess associations of post-pregnancy factors with teen mothers' educational attainment. Having child care was associated with increased odds of attaining a high school diploma and of attending college in both cohorts. Providing regular and subsidized child care for teen mothers is an opportunity to support teen mothers in achieving higher levels of educational attainment.
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Individual differences in the development of youth externalizing problems predict a broad range of adult psychosocial outcomes. Dev Psychopathol 2022; 35:630-651. [PMID: 35256022 DOI: 10.1017/s0954579421001772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined how youth aggressive and delinquent externalizing problem behaviors across childhood and adolescence are connected to consequential psychosocial life outcomes in adulthood. Using data from a longitudinal, high-risk sample (N = 1069) that assessed children and their parents regularly from early childhood (ages 3-5) through adulthood, multilevel growth factors of externalizing behaviors were used to predict adult outcomes (age 24-31), providing a sense of how externalizing problems across development were related to these outcomes via maternal, paternal, teacher, and child report. Findings indicated strong support for the lasting connections between youth externalizing problems with later educational attainment and legal difficulties, spanning informants and enduring beyond other meaningful contributors (i.e., child sex, cognitive ability, parental income and education, parental mental health and relationship quality). Some support was also found, although less consistently, linking externalizing problems and later alcohol use as well as romantic relationship quality. Delinquent/rule-breaking behaviors were often stronger predictors of later outcomes than aggressive behaviors. Taken together, these results indicate the importance of the role youth externalizing behaviors have in adult psychosocial functioning one to two decades later.
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Black CFD. Partner Emotional Support and Child Problem Behaviors: The Indirect Role of Harsh Parenting for Young Mothers and Their Children. FAMILY PROCESS 2022; 61:375-390. [PMID: 33908029 PMCID: PMC8812210 DOI: 10.1111/famp.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Emotionally supportive partners promote the well-being of teenage mothers and their children as they navigate sensitive developmental periods. Yet, having focused on young parents' relationship dissolution, we know very little about benefits of partner supportiveness for the development of children's psychological adjustment or processes that may explain this association. Using five waves of Fragile Families and Child Well-being Study data (N = 771) and parallel process latent growth curve modeling, this study tested whether trajectories of partner supportiveness (measured by maternal reports of fathers' emotional support) directly mitigated trajectories of children's externalizing and internalizing problem behaviors (measured by maternal reports of problem behaviors) and/or whether such effects were indirectly linked through lower levels of maternal harsh parenting (measured by observational ratings of mother-child interactions). Results suggest that higher levels of partner supportiveness at birth were associated with child externalizing and internalizing trajectories that started at lower levels and demonstrated slower improvements across time. Lower starting levels of maternal harsh parenting when children were three years old partially explained associations between partner supportiveness at birth and lower levels of child externalizing symptoms at age three. Lessons gleaned from this study are discussed in context of young families' strengths and applied to practice-based settings.
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Consequences of Teen Parenthood for Teen Mothers and Fathers in Canada. CANADIAN STUDIES IN POPULATION 2022. [DOI: 10.1007/s42650-021-00060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Pérez W, Ekholm Selling K, Zelaya Blandón E, Peña R, Contreras M, Persson LÅ, Sysoev O, Källestål C. Trends and factors related to adolescent pregnancies: an incidence trend and conditional inference trees analysis of northern Nicaragua demographic surveillance data. BMC Pregnancy Childbirth 2021; 21:749. [PMID: 34740316 PMCID: PMC8569964 DOI: 10.1186/s12884-021-04215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We aimed to identify the 2001-2013 incidence trend, and characteristics associated with adolescent pregnancies reported by 20-24-year-old women. METHODS A retrospective analysis of the Cuatro Santos Northern Nicaragua Health and Demographic Surveillance 2004-2014 data on women aged 15-19 and 20-24. To calculate adolescent birth and pregnancy rates, we used the first live birth at ages 10-14 and 15-19 years reported by women aged 15-19 and 20-24 years, respectively, along with estimates of annual incidence rates reported by women aged 20-24 years. We conducted conditional inference tree analyses using 52 variables to identify characteristics associated with adolescent pregnancies. RESULTS The number of first live births reported by women aged 20-24 years was 361 during the study period. Adolescent pregnancies and live births decreased from 2004 to 2009 and thereafter increased up to 2014. The adolescent pregnancy incidence (persons-years) trend dropped from 2001 (75.1 per 1000) to 2007 (27.2 per 1000), followed by a steep upward trend from 2007 to 2008 (19.1 per 1000) that increased in 2013 (26.5 per 1000). Associated factors with adolescent pregnancy were living in low-education households, where most adults in the household were working, and high proportion of adolescent pregnancies in the local community. Wealth was not linked to teenage pregnancies. CONCLUSIONS Interventions to prevent adolescent pregnancy are imperative and must bear into account the context that influences the culture of early motherhood and lead to socioeconomic and health gains in resource-poor settings.
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Affiliation(s)
- Wilton Pérez
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Institute of Nutrition of Central America and Panama (INCAP), Calzada Roosevelt 6-25, Zona 11, Guatemala, Guatemala.
| | | | - Elmer Zelaya Blandón
- Asociación para el Desarrollo Económico y Sostenible de El Espino (APRODESE), Chinandega, Nicaragua
- Nicaraguan Autonomous National University, León (UNAN-León), León, Nicaragua
| | - Rodolfo Peña
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Pan American Health Organization, Tegucigalpa, Honduras
| | - Mariela Contreras
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lars-Åke Persson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Oleg Sysoev
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Carina Källestål
- Department of Dental Research, Public Dental Service, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Song H. The unequal consequences of family structures for infant health. SOCIAL SCIENCE RESEARCH 2021; 100:102604. [PMID: 34627556 PMCID: PMC9812279 DOI: 10.1016/j.ssresearch.2021.102604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 05/10/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
Rapid changes in American families have reshaped inequalities in child well-being. This paper examines the unequal consequences of family structures for infant health, focusing on birthweight. Existing studies mainly address the average association between marriage (versus singlehood) and birthweight. I extend the literature by 1) explicitly considering cohabitation and 2) exploring the heterogeneous associations based on mother's likelihood of union formation at conception. Pooling nationally representative data from the National Survey of Family Growth 2011-17, I analyze a sample of recent births (N = 4,376) born to mothers aged between 20 and 49 years. Propensity score methods are used to address selections. Results show that 1) compared to single mothers, married mothers reap birthweight benefits, while cohabiting mothers do not; 2) married mothers with a higher likelihood to marry at conception (i.e., more advantaged) reap even larger birthweight benefits than their low-likelihood counterparts (i.e., less advantaged). Overall, the findings reveal important and nuanced roles of family structure in the reproduction of intergenerational inequality through infant health.
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Affiliation(s)
- Haoming Song
- Department of Sociology, Brown University, 108 George Street, Providence, RI, 02912, USA.
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Astuti AW, Hirst J, Bharj KK. Adolescent fathers’ experiences in Indonesia: a qualitative study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2021. [DOI: 10.1080/02673843.2021.1901749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Andari Wuri Astuti
- Midwifery Study Programme, Faculty of Health Sciences, Universitas Aisyiyah Yogyakarta (UNISA), Yogyakarta, Indonesia
- School of Healthcare, Faculty of Medicine, University of Leeds, Leeds, UK
| | - Janet Hirst
- School of Healthcare, Faculty of Medicine, University of Leeds, Leeds, UK
| | - Kuldip Kaur Bharj
- School of Healthcare, Faculty of Medicine, University of Leeds, Leeds, UK
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Berg V, Kuja-Halkola R, D'Onofrio BM, Lichtenstein P, Latvala A. Parental substance misuse and reproductive timing in offspring: A genetically informed study. EVOL HUM BEHAV 2021. [DOI: 10.1016/j.evolhumbehav.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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DeVille NV, Khalili R, Levy JI, Korrick SA, Vieira VM. Prenatal environmental exposures and associations with teen births. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:197-210. [PMID: 32913222 PMCID: PMC7943647 DOI: 10.1038/s41370-020-00262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Children's prenatal exposure to multiple environmental chemicals may contribute to subsequent deficits in impulse control, predisposing them to risk-taking. OBJECTIVE Our goal was to investigate associations between prenatal exposure mixtures and risk of teen birth, a manifestation of high-risk sexual activity, among 5865 girls (1st generation) born in southeast Massachusetts from 1992-1998. METHODS Exposures included prenatal modeled polychlorinated biphenyls (PCBs), ρ,ρ'-dichlorodiphenyl dichloroethylene (DDE), hexachlorobenzene (HCB), lead (Pb), and mercury (Hg). We fit adjusted generalized additive models with multivariable smooths of exposure mixtures, 1st generation infant's birth year, and maternal age at 1st generation birth. Predicted odds ratios (ORs) for teen birth were mapped as a function of joint exposures. We also conducted sensitivity analyses among 1st generation girls with measured exposure biomarkers (n = 371). RESULTS The highest teen birth risk was associated with a mixture of high prenatal HCB, Hg, Pb, and PCB, but low DDE exposure, with similar associations in sensitivity analyses. The highest OR predicted for girls born in 1995 to mothers of median age (26 years) was at the 95th percentile of the HCB and PCB exposure distributions (OR = 3.09; 95% confidence interval: 0.29, 32.4). Additionally, girls born earlier in the study period or to teen mothers were at increased risk of teen birth. SIGNIFICANCE Prenatal environmental chemical exposures and sociodemographic characteristics may interact to substantially increase risk of teen births.
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Affiliation(s)
- Nicole V DeVille
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, CA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Roxana Khalili
- Program in Environmental Health Sciences, College of Health Sciences, University of California, Irvine, Irvine, CA, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Susan A Korrick
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Verónica M Vieira
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, CA, USA
- Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA
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Richmond‐Rakerd LS, Moffitt TE, Arseneault L, Belsky DW, Connor J, Corcoran DL, Harrington H, Houts RM, Poulton R, Prinz JA, Ramrakha S, Sugden K, Wertz J, Williams BS, Caspi A. A polygenic score for age-at-first-birth predicts disinhibition. J Child Psychol Psychiatry 2020; 61:1349-1359. [PMID: 32220142 PMCID: PMC7529719 DOI: 10.1111/jcpp.13224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND A recent genome-wide association study identified molecular-genetic associations with age-at-first-birth. However, the meaning of these genetic discoveries is unclear. Drawing on evidence linking early pregnancy with disinhibitory behavior, we tested the hypothesis that genetic discoveries for age-at-first-birth predict disinhibition. METHODS We included participants with genotype data from the two-decade-long Environmental Risk (E-Risk) Study (N = 1,999) and the four-decade-long Dunedin Study (N = 918). We calculated a genome-wide polygenic score for age-at-first-birth and tested whether it was associated with a range of disinhibitory outcomes across the life course, including low childhood self-control; risk for externalizing psychopathology; officially recorded criminal offending; substance dependence; informant reports of disinhibitory problems; and number of lifetime sexual partners. We further tested whether associations were attributable to accelerated pubertal maturation. RESULTS In both cohorts, the age-at-first-birth polygenic score predicted low childhood self-control, externalizing psychopathology, officially recorded criminal offending, substance dependence, and number of sexual partners. Associations were modest, but robust across replication. Childhood disinhibition partly mediated associations between the polygenic score and reproductive behaviors. In contrast, associations were not attributable to accelerated pubertal timing. CONCLUSIONS Genomic discoveries for age-at-first-birth are about more than reproductive biology: They provide insight into the disinhibitory traits and behaviors that accompany early parenthood. Age-at-first-birth is a useful proxy phenotype for researchers interested in disinhibition. Further, interventions that improve self-regulation abilities may benefit young parents and their children.
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Affiliation(s)
- Leah S. Richmond‐Rakerd
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA,Frank Porter Graham Child Development InstituteUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Terrie E. Moffitt
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA,Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNCUSA,Center for Genomic and Computational BiologyDuke UniversityDurhamNCUSA,Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Louise Arseneault
- Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Daniel W. Belsky
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Jennie Connor
- Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
| | - David L. Corcoran
- Center for Genomic and Computational BiologyDuke UniversityDurhamNCUSA
| | | | - Renate M. Houts
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research UnitDepartment of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Joey A. Prinz
- Center for Genomic and Computational BiologyDuke UniversityDurhamNCUSA
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research UnitDepartment of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Karen Sugden
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA
| | - Jasmin Wertz
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA
| | | | - Avshalom Caspi
- Department of Psychology and NeuroscienceDuke UniversityDurhamNCUSA,Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNCUSA,Center for Genomic and Computational BiologyDuke UniversityDurhamNCUSA,Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
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Bostick EA, Greenberg KB, Fagnano M, Baldwin CD, Halterman JS, Yussman SM. Adolescent Self-Reported Use of Highly Effective Contraception: Does Provider Counseling Matter? J Pediatr Adolesc Gynecol 2020; 33:529-535. [PMID: 32544517 DOI: 10.1016/j.jpag.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/25/2020] [Accepted: 06/08/2020] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE To examine associations between provider counseling about specific contraceptive methods and method choices reported by adolescents. DESIGN A cross-sectional, secondary analysis of the local 2015 Youth Risk Behavior Survey, to which we added 2 new/modified questions about long-acting reversible contraception (LARC). SETTING Rochester, New York. PARTICIPANTS Female students in 9th-12th grade in the Rochester City School District. INTERVENTIONS An anonymous, standardized survey was administered to collect data. MAIN OUTCOME MEASURES We studied associations between students' reported contraceptive use and counseling (LARC, short-acting contraception [SAC], neither), health care factors, and potential risk/protective factors. Data were analyzed using bivariate and multivariate methods. RESULTS Among 730 sexually active female respondents, 353/730 (49%) were African American and 182/730 (25%) were Other/Mixed race. 416/730 (57%) used no hormonal method at last sex, and 95/730 (13%) used LARC. 210/730 (29%) of participants recalled any LARC-specific counseling, and 265/730 (36%) any counseling on SAC. Recall of LARC and SAC counseling and use were significantly associated with speaking privately with a provider, but were not related to personal risk/protective factors. Multivariate analyses showed that recollection of LARC counseling was significantly associated with higher odds of using either LARC (adjusted odds ratio, 14.3; P < .001) or SAC (adjusted odds ratio, 2.1; P = .007). Recollection of either LARC or SAC counseling was associated with significantly lower odds of using no contraception. CONCLUSION Adolescents' use of LARC was only 13%, but those who recalled contraceptive counseling had higher odds of using some hormonal method. Efforts are needed to improve provider counseling, maintain confidentiality, and identify effective methods to engage adolescents in meaningful, memorable discussions of LARC.
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Affiliation(s)
- Erica A Bostick
- Division of Adolescent Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York.
| | - Katherine B Greenberg
- Division of Adolescent Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Maria Fagnano
- Division of General Pediatrics, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Constance D Baldwin
- Division of General Pediatrics, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Jill S Halterman
- Division of General Pediatrics, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Susan M Yussman
- Division of Adolescent Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
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17
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Harding JF, Knab J, Zief S, Kelly K, McCallum D. A Systematic Review of Programs to Promote Aspects of Teen Parents' Self-sufficiency: Supporting Educational Outcomes and Healthy Birth Spacing. Matern Child Health J 2020; 24:84-104. [PMID: 31965469 PMCID: PMC7497377 DOI: 10.1007/s10995-019-02854-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Expectant and parenting teens experience many challenges to achieving self-sufficiency and promoting their children's healthy development. Teen parents need support to help them address these challenges, and many different types of programs aim to support them. In this systematic review, we examine the research about programs that aim to support aspects of teen parents' self-sufficiency by promoting their educational outcomes and healthy birth spacing. METHODS We conducted a comprehensive literature search of published and unpublished literature to identify studies of programs to support teen parents that met this review's eligibility criteria. The quality and execution of the eligible study research designs were assessed to determine whether studies' findings were at risk of bias. We then extracted information about study characteristics, outcomes, and program characteristics for studies considered to provide rigorous evidence. RESULTS We identified 58 eligible studies. Twenty-three studies were considered to provide rigorous evidence about either education, contraceptive use, or repeat pregnancy or birth. Seventeen of these studies showed at least one favorable effect on an outcome in one of these domains, whereas the other six did not show any significant or substantial effects in these domains. These 17 studies represent 14 effective programs. DISCUSSION Effective programs to support expectant and parenting teens have diverse characteristics, indicating there is no single approach for promoting teens' education and healthy birth spacing. More rigorous studies of programs to support teen parents are needed to understand more about how to support teen fathers and the program characteristics associated with effectiveness.
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Affiliation(s)
| | - Jean Knab
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Susan Zief
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Kevin Kelly
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Diana McCallum
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
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18
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Rossier C, Schoumaker B, Delaunay V, Beguy D, Jain A, Bangha M, Aregay A, Beck B, Derra K, Millogo M, Dube AN, Siaka K, Wamukoya M, Zabre P. Adolescent Fertility Is Lower than Expected in Rural Areas: Results from 10 African HDSS. Stud Fam Plann 2020; 51:177-192. [PMID: 32529644 DOI: 10.1111/sifp.12116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The adolescent birth rate (ABR) is an important indicator of maternal health, adolescent sexual health, and gender equity; it remains high in sub-Saharan Africa. While Demographic and Health Surveys (DHS) are the main source of ABR estimates, Health and Demographic Surveillance Systems (HDSS) also produce ABRs. Studies are lacking, however, to assess the ease of access and accuracy of HDSS ABR measures. In this paper, we use birth and exposure data from 10 HDSS in six African countries to compute local ABRs and compare these rates to DHS regional rates where the HDSS sites are located, standardizing by education and place of residence. In rural HDSS sites, the ABR measure is on average 44 percent lower than the DHS measure, after controlling for education and place of residence. Strong temporary migration of childless young women out of rural areas and different capacities in capturing temporarily absent women in the DHS and HDSS could explain this discrepancy. Further comparisons based on more strictly similar populations and measures seem warranted.
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19
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Lee JO, Jeong CH, Yuan C, Boden JM, Umaña-Taylor AJ, Noris M, Cederbaum JA. Externalizing Behavior Problems in Offspring of Teen Mothers: A Meta-Analysis. J Youth Adolesc 2020; 49:1146-1161. [PMID: 32285288 PMCID: PMC7242132 DOI: 10.1007/s10964-020-01232-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/20/2020] [Indexed: 11/26/2022]
Abstract
Young maternal age at birth has been consistently recognized as a factor contributing to externalizing behavior. However, estimates of the magnitude of this association across existing studies are inconsistent. Such inconsistencies cloud the interpretation of the literature and highlight the need for a systematic synthesis of existing empirical evidence. Further, the roles of possible moderators in the association remain to be revealed. Moderation analyses will enhance the field's capacity to evaluate needs and locate a subgroup of children born to teen mothers with particularly heightened vulnerabilities. To address these gaps, the present study had two primary aims. First, a meta-analysis was conducted to quantify the magnitude of the association between being born to young mothers and children's externalizing behavior across existing studies. Second, moderation meta-analyses were conducted to evaluate whether the influence of being born to teen mothers on children's externalizing behavior is stronger during specific developmental periods, for a specific gender, for a specific race, or across contexts with varying teen pregnancy rates at a societal level. The current study followed the PRISMA guidelines. The search utilized multiple electronic databases including Web of Science, ProQuest, PubMed, and Ovid MEDLINE through July 2019. Standardized mean difference, Cohen's d, was used as a summary estimate of effect size. A random-effects model was conducted. Moderating effects were evaluated. Twenty-one effect sizes from 18 independent samples (n = 133,585) were included in the meta-analysis. The main meta-analysis and sensitivity analysis suggested a small yet robust association between teenage motherhood and children's externalizing behavior problems. The relevant moderation analyses detected no statistically significant moderating effect for a specific gender, for racial and ethnic minority groups, during a specific developmental period, or across varying contexts. The current meta-analysis findings suggest that the impact of young maternal age on children's externalizing behavior is small, yet independent. Further, such impacts of young maternal age were similar for girls and boys, in different racial and ethnic groups, across developmental periods, and across different contexts with varying teen pregnancy rates. Prevention efforts seeking to curb the emergence of youth's externalizing behavior should focus on parenting teens, regardless of their child's gender, race, age, or contexts. Further, the current findings suggest that prevention strategies for this specific group may benefit from a hybrid approach that combines universal, selective, and indicated prevention strategies.
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Affiliation(s)
- Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
| | - Chung H Jeong
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Chaoyue Yuan
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Mireya Noris
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Julie A Cederbaum
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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20
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Teen childbearing and offspring internalizing symptoms: The mediating role of child maltreatment. Dev Psychopathol 2020; 33:1184-1196. [PMID: 32441239 DOI: 10.1017/s0954579420000413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Teenage childbearing (age 15-19 years) represents a significant public health issue that can generate considerable deleterious, multigenerational consequences for teen-childbearing mothers and their offspring. However, few studies have examined the potential mediating mechanisms that may explain if and how teen childbearing is associated with the development of offspring psychopathology. The current study used a developmental model to test the mediating role of chronic child maltreatment in the relationship between teen childbearing and offspring internalizing symptoms in childhood and emerging adulthood. The study participants were 384 individuals from socioeconomically disadvantaged, ethnically diverse backgrounds, assessed across two longitudinal waves of data (i.e., ages 10-12 and 18-20). The sample included maltreated and nonmaltreated children, all of whom were comparable in terms of family income. Structural equation modeling was conducted to test direct and indirect pathways from teen childbearing to offspring psychopathology. A multigenerational developmental cascade was found such that individuals born to mothers who began their childbearing in adolescence were more likely to experience chronic maltreatment during childhood, which in turn predicted greater internalizing symptoms throughout childhood and emerging adulthood. Using a developmental psychopathology framework, the results are discussed with regard to implications for prevention and early intervention.
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21
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Laurenzi CA, Gordon S, Abrahams N, du Toit S, Bradshaw M, Brand A, Melendez-Torres GJ, Tomlinson M, Ross DA, Servili C, Carvajal-Aguirre L, Lai J, Dua T, Fleischmann A, Skeen S. Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reprod Health 2020; 17:65. [PMID: 32410710 PMCID: PMC7227359 DOI: 10.1186/s12978-020-00913-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/24/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Pregnancy and parenthood are known to be high-risk times for mental health. However, less is known about the mental health of pregnant adolescents or adolescent parents. Despite the substantial literature on the risks associated with adolescent pregnancy, there is limited evidence on best practices for preventing poor mental health in this vulnerable group. This systematic review therefore aimed to identify whether psychosocial interventions can effectively promote positive mental health and prevent mental health conditions in pregnant and parenting adolescents. METHODS We used the standardized systematic review methodology based on the process outlined in the World Health Organization's Handbook for Guidelines Development. This review focused on randomized controlled trials of preventive psychosocial interventions to promote the mental health of pregnant and parenting adolescents, as compared to treatment as usual. We searched PubMed/Medline, PsycINFO, ERIC, EMBASE and ASSIA databases, as well as reference lists of relevant articles, grey literature, and consultation with experts in the field. GRADE was used to assess the quality of evidence. RESULTS We included 17 eligible studies (n = 3245 participants). Interventions had small to moderate, beneficial effects on positive mental health (SMD = 0.35, very low quality evidence), and moderate beneficial effects on school attendance (SMD = 0.64, high quality evidence). There was limited evidence for the effectiveness of psychosocial interventions on mental health disorders including depression and anxiety, substance use, risky sexual and reproductive health behaviors, adherence to antenatal and postnatal care, and parenting skills. There were no available data for outcomes on self-harm and suicide; aggressive, disruptive, and oppositional behaviors; or exposure to intimate partner violence. Only two studies included adolescent fathers. No studies were based in low- or middle-income countries. CONCLUSION Despite the encouraging findings in terms of effects on positive mental health and school attendance outcomes, there is a critical evidence gap related to the effectiveness of psychosocial interventions for improving mental health, preventing disorders, self-harm, and other risk behaviors among pregnant and parenting adolescents. There is an urgent need to adapt and design new psychosocial interventions that can be pilot-tested and scaled with pregnant adolescents and adolescent parents and their extended networks, particularly in low-income settings.
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Affiliation(s)
- Christina A Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa.
| | - Sarah Gordon
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | - Nina Abrahams
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | - Stefani du Toit
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | - Melissa Bradshaw
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | - Amanda Brand
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | | | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - David A Ross
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Liliana Carvajal-Aguirre
- Data and Analytics Section, Division of Data, Analysis, Planning and Monitoring, UNICEF Headquarters, New York, USA
| | - Joanna Lai
- Maternal, Newborn and Adolescent Health Unit, Health Section, UNICEF Headquarters, New York, USA
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Alexandra Fleischmann
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
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22
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Berg V, Lawson DW, Rotkirch A. Financial opportunity costs and deaths among close kin are independently associated with reproductive timing in a contemporary high-income society. Proc Biol Sci 2020; 287:20192478. [PMID: 31964300 DOI: 10.1098/rspb.2019.2478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Evolutionary demography predicts that variation in reproductive timing stems from socio-ecologically contingent trade-offs between current and future reproduction. In contemporary high-income societies, the costs and benefits of current reproduction are likely to vary by socioeconomic status (SES). Two influential hypotheses, focusing on the parenthood 'wage penalty', and responses to local mortality have separately been proposed to influence the timing of parenthood. Economic costs of reproduction (i.e. income loss) are hypothesized to delay fertility, especially among high childhood SES individuals who experience greater opportunities to build capital through advantageous education and career opportunities. On the other hand, relatively low childhood SES individuals experience higher mortality risk, which may favour earlier reproduction. Here, we examine both hypotheses with a representative register-based, multigenerational dataset from contemporary Finland (N = 47 678). Consistent with each hypothesis, the predicted financial cost of early parenthood was smaller, and mortality among close kin was higher for individuals with lower childhood SES. Within the same dataset, lower predicted adulthood income and more kin deaths were also independently associated with earlier parenthood. Our results provide a robust demonstration of how economic costs and mortality relate to reproductive timing. We discuss the implications of our findings for demographic theory and public policy.
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Affiliation(s)
- V Berg
- Population Research Institute, Väestöliitto, Helsinki 00101, Finland.,Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki 00014, Finland
| | - D W Lawson
- Department of Anthropology, University of California, Santa Barbara, CA 93106-3210, USA
| | - A Rotkirch
- Population Research Institute, Väestöliitto, Helsinki 00101, Finland
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23
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Salas-Wright CP, AbiNader MA, Vaughn MG, Sanchez M, De La Rosa M. Trends in participation in teen pregnancy and STI prevention programming, 2002-2016. Prev Med 2019; 126:105753. [PMID: 31220508 PMCID: PMC6697591 DOI: 10.1016/j.ypmed.2019.105753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/11/2019] [Accepted: 06/16/2019] [Indexed: 12/28/2022]
Abstract
Programs designed to help youth prevent early/unwanted pregnancy and sexually transmitted infection (STI) have been shown to yield a positive impact on youth behavior and key outcomes. However, recent evidence suggests that youth participation in prevention programming for health-risk behavior may be declining. The aim of the present study is to provide up-to-date information on the national trends in adolescent participation in prevention programming targeting early pregnancy and STI in the United States. We examined fifteen years of cross-sectional data (2002-2016, N = 234,803) from the National Survey on Drug Use and Health. Our main outcome was youth self-reported (no/yes) past-year participation in a pregnancy or STI prevention program. Survey adjusted prevalence estimates and logistic regression analysis were used to examine trends in participation. Youth participation in pregnancy and STI prevention programming decreased significantly from a high of 15% in 2003 to a low of 7% in 2016. Representing a 53% proportional decline in youth participation, this downward trend was significant even when controlling for age, gender, race/ethnicity, household income, and urbanicity (AOR: 0.947, 95% CI: 0.943-0.951). The downward trend in participation was observed across racial/ethnic subgroups. A consistent pattern of differences in prevalence was observed with African-American youth reporting the highest levels of participation followed by Hispanic, and then White youth. It is incumbent upon concerned citizens, scientists, and policymakers to push for change that can shift the trend line in adolescent participation in teen pregnancy and STI prevention programming to an upward tilt.
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Affiliation(s)
- Christopher P Salas-Wright
- School of Social Work, Boston University, Boston, MA, United States; Miller School of Medicine, University of Miami, Miami, FL, United States.
| | | | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States; Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Mariana Sanchez
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Mario De La Rosa
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
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24
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The Intergenerational Transmission of Early Childbearing: Examining Direct and Indirect Associations in a Swedish Birth Cohort. Behav Sci (Basel) 2019; 9:bs9050054. [PMID: 31100838 PMCID: PMC6562998 DOI: 10.3390/bs9050054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/29/2022] Open
Abstract
Background. Research shows that early childbearing is associated negatively with educational attainment and socioeconomic status (SES). Children born to young versus older mothers often do less well in school, and many have early first births. Some studies suggest that mothers’ early childbearing operates through SES to influence the daughters’ early childbearing, and some argue that the association is strong net of SES. The current study tests these direct and indirect associations. Methods. We estimate the pathways through which mothers’ early childbearing influences daughters’ early childbearing in several steps. First, we examine bivariate associations between mothers’ early childbearing and SES, followed by bivariate associations between mothers’ SES outcomes and their daughters’ early childbearing. We then estimate the average marginal effects (AMEs) of mothers’ early children on daughters’, and a KHB decomposition to examine direct and indirect associations. Results. Findings suggest both direct and indirect associations. Nested models show that, net of a range of SES characteristics, mothers’ early childbearing increases the probability of daughters’ by approximately 8%; and KHB results suggest 37% mediation, with daughters’ school performance (12%) and household educational attainment (10%) contributing the highest shares. Conclusion. Mothers’ early childbearing and subsequent SES collectively influence the long-term wellbeing of children. Thus, early childbearing has consequences both within and across generations.
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25
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Yoon Y, Cederbaum JA, Mennen FE, Traube DE, Chou CP, Lee JO. Linkage between teen mother's childhood adversity and externalizing behaviors in their children at age 11: Three aspects of parenting. CHILD ABUSE & NEGLECT 2019; 88:326-336. [PMID: 30554124 PMCID: PMC6661175 DOI: 10.1016/j.chiabu.2018.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Experiences of childhood adversity are consistently associated with compromised behavioral health later in life. Less clear is the intergenerational influence of maternal childhood adversity on developmental outcome in children. Completely unknown are the mechanisms linking teen mother's childhood adversity to child developmental outcomes. OBJECTIVE The present study tested whether aspects of parenting (parenting stress, physical discipline, and disagreement with grandparents) served as the pathways between teen mother's childhood adversity and the externalizing behaviors of their offspring at age 11, by gender. PARTICIPANTS AND SETTING Data were from a longitudinal panel study of teen mothers and their children, the Young Women and Child Development Study (N = 495; 57% male). METHODS The pathways from teen mother's childhood adversity to their offspring's externalizing behavior were tested by two subscales: rule-breaking behavior and aggressive behavior. In addition, multiple-group analysis was examined for potential gender differences. RESULTS Teen mother's childhood adversity was positively associated with greater use of parenting stress (β = 0.16, p < .01) and physical discipline (β=0.11, p < .05). In addition, parenting stress, physical discipline, and disagreement with grandparent were all associated with increased rule-breaking and aggressive behaviors in children. Multiple group analysis revealed that the path between physical discipline and externalizing behavior differed by gender, with the path only significant for girls. CONCLUSIONS These findings have implications for early intervention efforts that emphasize the need to intervene with children and parents, particularly helping teen mothers gain knowledge and skills to offset the impact of their experiences of childhood adversity on their parenting behaviors.
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Affiliation(s)
- Yoewon Yoon
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Children, Youth, and Families, Los Angeles, CA, 669 W. 34th Street, 90089, United States.
| | - Julie A Cederbaum
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Children, Youth, and Families, Los Angeles, CA, 669 W. 34th Street, 90089, United States
| | - Ferol E Mennen
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Children, Youth, and Families, Los Angeles, CA, 669 W. 34th Street, 90089, United States
| | - Dorian E Traube
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Children, Youth, and Families, Los Angeles, CA, 669 W. 34th Street, 90089, United States
| | - Chih-Ping Chou
- University of Southern California, Department of Preventive Medicine, 2001 N. Soto. Street, Los Angeles, CA, 90032, United States
| | - Jungeun Olivia Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Children, Youth, and Families, Los Angeles, CA, 669 W. 34th Street, 90089, United States
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26
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Smith C, Strohschein L, Crosnoe R. Family Histories and Teen Pregnancy in the United States and Canada. JOURNAL OF MARRIAGE AND THE FAMILY 2018; 80:1244-1258. [PMID: 30555182 PMCID: PMC6289283 DOI: 10.1111/jomf.12512] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 04/11/2018] [Indexed: 05/26/2023]
Abstract
OBJECTIVE This study took a long view of childhood experiences that can contribute to the risk of teen pregnancy in the U.S. and Canada, two countries with different norms and policies surrounding family life and inequality. BACKGROUND Teenage pregnancy is a major life experience arising from life course trajectories unfolding over a young woman's childhood. Cross-national comparisons can elucidate family-based pathways while embedding youth within broader national contexts of the U.S. and Canada, which are similar in some respects yet different in others. METHOD Longitudinal data from the U.S. NLSY79 Young Adult Survey (n = 3,122) and the Canadian NLSCY (n = 2,517) connected childhood histories to teenage pregnancy. Competing risk models estimated the risk of teenage pregnancy with family structure changes and episodes in poverty during childhood. RESULTS Teenage pregnancy, family change, and poverty were more common in the U.S. In the U.S., only multiple experiences of instability and poverty were associated with greater risk of teenage pregnancy, but, in Canada, any experience of childhood disadvantage was associated with elevated risk. CONCLUSION The risk of teen pregnancy was higher among both U.S. and Canadian adolescents from more unstable and economically insecure families, and that link between cumulative experiences of childhood disadvantage and adolescent pregnancy was stronger in Canada. IMPLICATIONS Policies and interventions to reduce teen pregnancy must address childhood socioeconomic disadvantage.
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Affiliation(s)
- Chelsea Smith
- University of Texas at Austin, Population Research Center, 305 E 23rd Street, Stop G1800, Austin, TX 78712
| | - Lisa Strohschein
- University of Alberta, Sociology, 5-21 Tory Building, Edmonton, AB, CAN T6J 2H4
| | - Robert Crosnoe
- University of Texas at Austin, Population Research Center, 305 E 23rd Street, Stop G1800, Austin, TX 78712
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Firk C, Konrad K, Herpertz-Dahlmann B, Scharke W, Dahmen B. Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity. Infant Behav Dev 2018; 50:238-246. [PMID: 29448186 DOI: 10.1016/j.infbeh.2018.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Adolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children's developmental outcome. OBJECTIVE Therefore, the aim of the current study was to investigate differences in children's cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers. METHODS Adolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months). RESULTS Children of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children's cognitive development. DISCUSSION The present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors.
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Affiliation(s)
- Christine Firk
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany.
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
| | - Wolfgang Scharke
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Germany
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Thern E, Carslake D, Davey Smith G, Tynelius P, Rasmussen F. The effect of increased alcohol availability on alcohol-related health problems up to the age of 42 among children exposed in utero: a natural experiment. Alcohol Alcohol 2018; 53:104-111. [PMID: 29053772 PMCID: PMC6019000 DOI: 10.1093/alcalc/agx069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/14/2017] [Accepted: 08/30/2017] [Indexed: 01/10/2023] Open
Abstract
AIM To examine whether exposure to increased alcohol availability in utero is associated with later alcohol-related health problems. METHOD Register-linked population-based longitudinal study using data from a natural experiment setting, including 363 286 children born 1965-71. An experimental alcohol policy change was piloted in two regions of Sweden in 1967-68, where access to strong beer increased for 16-20 year old. Children exposed in utero to the policy change were compared to children born elsewhere in Sweden (excluding a border area), and to children born before and after the policy change. The outcome was obtained from the National Hospital Discharge Register using the Swedish index of alcohol-related inpatient care. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox regression analysis. RESULTS The results suggest that children conceived by young mothers prior to the policy change but exposed to it in utero had a slightly increased risk of alcohol-related health problems later in life (HR 1.26, 95% CI 0.94-1.68). A tendency towards an inverse association was found among children conceived by older mothers (HR 0.88, 95% CI 0.74-1.06). CONCLUSION Results obtained from a natural experiment setting found no consistent evidence of long-term health consequences among children exposed in utero to an alcohol policy change. Some evidence however suggested an increased risk of alcohol-related health problems among the exposed children of young mothers.
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Affiliation(s)
- Emelie Thern
- Department of Public Health Sciences, Karolinska Institutet, Torsplan, Solnavägen 1E, Stockholm, Sweden
| | - David Carslake
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, Torsplan, Solnavägen 1E, Stockholm, Sweden
- Centre of Epidemiology and Community Council, Health Care Services, Torsplan, Solnavägen 1E, Stockholm, Sweden
| | - Finn Rasmussen
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Leonard NR, Casarjian B, Fletcher RR, Praia C, Sherpa D, Kelemen A, Rajan S, Salaam R, Cleland CM, Gwadz MV. Theoretically-Based Emotion Regulation Strategies Using a Mobile App and Wearable Sensor Among Homeless Adolescent Mothers: Acceptability and Feasibility Study. JMIR Pediatr Parent 2018; 1:e1. [PMID: 30637376 PMCID: PMC6326370 DOI: 10.2196/pediatrics.9037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many adolescent mothers are parenting young children under highly stressful conditions as they are managing first-time parenthood, poverty, lack of housing, school and work, and challenging peer and familial relationships. Mobile health (mHealth) technology has the potential to intervene at various points in the emotion regulation process of adolescent mothers to provide them support for more adaptive emotional and behavioral regulation in the course of their daily life. OBJECTIVE The goal of this study was to examine the acceptability, feasibility, use patterns, and mechanisms by which a mobile technology used as an adjunct to in-person, provider-delivered sessions fostered adolescent mothers' adaptive emotion regulation strategies under real-life conditions. METHODS Participants (N=49) were enrolled in the intervention condition of a larger pilot study of homeless adolescent mothers living in group-based shelters. The mHealth technology. Calm Mom, consisted of a mobile app and a wrist-worn sensorband for the ambulatory measurement and alerting of increased electrodermal activity (EDA), a physiological measurement of stress. We examined logs of mobile app activity and conducted semistructured qualitative interviews with a subsample (N=10) of participants. Qualitative data analysis was guided by the theoretical frames of the intervention and a technology acceptance model and included an analysis of emerging themes and concepts. RESULTS Overall, participants indicated that one or more of the elements of Calm Mom supported their ability to effectively regulate their emotions in the course of their daily life in ways that were consonant with the intervention's theoretical model. For many adolescent mothers, the app became an integral tool for managing stress. Due to technical challenges, fewer participants received sensorband alerts; however, those who received alerts reported high levels of acceptability as the technology helped them to identify their emotions and supported them in engaging in more adaptive behaviors during real-life stressful situations with their children, peers, and family members. CONCLUSIONS Calm Mom is a promising technology for providing theoretically driven behavioral intervention strategies during real-life stressful moments among a highly vulnerable population. Future research efforts will involve addressing technology challenges and refining tailoring algorithms for implementation in larger-scale studies.
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Affiliation(s)
- Noelle R Leonard
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States.,Teachers College, Columbia University, New York, NY, United States
| | | | | | | | - Dawa Sherpa
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States
| | - Anna Kelemen
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States.,Teachers College, Columbia University, New York, NY, United States
| | - Sonali Rajan
- Teachers College, Columbia University, New York, NY, United States
| | - Rasheeda Salaam
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States
| | - Charles M Cleland
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States
| | - Marya Viorst Gwadz
- Center for Drug Use and HIV Research, Rory Meyers College Of Nursing, New York University, New York, NY, United States
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Mirzamoradi M, Saleh M, Jamali M, Bakhtiyari M, Pooransari P, Saleh Gargari S. Factors related to unwanted pregnancies and abortion in the northern district of the city of Tehran, Iran. Women Health 2017; 58:714-728. [DOI: 10.1080/03630242.2017.1342738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Masoumeh Mirzamoradi
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Saleh
- Department of Gynecologys & Obstetric, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieyeh Jamali
- School of medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Bakhtiyari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parichehr Pooransari
- Department of Gynecology & Obstetric, Shohada Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran Iran
| | - Soraya Saleh Gargari
- Department of Gynecology & Obstetric, Shohada Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran Iran
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Lee JO, Gilchrist LD, Beadnell BA, Lohr MJ, Yuan C, Hartigan LA, Morrison DM. Assessing Variations in Developmental Outcomes Among Teenage Offspring of Teen Mothers: Maternal Life Course Correlates. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:550-565. [PMID: 28776838 DOI: 10.1111/jora.12293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study investigated potential heterogeneity in development among offspring (age 17) of teen mothers and maternal life course as correlates of variation. Using latent class analysis, subgroups of developmental outcomes were identified. Maternal standing in two life course realms (i.e., socioeconomic and domestic) was considered as a potential explanation for heterogeneity in offspring's development. Offspring reported on measures assessing their psychological, academic, and behavioral development. Teen mothers reported on measures of life course realms. Three subgroups of developmental outcomes were identified: on track (52%), at risk (37%), and troubled (11%). Findings suggest that economic hardship and number of pregnancies among teen mothers distinguish developmental patterns among teenage offspring, whereas teen mothers' educational attainment and marital status do not.
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Daniels S, Robson D, Flatley C, Kumar S. Demographic characteristics and pregnancy outcomes in adolescents - Experience from an Australian perinatal centre. Aust N Z J Obstet Gynaecol 2017. [PMID: 28635013 DOI: 10.1111/ajo.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Adolescent pregnancy is defined as pregnancy in girls aged 10-19 years and can be associated with increased risks. AIM To investigate obstetric and perinatal outcomes in a cohort of adolescent girls from a major Australian tertiary centre. MATERIALS AND METHODS This was a nine-year retrospective cohort study of women who birthed at the Mater Mother's Hospital (MMH) in Brisbane, Australia between 1 January 2007 and 31 December 2015. The adolescent cohort was aged <19 years and the control group was aged 20-24 years. RESULTS Over the study period the total study cohort comprised 8904 women. Of these, the adolescent cohort consisted of 1625 girls (18.2%) and the control group consisted of 7279 women (81.8%). Adolescents were more likely to be nulliparous, single, of Indigenous ethnicity or to have refugee status. They had higher rates of smoking, asthma, diabetes mellitus and thyroid disease. They were more likely to have an uncomplicated spontaneous vaginal delivery but were less likely to have an intact perineum and had higher rates of pre-term delivery and low birth weight babies. There were no differences in rates of postpartum haemorrhage. CONCLUSIONS Teenage pregnancy results in poorer obstetric and perinatal outcomes. A focus on optimising maternal health care and providing culturally appropriate antenatal and intrapartum care is imperative to improving outcomes.
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Affiliation(s)
- Samuel Daniels
- Mater Research Institute, University of Queensland, South Brisbane, QLD, Australia
| | - Danielle Robson
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Christopher Flatley
- Mater Research Institute, University of Queensland, South Brisbane, QLD, Australia
| | - Sailesh Kumar
- Mater Research Institute, University of Queensland, South Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Kagawa RMC, Deardorff J, Domínguez Esponda R, Craig D, Fernald LCH. The experience of adolescent motherhood: An exploratory mixed methods study. J Adv Nurs 2017; 73:2566-2576. [DOI: 10.1111/jan.13329] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Rose M. C. Kagawa
- Division of Community Health Sciences; School of Public Health; University of California; Berkeley CA USA
- Department of Emergency Medicine; University of California; Davis CA USA
| | - Julianna Deardorff
- Division of Community Health Sciences; School of Public Health; University of California; Berkeley CA USA
| | - Rosalinda Domínguez Esponda
- Center for Nutrition and Health Research; National Institute of Public Health; Cuernavaca Morelos Mexico
- Research Ethics Committee; National Institute of Public Health; Cuernavaca Morelos Mexico
| | - Darcy Craig
- Division of Community Health Sciences; School of Public Health; University of California; Berkeley CA USA
| | - Lia C. H. Fernald
- Division of Community Health Sciences; School of Public Health; University of California; Berkeley CA USA
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An umbrella review of meta-analyses of interventions to improve maternal outcomes for teen mothers. J Adolesc 2017; 59:97-111. [PMID: 28601024 DOI: 10.1016/j.adolescence.2017.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 01/12/2017] [Accepted: 05/29/2017] [Indexed: 01/08/2023]
Abstract
The purpose of this study was to perform an umbrella review of meta-analyses of intervention studies designed to improve outcomes of pregnant or parenting teenagers. An extensive search retrieved nine reports which provided 21 meta-analyses analyses. Data were extracted by two reviewers. Methodological quality was assessed using the AMSTAR Instrument. Most effect sizes were small but high quality studies showed significant outcomes for reduced low birth weight (RR = 0.60), repeat pregnancies/births (OR = 0.47-0.62), maternal education (OR = 1.21-1.83), and maternal employment (OR = 1.26). Several parenting outcomes (parent-child teaching interaction post-intervention [SMD = -0.91] and at follow-up [SMD = -1.07], and parent-child relationship post-intervention [SMD = -0.71] and at follow-up [SMD = -0.90]) were significant, but sample sizes were very small. Many reports did not include moderator analyses. Behavioral interventions offer limited resources and occur too late to mitigate the educational and social disparities that precede teen pregnancy. Future intervention research and policies that redress the social determinants of early childbearing are recommended.
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Machira K, Palamuleni ME. Health Care Factors Influencing Teen Mothers' Use Of Contraceptives in Malawi. Ghana Med J 2017; 51:88-93. [PMID: 28955105 PMCID: PMC5611910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. METHODS The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage. RESULTS The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers' use of modern contraceptives. CONCLUSION Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women's use of contraceptives in Malawi. Ameliorating these health encounters call for wide-range approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility. FUNDING None declared.
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Affiliation(s)
- Kennedy Machira
- Department Agriculture and Applied Economics, Lilongwe University of Agriculture and Natural Resources, P.O. Box 219, Lilongwe, Malawi
- Population Training and Research Unit, North West University - Mafikeng, Private Bag x2046, Mmabatho, 2735, South Africa
| | - Martin E Palamuleni
- Population Training and Research Unit, North West University - Mafikeng, Private Bag x2046, Mmabatho, 2735, South Africa
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Reddy J, Mistry J, Jacobs F. Rapid Repeat Birth: Intersections Between Meaning-Making and Situational Support Among Multiparous Adolescent Mothers. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743558416684956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined interpretations of motherhood among adolescents who have experienced rapid repeat births (second births within 24 months of the primiparous birth). Analyses of participants’ descriptions of their transitions to motherhood indicate four modal narratives that vary along two axes: the adoption of a motherhood identity, and the nature (or stability) of relational support available. By using subjective perceptions of motivation, stability, and feelings of competence, this study linked intrapersonal meaning-making with situational sources of support to describe various pathways through repeat adolescent childbearing in a way that both confirms and enriches extant literature. The implications of this study instruct home visiting programs and other interventions designed to forestall repeat pregnancies by elucidating pathways of reinforcement or increased risk inherent in some maternal trajectories. Following this logic, interventions directed at improving outcomes for young mothers and their children would do well to consider the interplay between internal meaning-making, relational support, and the transformative power of adopting the mother identity.
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van Vugt E, Loeber R, Pardini D. Why is young maternal age at first childbirth a risk factor for persistent delinquency in their male offspring? Examining the role of family and parenting factors. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2016; 26:322-335. [PMID: 25975414 DOI: 10.1002/cbm.1959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Children born to mothers who were younger than average at their first childbirth are at increased risk for future persistent delinquent behaviour, but explanations for this remain unclear. AIMS Our aim was to identify possible family and parenting variables that may help explain this relationship. We hypothesised that parental stress, large number of children in the home, low socioeconomic status (including neighbourhood problems) and poor parenting would account for the link between early first motherhood and their offspring's delinquency. METHODS Four hundred and sixty-two boys were selected from the Pittsburgh Youth Study, a longitudinal study of a random sample of school boys in Pittsburgh, initially assessed half-yearly and then annually from 7 to 19 years of age, using self-reporting and other reporting methods. Indirect effect models were used to test relationships between variables. RESULTS Higher levels of parental stress, poorer parent-child communication and caring for a larger number of children all mediated the relationship between maternal youth and persistent delinquency by their boys, but only explained about 20% of it. DISCUSSION At least partial explanations of the relationship between a mother's age at first childbirth and persistent delinquency in her male offspring suggest that future research should test whether early interventions with younger mothers to decrease their sense of stress in parenting and improve their capacity for communication with their child(ren) may help to prevent persistent delinquency in their boys. Programmes designed to help young women make more informed and planned decisions about their pregnancies should also be evaluated. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eveline van Vugt
- Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| | - Rolf Loeber
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Dustin Pardini
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Panova OV, Kulikov AM, Berchtold A, Suris JC. Factors Associated with Unwanted Pregnancy among Adolescents in Russia. J Pediatr Adolesc Gynecol 2016; 29:501-505. [PMID: 27108227 DOI: 10.1016/j.jpag.2016.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 03/31/2016] [Accepted: 04/05/2016] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVE To identify social and behavioral factors associated with unintended pregnancy among adolescents in Russia. DESIGN Cross-sectional. SETTING AND PARTICIPANTS The investigation group consisted of 145 adolescents aged 15-19 years admitted to a youth-friendly clinic for induced abortion. The control group consisted of 77 sexually active never pregnant adolescent girls of similar age admitted for other reasons. INTERVENTIONS Both groups completed a self-administered questionnaire about their occupation, educational level of their mother, family structure and socioeconomic status, relationship with their mother, sexual behavior, and substance use. MAIN OUTCOME MEASURES Factors associated with unintended pregnancy. RESULTS In the bivariate analysis pregnant adolescents tended to have a lower educational level, to live in a nonintact family, to prefer stronger alcohol drinks, and to have a younger age at sexual debut and more frequent sexual intercourse. In the log-linear model six factors appeared to be directly linked to pregnancy: mother's lower education, alcohol consumption, nonintact family structure, low academic grades, higher frequency of sexual intercourse, and lower age at sexual debut. CONCLUSION Although the issue of unwanted pregnancy and possible ways to prevent it should be kept in mind in the psychosocial assessment of any adolescent, the results of our study suggest that some adolescents are at increased risk of unwanted pregnancy. This group includes adolescent girls with low educational attainment, living in a disrupted family, and reporting other risk behaviors. These adolescents might specially benefit from specific preventive programs to reduce the number of adverse outcomes.
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Affiliation(s)
- O V Panova
- Department of Pediatrics and Child Cardiology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia.
| | - A M Kulikov
- Department of Pediatrics and Child Cardiology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
| | - A Berchtold
- Institute of Social Sciences & NCCR LIVES, University of Lausanne, Lausanne, Switzerland
| | - J C Suris
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
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Ben-David V, Jonson-Reid M, Bright C, Drake B. Family formation: A positive outcome for vulnerable young women? CHILDREN AND YOUTH SERVICES REVIEW 2016; 67:57-66. [PMID: 27840465 PMCID: PMC5100828 DOI: 10.1016/j.childyouth.2016.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
While marriage and childbirth are generally considered positive adult outcomes, it is not clear that this holds true among low income young women. Beyond adolescent parenting, little empirical data exists on various types of family formation in this population. The aims of this study were twofold: (1) to understand predictors of type of family formation (e.g., none, childrearing, marriage, or both) among 4,385 young women with childhood histories of poverty and/or maltreatment; and (2) to explore whether family formation patterns were associated with negative adult behavioral and health outcomes. Results of the AIM 1 multinomial regression analysis of family formation indicated that the likelihood of childrearing with or without marriage increased with an increase in the number of adolescent risk behaviors after controlling for the maltreatment and/or poverty histories. Among women with maltreatment histories, early onset maltreatment was associated with childrearing or marriage compared to no family. Among previously maltreated women, predictors of family formation varied according to prior poverty history. AIM 2 Cox regression results indicated that having children with or without marriage was associated with a higher risk of negative outcomes after controlling for maltreatment and adolescent risk factors. Bivariate analyses suggested that most of the increased risk was associated with having at least two children. Findings underscore the importance of preventing adolescent risk behaviors among low income and maltreated girls as well as early and unplanned births among vulnerable young adult women.
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Affiliation(s)
- Vered Ben-David
- Brown School of Social Work, Washington University in St. Louis,
Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Melissa Jonson-Reid
- Brown School of Social Work, Washington University in St. Louis,
Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Charlotte Bright
- School of Social Work, University of Maryland, 525 W. Redwood St.,
Baltimore, MD 21201
| | - Brett Drake
- Brown School of Social Work, Washington University in St. Louis,
Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
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Leppälahti S, Heikinheimo O, Kalliala I, Santalahti P, Gissler M. Is underage abortion associated with adverse outcomes in early adulthood? A longitudinal birth cohort study up to 25 years of age. Hum Reprod 2016; 31:2142-9. [PMID: 27402909 DOI: 10.1093/humrep/dew178] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/15/2016] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Is underage abortion associated with adverse socioeconomic and health outcomes in early adulthood when compared with underage delivery? SUMMARY ANSWER Underage abortion was not found to be associated with mental health problems in early adulthood, and socioeconomic outcomes were better among those who experienced abortion compared with those who gave birth. WHAT IS KNOWN ALREADY Teenage motherhood has been linked with numerous adverse outcomes in later life, including low educational levels and poor physical and mental health. Whether abortion at a young age predisposes to similar consequences is not clear. STUDY DESIGN, SIZE, DURATION This nationwide, retrospective cohort study from Finland, included all women born in 1987 (n = 29 041) and followed until 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS We analysed socioeconomic, psychiatric and risk-taking-related health outcomes up to 25 years of age after underage (<18 years) abortion (n = 1041, 3.6%) and after childbirth (n = 394, 1.4%). Before and after conception analyses within the study groups were performed to further examine the association between abortion and adverse health outcomes. A group with no pregnancies up to 20 years of age (n = 25 312, 88.0%) served as an external reference group. MAIN RESULTS AND THE ROLE OF CHANCE We found no significant differences between the underage abortion and the childbirth group regarding risks of psychiatric disorders (adjusted odds ratio 0.96 [0.67-1.40]) or suffering from intentional or unintentional poisoning by medications or drugs (1.06 [0.57-1.98]). Compared with those who gave birth, girls who underwent abortion were less likely to achieve only a low educational level (0.41 [95% confidence interval 0.31-0.54]) or to be welfare-dependent (0.31 [0.22-0.45]), but more likely to suffer from injuries (1.51 [1.09-2.10]). Compared with the external control group, both pregnancy groups were disadvantaged already prior to the pregnancy. Psychiatric disorders and risk-taking-related health outcomes, including injury, were increased in the abortion group and in the childbirth group similarly on both sides of the pregnancy. LIMITATIONS, REASONS FOR CAUTION The retrospective nature of the study remains a limitation. The identification of study subjects in order to collect additional data was not allowed for ethical reasons. Therefore further confounding factors, such as the intentionality of the pregnancy, could not be checked. WIDER IMPLICATIONS OF THE FINDINGS Previous studies have found that abortion is not harmful to mental health in the majority of adult women. Our study adds to the current understanding in suggesting that this is also the case concerning underage girls. Furthermore, women with a history of underage abortion had better socioeconomic outcomes compared with those who gave birth. These findings can be generalized to settings of high-quality social and health-care services, where abortion is accessible and affordable to all citizens. Social and health-care professionals who care for and counsel underage girls facing unplanned pregnancy should acknowledge this information. STUDY FUNDING/COMPETING INTERESTS This study was financially supported by the Finnish Cultural Foundation and the Päivikki and Sakari Sohlberg Foundation. The researchers are independent of funders and the funders had no role in the study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication. The authors have no competing interests.
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Affiliation(s)
- Suvi Leppälahti
- Department of Obstetrics and Gynaecology, University of Helsinki and Kätilöopisto Hospital, Helsinki University Central Hospital, P.O. Box 610, 00029-HUS Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynaecology, University of Helsinki and Kätilöopisto Hospital, Helsinki University Central Hospital, P.O. Box 610, 00029-HUS Helsinki, Finland
| | - Ilkka Kalliala
- Department of Obstetrics and Gynaecology, University of Helsinki and Kätilöopisto Hospital, Helsinki University Central Hospital, P.O. Box 610, 00029-HUS Helsinki, Finland Department of Surgery & Cancer, IRDB, Faculty of Medicine, Imperial College, London W12 0NN, UK
| | - Päivi Santalahti
- THL, National Institute for Health and Welfare, P.O. BOX 30, 00271 Helsinki, Finland
| | - Mika Gissler
- THL, National Institute for Health and Welfare, P.O. BOX 30, 00271 Helsinki, Finland Research Centre for Child Psychiatry, University of Turku, Turku, Finland Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Hipwell AE, Murray J, Xiong S, Stepp SD, Keenan KE. Effects of Adolescent Childbearing on Maternal Depression and Problem Behaviors: A Prospective, Population-Based Study Using Risk-Set Propensity Scores. PLoS One 2016; 11:e0155641. [PMID: 27176826 PMCID: PMC4866683 DOI: 10.1371/journal.pone.0155641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 05/02/2016] [Indexed: 01/22/2023] Open
Abstract
Adolescent mothers are reportedly at risk for depression and problem behaviors in the postpartum period, but studies have rarely considered developmental context and have yet to disentangle the effects of childbearing on adolescent functioning from selection effects that are associated with early pregnancy. The current study examined changes in adolescent depression, conduct problems and substance use (alcohol, tobacco and marijuana) across the peripartum period using risk-set propensity scores derived from a population-based, prospective study that began in childhood (the Pittsburgh Girls Study, PGS). Each of 147 childbearing adolescents (ages 12–19) was matched with two same-age, non-childbearing adolescents (n = 294) on pregnancy propensity using 15 time-varying risk variables derived from sociodemographic, psychopathology, substance use, family, peer and neighborhood domains assessed in the PGS wave prior to each pregnancy (T1). Postpartum depression and problem behaviors were assessed within the first 6 months following delivery (T2); data gathered from the non-childbearing adolescent controls spanned the same interval. Within the childbearing group, conduct problems and marijuana use reduced from T1 to T2, but depression severity and frequency of alcohol or tobacco use showed no change. When change was compared across the matched groups, conduct problems showed a greater reduction among childbearing adolescents. Relative to non-childbearing adolescents who reported more frequent substance use with time, childbearing adolescents reported no change in alcohol use and less frequent use of marijuana across the peripartum period. There were no group differences in patterns of change for depression severity and tobacco use. The results do not support the notion that adolescent childbearing represents a period of heightened risk for depression or problem behaviors.
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Affiliation(s)
- Alison E. Hipwell
- Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Joseph Murray
- Department of Psychiatry, University of Cambridge, Cambridgeshire, United Kingdom
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Shuangyan Xiong
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Stephanie D. Stepp
- Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Kate E. Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, United States of America
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Sadler LS, Novick G, Meadows-Oliver M. "Having a Baby Changes Everything" Reflective Functioning in Pregnant Adolescents. J Pediatr Nurs 2016; 31:e219-31. [PMID: 26796625 PMCID: PMC4862914 DOI: 10.1016/j.pedn.2015.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/13/2015] [Accepted: 11/15/2015] [Indexed: 01/12/2023]
Abstract
UNLABELLED Reflective functioning (RF), the capacity to envision thoughts, feelings, needs and intentions within the self and others, is thought to be central to sensitive parenting, yet this capacity has been unexamined among pregnant adolescents. We explored how RF was related to the emotional experience of adolescent pregnancy. DESIGN AND METHODS This qualitative study was guided by interpretive description. Participants were 30 Latina and African-American adolescents (mean age 17.7+1.5years) residing in a low-income urban community. All adolescents were interviewed with the Pregnancy Interview (a 22 question semi-structured interview) in their third trimester of pregnancy. Interview transcripts had been previously coded for levels of RF (1-9 with higher levels denoting higher reflectiveness), and this secondary analysis focused on the teens' experience of pregnancy and their emerging reflective capacities. We used a priori and inductive coding with all interviews and developed patterns and themes. RESULTS These interviews provided an in-depth understanding of the complex adolescent emotional experiences of pregnancy. We identified five themes that create a picture of how the participants reflected upon their pregnancies, unborn babies, emerging parental roles, and complicated relationships with family and partners. CONCLUSIONS AND PRACTICE IMPLICATIONS Adolescent developmental issues and harsh family and neighborhood environments permeated the teens' experience of pregnancy and limited capacity for RF. Understanding distinctive features of RF in pregnant adolescents may contribute to developing conceptual models and tailored clinical approaches for enhancing parental reflectiveness and sensitivity in these vulnerable young women as they enter into the transition to parenthood.
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Affiliation(s)
- Lois S. Sadler
- Yale University School of Nursing, Yale Child Study Center, Yale University West Campus, 400 West Campus Drive, Orange, CT 06477
| | - Gina Novick
- Yale University School of Nursing, Yale University West Campus, 400 West Campus Drive, Orange, CT 06477
| | - Mikki Meadows-Oliver
- Yale University School of Nursing, Yale University West Campus, 400 West Campus Drive, Orange, CT 06477
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Killoren SE, Zeiders KH, Updegraff KA, Umaña-Taylor AJ. The Sociocultural Context of Mexican-Origin Pregnant Adolescents' Attitudes Toward Teen Pregnancy and Links to Future Outcomes. J Youth Adolesc 2016; 45:887-99. [PMID: 26573862 PMCID: PMC4826852 DOI: 10.1007/s10964-015-0387-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers' lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents' cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents' pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes.
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Affiliation(s)
- Sarah E. Killoren
- Department of Human Development and Family Science, University of Missouri, 314 Gentry Hall, Columbia, MO 65211
| | - Katharine H. Zeiders
- Department of Human Development and Family Science, University of Missouri, 314 Gentry Hall, Columbia, MO 65211.
| | - Kimberly A. Updegraff
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701 Tempe, AZ 85287-3701,
| | - Adriana J. Umaña-Taylor
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701 Tempe, AZ 85287-3701, Umana-Taylor
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44
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Brännström L, Vinnerljung B, Hjern A. Child welfare clients have higher risks for teenage childbirths: which are the major confounders? Eur J Public Health 2016; 26:592-7. [PMID: 27085195 PMCID: PMC4946411 DOI: 10.1093/eurpub/ckw057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Aiming to support effective social intervention strategies targeting high-risk groups for teenage motherhood, this study examined to what extent the elevated crude risks of teenage childbirth among child welfare groups were attributable to the uneven distribution of adverse individual and family background factors. METHODS Comprehensive longitudinal register data for more than 700 000 Swedish females born 1973-1989 (including around 29 000 child welfare clients) were analysed by means of binary logistic regression. The Karlson/Holm/Breen-method was used to decompose each confounding factor's relative contribution to the difference between crude and adjusted odds ratios (ORs). RESULTS Elevated crude risks for teenage childbirth are to a large extent attributable to selection on observables. Girls' school failure was the most potent confounder, accounting for 28-35% of the difference between crude and adjusted ORs. CONCLUSION As in majority populations, girls' school failure was a strong risk factor for teenage childbirth among former child welfare children. At least among pre-adolescents, promoting school performance among children in the child welfare system seems to be a viable intervention path.
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Affiliation(s)
- Lars Brännström
- 1 Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Bo Vinnerljung
- 1 Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Anders Hjern
- 2 Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
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45
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Leppälahti S, Heikinheimo O, Paananen R, Santalahti P, Merikukka M, Gissler M. Determinants of underage induced abortion--the 1987 Finnish Birth Cohort study. Acta Obstet Gynecol Scand 2016; 95:572-9. [PMID: 26915819 DOI: 10.1111/aogs.12879] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/09/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Although underage pregnancies often end in induced abortion, data on girls who undergo termination of pregnancy are lacking. Our aim was to identify determinants of underage induced abortion and compare them with those of childbirth. MATERIAL AND METHODS All girls born in 1987 in Finland surviving the perinatal period (n = 29 041) were included in the study and divided into three study groups: Girls undergoing induced abortion (n = 1041, 3.6%) or childbirth (n = 395, 1.4%) at <18 years of age and girls with no underage pregnancies (n = 27 605, 95.0%). RESULTS Shared risk factors of underage induced abortion and childbirth included early onset behavioral and emotional disorders [adjusted OR 1.9 (1.4-2.5) and 2.7 (95% CI 1.8-3.9)], a history of foster care [1.5 [1.1-1.9] and 3.0 [2.3-4.1)], and socioeconomic factors, including living in a family receiving income support [1.8 (1.5-2.1) and 3.4 (2.7-4.4)], respectively. Specific risk factors of underage induced abortion were psychoactive substance use disorders [2.2 (1.3-3.5)], having a mother who smoked during pregnancy [1.5 (1.3-1.8)] or had undergone induced abortion [1.8 (1.5-2.2)]. Coping with a chronic physical illness [0.7 (0.5-0.9)], and perinatal problems [0.6 (0.4-0.7)] were inversely associated with underage induced abortion. CONCLUSIONS The traditionally acknowledged determinants of underage childbirth played a less prominent role in induced abortion. Novel risk factors of underage induced abortion were found, including severe substance abuse and adverse maternal reproductive history, and should be addressed at all levels offering youth healthcare and social welfare services.
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Affiliation(s)
- Suvi Leppälahti
- Department of Obstetrics and Gynecology, University of Helsinki and Kätilöopisto Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Kätilöopisto Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Reija Paananen
- THL, National Institute for Health and Welfare, Oulu, Finland
| | - Päivi Santalahti
- THL, National Institute for Health and Welfare, Helsinki, Finland
| | - Marko Merikukka
- THL, National Institute for Health and Welfare, Oulu, Finland
| | - Mika Gissler
- THL, National Institute for Health and Welfare, Helsinki, Finland
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46
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D'Onofrio BM, Class QA, Rickert ME, Sujan AC, Larsson H, Kuja-Halkola R, Sjölander A, Almqvist C, Lichtenstein P, Oberg AS. Translational Epidemiologic Approaches to Understanding the Consequences of Early-Life Exposures. Behav Genet 2015; 46:315-28. [PMID: 26590988 DOI: 10.1007/s10519-015-9769-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 10/25/2015] [Indexed: 12/23/2022]
Abstract
Prominent developmental theories posit a causal link between early-life exposures and later functioning. Yet, observed associations with early exposures may not reflect causal effects because of genetic and environmental confounding. The current manuscript describes how a systematic series of epidemiologic analyses that combine several genetically-informative designs and statistical approaches can help distinguish between competing theories. In particular, the manuscript details how combining the use of measured covariates with sibling-comparisons, cousin-comparisons, and additional designs can help elucidate the sources of covariation between early-life exposures and later outcomes, including the roles of (a) factors that are not shared in families, including a potential causal effect of the exposure; (b) carryover effects from the exposure of one child to the next; and (c) familial confounding. We also describe key assumptions and how they can be critically evaluated. Furthermore, we outline how subsequent analyses, including effect decomposition with respect to measured, plausible mediators, and quantitative genetic models can help further specify the underlying processes that account for the associations between early-life exposures and offspring outcomes.
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Affiliation(s)
- Brian M D'Onofrio
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St., Bloomington, IN, 47405, USA.
| | - Quetzal A Class
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St., Bloomington, IN, 47405, USA
| | - Martin E Rickert
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St., Bloomington, IN, 47405, USA
| | - Ayesha C Sujan
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St., Bloomington, IN, 47405, USA
| | | | | | | | | | | | - A Sara Oberg
- Karolinska Institutet, Stockholm, Sweden.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
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A Genetically Informed Study of the Associations Between Maternal Age at Childbearing and Adverse Perinatal Outcomes. Behav Genet 2015; 46:431-56. [PMID: 26404627 DOI: 10.1007/s10519-015-9748-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
Abstract
We examined associations of maternal age at childbearing (MAC) with gestational age and fetal growth (i.e., birth weight adjusting for gestational age), using two genetically informed designs (cousin and sibling comparisons) and data from two cohorts, a population-based Swedish sample and a nationally representative United States sample. We also conducted sensitivity analyses to test limitations of the designs. The findings were consistent across samples and suggested that, associations observed in the population between younger MAC and shorter gestational age were confounded by shared familial factors; however, associations of advanced MAC with shorter gestational age remained robust after accounting for shared familial factors. In contrast to the gestational age findings, neither early nor advanced MAC was associated with lower fetal growth after accounting for shared familial factors. Given certain assumptions, these findings provide support for a causal association between advanced MAC and shorter gestational age. The results also suggest that there are not causal associations between early MAC and shorter gestational age, between early MAC and lower fetal growth, and between advanced MAC and lower fetal growth.
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48
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Challinor EP. In dialogue with self and the world: Cape Verdean migrant pregnancy in Portugal. WOMENS STUDIES INTERNATIONAL FORUM 2015. [DOI: 10.1016/j.wsif.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health 2015; 56:223-30. [PMID: 25620306 PMCID: PMC4852976 DOI: 10.1016/j.jadohealth.2014.09.007] [Citation(s) in RCA: 443] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 08/26/2014] [Accepted: 09/04/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE To examine pregnancy rates and outcomes (births and abortions) among 15- to 19-year olds and 10- to 14-year olds in all countries for which recent information could be obtained and to examine trends since the mid-1990s. METHODS Information was obtained from countries' vital statistics reports and the United Nations Statistics Division for most countries in this study. Alternate sources of information were used if needed and available. We present estimates primarily for 2011 and compare them to estimates published for the mid-1990s. RESULTS Among the 21 countries with complete statistics, the pregnancy rate among 15- to 19-year olds was the highest in the United States (57 pregnancies per 1,000 females) and the lowest rate was in Switzerland (8). Rates were higher in some former Soviet countries with incomplete statistics; they were the highest in Mexico and Sub-Saharan African countries with available information. Among countries with reliable evidence, the highest rate among 10- to 14-year olds was in Hungary. The proportion of teen pregnancies that ended in abortion ranged from 17% in Slovakia to 69% in Sweden. The proportion of pregnancies that ended in live births tended to be higher in countries with high teen pregnancy rates (p = .02). The pregnancy rate has declined since the mid-1990s in the majority of the 16 countries where trends could be assessed. CONCLUSIONS Despite recent declines, teen pregnancy rates remain high in many countries. Research on the planning status of these pregnancies and on factors that determine how teens resolve their pregnancies could further inform programs and policies.
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50
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Chang Z, Lichtenstein P, D'Onofrio BM, Almqvist C, Kuja-Halkola R, Sjölander A, Larsson H. Maternal age at childbirth and risk for ADHD in offspring: a population-based cohort study. Int J Epidemiol 2014; 43:1815-24. [PMID: 25355726 DOI: 10.1093/ije/dyu204] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Women who give birth at younger ages (e.g. teenage mothers) are more likely to have children who exhibit behaviour problems, such as attention-deficit/hyperactivity disorder (ADHD). However, it is not clear whether young maternal age is causally associated with poor offspring outcomes or confounded by familial factors. METHODS The association between early maternal age at childbirth and offspring ADHD was studied using data from Swedish national registers. The sample included all children born in Sweden between 1988 and 2003 (N = 1 495 543), including 30 674 children with ADHD. We used sibling- and cousin-comparisons to control for unmeasured genetic and environmental confounding. Further, we used a children-of-siblings model to quantify the genetic and environmental contribution to the association between maternal age and offspring ADHD. RESULTS Maternal age at first birth (MAFB) was associated with offspring ADHD. Teenage childbirth (<20 years) was associated with 78% increased risk of ADHD. The association attenuated in cousin-comparison, suggesting unmeasured familial confounding. The children-of-siblings model indicated that the association between MAFB and ADHD was mainly explained by genetic confounding. CONCLUSIONS All children born to mothers who bore their first child early in their reproductive lives were at increased risk of ADHD. The association was mainly explained by genetic factors transmitted from mothers to their offspring that contribute to both age at childbirth and ADHD in offspring. Our results highlight the importance of using family-based designs to understand how early life circumstances affect child development.
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Affiliation(s)
- Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychiatry, University of Oxford, Oxford, UK, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA and Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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