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Ngonzi J, Birungi W, Byamukama O, Kamugisha A, Asiimwe J, Ntaro M, Nambozi G, Tibaijuka L, Tushabomwe-Kazooba C. Prevalence of and Factors Associated With Adverse Maternal Obstetrical Events Among Teenage Mothers Delivering in a Tertiary Referral Hospital in Southwestern Uganda. Cureus 2024; 16:e66168. [PMID: 39105202 PMCID: PMC11299131 DOI: 10.7759/cureus.66168] [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] [Accepted: 08/04/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Many female teenagers in low-resource settings conceive, of which half are unplanned and end in many deaths in sub-Saharan Africa, accounting for the majority of the cases. Teenage pregnancy is associated sometimes with poor maternal, newborn, and child deaths. OBJECTIVES The aim of the study was to determine the prevalence, maternal obstetric outcomes, and factors associated with poor maternal obstetric outcomes among teenage mothers delivering at Mbarara Regional Referral Hospital. METHODS This was a cross-sectional study carried out in a maternity ward at Mbarara Regional Referral Hospital, where 9,200 mothers deliver annually. All the women coming in for the delivery of their babies were consecutively approached for inclusion in the study. The women were enrolled in the post-delivery ward after delivery and interviewed with pretested questionnaires to capture the sociodemographic, obstetric, and medical profiles of the mothers. Factors were significant if the p-value was <0.05. Results: Out of the 327 participants, the majority were rural dwellers (68.5%), married (75.8%), attained primary education (69.4%), had not used contraception (89%), and had had a planned pregnancy (63.3%). The prevalence of adverse maternal obstetrical events was 59.9%. The HIV-positive rate was 4.9%, and about half of the participants had delivered by cesarean section (41.6%). The participants' mean age was 18.4 years and SD 1.1. The mean number of antenatal care contacts attended was 4.59 and SD 1.9. The adverse maternal outcomes included episiotomy (30.9%), perineal tear (18.7%), premature rupture of membranes (10.1%), placenta abruption (5.2%), and pre-eclampsia/eclampsia (4%). Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants by 97% (adjusted odds ratio (aOR) (95% CI) of 0.03 (0.02-0.06), p-value<0.001). Having a prior history of a miscarriage was significantly associated with the occurrence of adverse maternal obstetrical events among the participants (aOR (95% CI) of 6.55 (1.46-29.42), p-value0.014). CONCLUSIONS Slightly more than half of the teenage mothers had adverse maternal obstetrical outcomes, and a history of a miscarriage in previous pregnancies was significantly associated with adverse maternal obstetrical outcomes. Having a cesarean delivery was found to significantly reduce the occurrence of adverse maternal obstetric events among the participants. Teenage mothers are at a high risk of adverse maternal obstetrical outcomes, and close antepartum and intrapartum surveillance is recommended.
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Affiliation(s)
- Joseph Ngonzi
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Wilson Birungi
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Onesmus Byamukama
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Arnold Kamugisha
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
| | - Josephine Asiimwe
- Business Administration, Mbarara University of Science and Technology, Mbarara, UGA
| | - Moses Ntaro
- Community Health, Mbarara University of Science and Technology, Mbarara, UGA
| | - Grace Nambozi
- Nursing, Mbarara University of Science and Technology, Mbarara, UGA
| | - Leevan Tibaijuka
- Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA
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Chan PP, Lee VWY, Yam JCS, Brelén ME, Chu WK, Wan KH, Chen LJ, Tham CC, Pang CP. Flipped Classroom Case Learning vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1053-1061. [PMID: 37067959 DOI: 10.1097/acm.0000000000005238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE To address the problem of teaching noncore specialties, for which there is often limited teaching time and low student engagement, a flipped classroom case learning (FCCL) module was designed and implemented in a compulsory 5-day ophthalmology rotation for undergraduate medical students. The module consisted of a flipped classroom, online gamified clinical cases, and case-based learning. METHOD Final-year medical students in a 5-day ophthalmology rotation were randomized to the FCCL or a traditional lecture-based (TLB) module. The outcomes of subjective assessments (student-rated anonymous Likert scale questionnaire, scale 1 to 5, and course and teaching evaluation, scale 1 to 6) and objective assessments (end-of-rotation and post-MBChB multiple-choice questions, scale 0 to 60) were compared between the 2 groups. RESULTS Between May 2021 and June 2022, 216 students (108 in each group) completed the study. Compared with the TLB students, the students in the FCCL group rated various aspects of the course statistically significantly higher, including feeling more enthusiastic and engaged by the course and more encouraged to ask questions and participate in discussions (all P < .001). They also gave higher ratings for the instructional methods, course assignments, course outcomes, and course workload ( P < .001). They gave higher course and teaching evaluation scores to the tutors (5.7 ± 0.6 vs 5.0 ± 1.0, P < .001). The FCCL group scored higher than the TLB group on the end-of-rotation multiple-choice questions (53.6 ± 3.1 vs 51.8 ± 2.8, P < .001). When 32 FCCL students and 36 TLB students were reassessed approximately 20 weeks after the rotation, the FCCL group scored higher (40.3 ± 9.1) than the TLB group (34.3 ± 10.9, P = .018). CONCLUSIONS Applying the FCCL module in ophthalmology teaching enhanced medical students' satisfaction, examination performance, and knowledge retention. A similar model may be suitable for other specialties.
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Affiliation(s)
- Poemen P Chan
- P.P. Chan is assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian W Y Lee
- V.W.Y. Lee is associate professor, Centre for Learning Enhancement And Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C S Yam
- J.C.S. Yam is associate professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Marten E Brelén
- M.E. Brelén is associate professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Wai Kit Chu
- W.K. Chu is research assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelvin H Wan
- K.H. Wan was assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China, at the time of writing
| | - Li J Chen
- L.J. Chen is professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C Tham
- C.C. Tham is S.H. Ho Professor of Ophthalmology and Visual Sciences and chairman, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi P Pang
- C.P. Pang is S.H. Ho Research Professor of Visual Science, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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Riyanti, Salim LA, Heriteluna M, Legawati. Development of pregnancy class with husband's assistance on the outcome of teenage pregnancy. J Public Health Res 2023; 12:22799036231197195. [PMID: 37746517 PMCID: PMC10515537 DOI: 10.1177/22799036231197195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/30/2023] [Indexed: 09/26/2023] Open
Abstract
Background Teenage pregnancy is an international phenomenon without a definite solution to date. Globally, an estimated 16 million girls aged 15-19 give birth each year. Husbands need to play their assistance role in order to thwart the negative impact of the outcome of teenage pregnancy. Research objective To identify the effect of the development of Pregnancy Classes with the Husband's Assistance on the Outcome of Teenage Pregnancy in the Dayak community, Central Kalimantan. Research methods This was a quasi-experimental study with the posttest-only non-equivalent control group design involving the husband's assistance in pregnancy classes. The respondents were 60 individuals where 30 of them were given the pregnancy class assistance intervention while the other 30 were not given any intervention (control group). Results and discussion Pregnancy class with Assistance by the husband increases positive pregnancy outcomes 2.4 times compared to without the husband's assistance. Family support increases positive pregnancy outcomes 2.5 times compared to pregnant women without support from the family. Pregnant women that are highly motivated regarding antenatal care are likely to have positive pregnancy outcomes 5.4 times greater than pregnant women with low motivation. Based on the analysis, then the variables that have no effect are the history of antenatal care, frequency of antenatal care, and support from health workers. Conclusions Pregnancy class with husband's assistance affects positive outcomes of teenage pregnancy. Other factors with meaningful influence on pregnancy outcomes include family support and motivation to seek teenage antenatal care. Furthermore, other factors that have no influence include the teenager's age, history of antenatal care, frequency of antenatal care, and support from health workers. An intervention is needed that involves the husband/partner in the form of active assistance.
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Affiliation(s)
- Riyanti
- Faculty of Public Health, UNAIR, Surabaya, Jawa Timur, Indonesia
| | - Lutfi Agus Salim
- Department of Epidemiology, Population Biostatistics and Health Promotion, Faculty of Public Health, UNAIR, Surabaya, Jawa Timur, Indonesia
| | - Marselinus Heriteluna
- Diploma IV Program of Nursing, Politeknik Kesehatan Kemenkes Palangka Raya, Palangka Raya, Kalimantan Tengah, Indonesia
| | - Legawati
- Diploma III Program of Midwifery, Politeknik Kesehatan Kemenkes Palangka Raya, Palangka Raya, Center of Kalimantan, Indonesia
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Sobczak A, Taylor L, Solomon S, Ho J, Kemper S, Phillips B, Jacobson K, Castellano C, Ring A, Castellano B, Jacobs RJ. The Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review. Cureus 2023; 15:e39451. [PMID: 37378162 PMCID: PMC10292163 DOI: 10.7759/cureus.39451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
A source of support during birth could be the solution to negative outcomes for the mother and her baby. To improve the birthing experience and increase positive birthing outcomes, sources of support during pregnancy should be evaluated and understood. The goal of this review was to synthesize the existing literature on how doulas might improve birth outcomes. This scoping review also aimed to shed light on the positive impact emotional support during childbirth can have on the health and well-being of mother and child. PubMed and EBSCOhost were used to identify articles using the search words with Boolean operators "doulas" AND "labor support" AND "birth outcomes" AND "pregnancy" AND "effects during labor." The eligibility criteria for article selection included primary studies investigating how doulas contributed to birth outcomes. The studies in this review indicated that doula guidance in perinatal care was associated with positive delivery outcomes including reduced cesarean sections, premature deliveries, and length of labor. Moreover, the emotional support provided by doulas was seen to reduce anxiety and stress. Doula support, specifically in low-income women, was shown to improve breastfeeding success, with quicker lactogenesis and continued breastfeeding weeks after childbirth. Doulas can be a great resource for birthing mothers, and consideration should be given to using them more, as they may have a positive impact on the well-being of the mother and child. This study raised questions about the accessibility of doulas and how they may help mitigate health disparities among women from different socioeconomic levels.
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Affiliation(s)
- Alexandria Sobczak
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Lauren Taylor
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Sydney Solomon
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Jodi Ho
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Scotland Kemper
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Brandon Phillips
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Kailey Jacobson
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Courteney Castellano
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Ashley Ring
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Brianna Castellano
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Robin J Jacobs
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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De Silva DA, Gleason JL. Affordable Care Act (ACA) Implementation and Adolescent Births by Insurance Type: An Interrupted Time Series Analysis of Births between 2009 and 2017 in the United States. J Pediatr Adolesc Gynecol 2022; 35:685-691. [PMID: 35820607 DOI: 10.1016/j.jpag.2022.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/22/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND In 2010, the Affordable Care Act (ACA) was enacted, with full provisions in effect by 2014, including expanded Medicaid coverage, changes to the marketplace, and contraceptive coverage, but its impact on birth trends, particularly adolescent births, is currently unknown. OBJECTIVES We sought to determine whether ACA implementation was associated with changes in adolescent births and whether this differed by insurance type (Medicaid or private insurance). METHODS We used revised 2009-2017 birth certificate data, restricted to resident women with a Medicaid or privately paid singleton birth (N = 27,748,028). Segmented regression analysis was used to examine births to adolescent mothers (12-19 years old) before and after the ACA. RESULTS There were 27,748,028 singleton births (n = 2,013,521 adolescent births) among U.S. residents between 2009 and 2017 in this analytic sample. Adjusted models revealed that the ACA was associated with a 23% significant decrease in odds of an adolescent birth (OR = 0.78; 95% CI, 0.77-0.79) for Medicaid-funded births and a 19% decrease (OR = 0.81; 95% CI, 0.79-0.83) for privately insured births, with a further declining trend. Overall declines in adolescent births among the Medicaid population appear to be driven by states that chose to expand Medicaid. CONCLUSION Beyond the declining secular trend already observed in adolescent pregnancy over the last 10 years, the ACA appears to have had a substantial impact on adolescent births, likely due to Medicaid expansion and increased access to affordable contraception. From a population health perspective, efforts to undo the ACA could have important consequences for maternal, infant, and family health in the United States.
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Affiliation(s)
- Dane A De Silva
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States.
| | - Jessica L Gleason
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States
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Uzun Aksoy M, Şentürk Erenel A. Does Childbirth Preparation Education Affect Prenatal Adaptation? INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVETo determine the effect of childbirth preparation education on the prenatal adaptation of pregnant women.METHODSThis study design was a quasi-experimental; one-group pretest-posttest. This study was conducted with the participation of 42 pregnant women and their spouses. The educations were given in four sessions in a special area designed for childbirth preparation educations in a private hospital where the study was conducted. The data of the study were collected using the Pregnant Women Information Form and the Prenatal Self-Evaluation Questionnaire. Prenatal Self-Evaluation Questionnaire consists of seven subscales which are the well-being of pregnant women and their infants, acceptance of pregnancy, acceptance of motherhood, fear of childbirth, relationship with her mother and relationship with her spouse. The Wilcoxon signed rank test statistics were used to analyze the difference between the pretest and posttest PSEQ scores.RESULTSThe concerns about the well-being of pregnant women and their infants (p < .05), acceptance of pregnancy (p < .05), acceptance of motherhood (p < .05), fear of childbirth (p < .05), relationship with her mother (p < .05), relationship with her spouse (p < .05) subscale and total adaptation score (p < .05) were significantly higher before the education compared with the after the education. However, there was no significant difference between pre and post-education scores regarding readiness for birth subscale (p > .05).CONCLUSIONThis study showed that childbirth preparation education improves prenatal adaptation, acceptance of pregnancy and motherhood, relationship with her mother and relationship with her partner of pregnant women. In addition, it decreased fear of childbirth of pregnant women.
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Muluneh AG, Asratie MH, Gebremariam T, Adu A, Enyew MM, Cherkos EA, Melkamu S, Berta M, Mamo W, Kassahun D, Tsega NT, Kebede AA, Asmamaw DB, Kassa GM, Mihret MS. Lifetime adverse pregnancy outcomes and associated factors among antenatal care booked women in Central Gondar zone and Gondar city administration, Northwest Ethiopia. Front Public Health 2022; 10:966055. [PMID: 36033730 PMCID: PMC9399634 DOI: 10.3389/fpubh.2022.966055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background In developing countries, adverse pregnancy outcomes are major public health issues. It is one of the leading causes of neonatal morbidity and mortality worldwide. Despite the fact that ending prenatal mortality and morbidity is one of the third Sustainable Development Goals (SDG), the burden of the problem continues to be a huge concern in developing countries, including Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of lifetime adverse pregnancy outcomes among antenatal care (ANC) booked women in Northwest Ethiopia. Methods An institutional-based cross-sectional study design was conducted in Northwest Ethiopia, between March 2021 and June 2021. A multi-stage stratified random sampling technique was employed to recruit participants. An interviewer-administered and checklist questionnaire were used to collect the data. The data were entered into Epi-data version 4.6 software and exported to Stata version 16 for analysis. The binary logistic regression model was fitted to identify an association between associated factors and the outcome variable. Variables with a p-value of < 0.05 in the multivariable logistic regression model were declared as statistically significant. Results In this study, the lifetime prevalence of adverse pregnancy outcome among study participants was 14.53% (95%CI: 11.61, 18.04). Road access to the health facilities (AOR = 2.62; 95% CI: 1.14, 6.02) and husband-supported pregnancy (AOR = 2.63; 95 CI: 1.46, 4.72) were significantly associated with adverse pregnancy outcomes. Conclusions More than one in 10 reproductive age women had adverse pregnancy outcome throughout their life. Road access to health facilities and husband-supported pregnancy were statistically significant factors for adverse events in pregnancy. Therefore, it is better to give more attention to expanding infrastructure like road accessibility and increasing husband-supported pregnancy to reduce adverse pregnancy outcomes.
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Affiliation(s)
- Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfamichael Gebremariam
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aynalem Adu
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihretu Molla Enyew
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Endeshaw Admasu Cherkos
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Senetsehuf Melkamu
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Martha Berta
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Worku Mamo
- North Gondar Zonal Health Department, Carter Center Zonal Project Coordinator, Gondar, Ethiopia
| | - Dawit Kassahun
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nuhamin Tesfa Tsega
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,*Correspondence: Desale Bihonegn Asmamaw
| | - Getahun Molla Kassa
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Corsack C, Wallenborn JT, Harley KG, Eskenazi B. Parental Cohabitation and Breastfeeding Outcomes Among United States Adolescent Mothers. Breastfeed Med 2022; 17:72-78. [PMID: 34958231 DOI: 10.1089/bfm.2021.0090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AbstractBackground: Adolescent mothers in the United States experience disproportionately lower rates of breastfeeding compared to older mothers. Evidence suggests that paternal support helps improve breastfeeding outcomes; however, support is difficult to quantify. Parental cohabitation is easy to identify and could be used to quantify paternal support. Research Aim: Our study is to investigate the association between parental cohabitation and breastfeeding initiation and duration among US adolescent mothers. Materials and Methods: Data from the 2011-2017 National Survey of Family Growth were used. Our study sample included primipara, adolescent mothers (aged 15-19 years) who gave birth to a singleton (n = 1,867). Multivariate logistic regression and Cox Proportional Hazards models were used to analyze the relationship between cohabitation and breastfeeding initiation and duration, respectively. All models were subsequently stratified by race/ethnicity due to evidence of effect modification. Results: After adjusting for all a priori confounders, cohabiting with the infant's father at birth was associated with increased odds of breastfeeding initiation compared to noncohabiting adolescent mothers (odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.08-2.16). After stratifying by race/ethnicity, both Hispanic and non-Hispanic white adolescent mothers were more likely to initiate breastfeeding if cohabiting with the infant's father (ORHispanic: 1.9, 95% CI: 1.10-3.35; ORNon-Hispanic white: 1.7, 95% CI: 1.05-2.87). We found no evidence of an association between parental cohabitation and breastfeeding duration. Conclusions: Our study found evidence that cohabitation status at birth increases the odds of breastfeeding initiation in adolescent mothers. Practitioners should consider cohabitation status when working with adolescent mothers.
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Affiliation(s)
- Cheralynn Corsack
- Center of Excellence in Maternal, Child, and Adolescent Health, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Jordyn T Wallenborn
- Center of Excellence in Maternal, Child, and Adolescent Health, University of California Berkeley School of Public Health, Berkeley, California, USA.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,School of Medicine, Department of Epidemiology and Public Health, University of Basel, Basel, Switzerland
| | - Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, California, USA
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Amjad S, Adesunkanmi M, Twynstra J, Seabrook JA, Ospina MB. Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies. Semin Reprod Med 2021; 40:116-123. [PMID: 34500474 DOI: 10.1055/s-0041-1735847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.
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Affiliation(s)
- S Amjad
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - M Adesunkanmi
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - J Twynstra
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada
| | - J A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
| | - M B Ospina
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Killian-Farrell C, Rizo CF, Lombardi BM, Meltzer-Brody S, Bledsoe SE. Traumatic Experience, Polytraumatization, and Perinatal Depression in a Diverse Sample of Adolescent Mothers. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:6017-6040. [PMID: 29294877 DOI: 10.1177/0886260517726410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study examines the prevalence of trauma subtypes, polytraumatization, and perinatal depression (PND) in a diverse sample of adolescent mothers to help inform PND prevention, screening, and treatment efforts. We conducted a secondary analysis of a sample (N = 210) of adolescent mothers aged 14 to 20 years from a prospective longitudinal study of PND. Participants were recruited from a county-based, public health prenatal clinic, and data were collected in the prenatal and postpartum periods. In this sample, 81% of adolescent mothers reported at least one trauma experience and 75% reported lifetime experience of intimate partner violence (IPV). The most prevalent trauma types among adolescent mothers reporting PND were sexual trauma prior to age 13 (11.9%), loss of a caregiver or sibling (28.3%), emotional adversity (17.1%), and polytraumatization (43%). Trauma is alarmingly prevalent among adolescent mothers. Results suggest standards of care for adolescent mothers should include screening adolescent mothers for trauma history and provision of appropriate referrals for IPV. Findings support the need for trauma-informed treatment in perinatal public health clinics to decrease potential health risks to both mother and baby.
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Affiliation(s)
| | - Cynthia F Rizo
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | | | - Sarah E Bledsoe
- University of North Carolina at Chapel Hill, Chapel Hill, USA
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Paternal influences from early pregnancy to postpartum years on child development: A longitudinal study. J Affect Disord 2020; 275:23-30. [PMID: 32658819 DOI: 10.1016/j.jad.2020.06.018] [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: 12/18/2019] [Revised: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although an array of maternal and child-centered risks have been researched, considerably less is known about the effects of paternal influences on child's birth outcomes and early development. This longitudinal study thus examined the effects of paternal influences (parental stress, partner support, childcare and nursing, and father-child interaction) from early pregnancy to 2 years postpartum on pregnancy outcomes and toddlerhood development, with a simultaneous consideration of maternal depression. METHODS Pregnant women together with their partners were recruited from 2011 to 2016 at five selected hospitals in Taipei, Taiwan. In total, 440 families completed seven assessments from early pregnancy to 2 years postpartum. Self-reported data were analyzed using logistic regression and generalized estimating equation models. RESULTS The increment in parental stress from early to late pregnancy was independently and significantly associated with higher risks of low birthweight (adjusted odds ratio [aOR] = 5.3, 95% confidence interval [CI] = 1.0-27.7). In the postpartum years, paternal poorer childcare and nursing (aOR = 1.7, 95% CI = 1.0-3.0) and father-child interaction (aOR = 1.8, 95% CI = 1.2-2.9) were significantly associated with increased risks of child's suspected developmental delay up to 2 years postpartum, particularly among children of nondepressed mothers' children. LIMITATIONS Selecting both parents in metropolitan areas with higher socioeconomic status may compromise the generalizability of the study. CONCLUSIONS We suggested the essential role of longitudinal paternal influences from early pregnancy on birth outcomes and child's development during infancy and toddlerhood. Maternal depression remains critical to concern.
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SmithBattle L, Loman DG, Cibulka NJ. Family-Centered Primary Care for Teen Parents and Their Children. J Pediatr Health Care 2020; 34:204-211. [PMID: 31859135 DOI: 10.1016/j.pedhc.2019.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
Although the teen birth rate in the United States continues to decline, births remain disproportionately high among disadvantaged teens and teens of color. The vulnerabilities and resilience of teen parents are described from a historical context, with recommendations for advancing primary care of these families. We endorse comprehensive primary care and clinical practices that capitalize on the strengths and resilience of these families while recognizing the social inequities that compromise their health and development. To strengthen the bonds among young mothers, fathers, and children, we recommend family-centered primary care services that are of a youth- and father-friendly, nonstigmatizing, strength-based, and trauma-informed nature.
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Kendler KS, Ohlsson H, Sundquist J, Sundquist K. Maternal half-sibling families with discordant fathers: a contrastive design assessing cross-generational paternal genetic transmission of alcohol use disorder, drug abuse and major depression. Psychol Med 2020; 50:973-980. [PMID: 30992087 PMCID: PMC6800743 DOI: 10.1017/s0033291719000874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND We introduce and apply an elegant, contrastive genetic-epidemiological design - Maternal Half-Sibling Families with Discordant Fathers - to clarify cross-generational transmission of genetic risk to alcohol use disorder (AUD), drug abuse (DA) and major depression (MD). METHOD Using Swedish national registries, we identified 73 108 eligible pairs of reared together maternal half-siblings and selected those whose biological fathers were discordant for AUD, DA and MD, and had minimal contact with the affected father. We examined differences in outcome in half-siblings with an affected v. unaffected father. RESULTS For AUD, DA and MD, the HR (95% confidence intervals) for the offspring of affected v. unaffected fathers were, respectively, 1.72 (1.61; 1.84), 1.55 (1.41; 1.70) and 1.51 (1.40; 1.64). Paternal DA and AUD, but not MD, predicted risk in offspring for attention deficit hyperactivity disorder, conduct disorder, and poor educational performance and attainment. Offspring of affected v. unaffected fathers had poorer pregnancy outcomes, with the effect strongest for DA and weakest for MD. A range of potential biases and confounders were examined and were not found to alter these findings substantially. CONCLUSION Reared together maternal half-siblings differ in their paternal genetic endowment, sharing the same mother, family, school and community. They can help clarify the nature of paternal genetic effects and produce results consistent with other designs. Paternal genetic risk for DA and AUD have effects on offspring educational achievement, child and adult psychopathology, and possibly prenatal development. The impact of paternal genetic risk for MD is narrower in scope.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
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Zamani P, Ziaie T, Lakeh NM, Leili EK. The correlation between perceived social support and childbirth experience in pregnant women. Midwifery 2019; 75:146-151. [PMID: 31125906 DOI: 10.1016/j.midw.2019.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In recent years, the role of social support on different aspects of health especially pregnancy and childbirth has been emphasized. Social support facilitates individual access to necessary resources during stressful periods of life like pregnancy and childbirth. Present evidence of effects of social support on birth experience is inconsistent, Therefore, this study aimed to determine the correlation between perceived social support in pregnant women and their childbirth experience. DESIGN Analytic-cross sectional survey. SETTING Al-Zahra maternity hospital in Rasht, Iran. PARTICIPANTS 185 pregnant women who were in latent phase of labor entered the study and finally, 89.18% (n = 165) completed the study. MEASUREMENTS To measure perceived social support, the Multidimensional Scale of Perceived Social Support was used at latent phase of labor and to measure childbirth experience, the Childbirth Experience Questionnaire was used within 2 h after childbirth until the mother was discharged. RESULTS Mean score of perceived social support by significant others (4.18 ± 0.79) was higher than other dimensions of social support. Total mean score of childbirth experience was 58.13 ± 10.72 (score range: 22-88). Logistic regression results showed that support by significant others (P = 0.042, OR = 1.56), gestational age (P = 0.003, OR = 1.56) and mode of delivery (P = 0.004, OR = 0.33) are predictor variables of childbirth experience. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Perceived social support by significant others (spouse) during pregnancy has an important effect on woman`s childbirth experience. Therefore, providing training programs for family especially for spouse in order to increase maternal support during pregnancy is recommended, which can lead to a positive childbirth experience.
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Affiliation(s)
- Parisa Zamani
- Department of Midwifery, Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Tahereh Ziaie
- Department of Midwifery, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasrin Mokhtari Lakeh
- Department of Community Health Nursing, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad Leili
- Department of Biostatistics, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Tannis C, Sale-Shaw J, Lachapelle S, Garland E. Risk Factors and Birth Outcomes of a High-Risk Cohort of Women Served by a Community-Based Prenatal Home Visiting Program. J Community Health Nurs 2019; 36:1-10. [PMID: 30793959 DOI: 10.1080/07370016.2019.1555318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Our study explored risk factors and birth outcomes of a community maternal and child outreach program for high poverty mothers in East and Central Harlem. We conducted a retrospective chart review of 75 mother-infant dyads, with singleton pregnancies, receiving antepartum and postpartum home visits. Inexperienced parenting was associated with increased odds of giving birth to an infant weighing <2,700 g compared to experienced parenting after adjustment for race/ethnicity and preeclampsia diagnosis (odds ratio (OR) 4.9, p = 0.04). Mothers had comparatively lower depression risk in the postpartum period compared to antepartum (p = 0.006).
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Affiliation(s)
- Candace Tannis
- a Department of Environmental Medicine and Public Health , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Jean Sale-Shaw
- b Little Sisters of the Assumption Family Health Services , New York , NY , USA
| | - Susanne Lachapelle
- b Little Sisters of the Assumption Family Health Services , New York , NY , USA
| | - Elizabeth Garland
- a Department of Environmental Medicine and Public Health , Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Hispanic Immigrant Father Involvement with Young Children in the United States: A Comparison with US-Born Hispanic and White non-Hispanic Fathers. Matern Child Health J 2019; 22:1118-1126. [PMID: 29445979 DOI: 10.1007/s10995-018-2496-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Fathering is known to foster child development and health, yet evidence on Hispanic immigrant fathers' involvement with their young children is sparse. This study assessed disparities in pregnancy intendedness and father involvement with children ages 0-4 among Hispanic immigrant co-resident fathers versus two reference groups: US-born Hispanic and US-born White fathers. We hypothesized that differentials in involvement were associated with socioeconomic and cultural factors. Methods Using 2011-2013 data from the National Survey of Family Growth (N = 598), we performed bivariate, logistic and linear regression analyses to assess disparities in pregnancy intendedness and five father involvement outcomes (physical care, warmth, outings, reading and discipline). The models controlled for socio-economic, structural, health and cultural covariates. Results Pregnancy intendedness did not differ significantly between Hispanic immigrant fathers and the two reference groups. Compared with US-born Hispanics, unadjusted models showed that immigrant fathers were less likely to engage in physical care, warmth and reading, (p ≤ 0.05) though the differences were attenuated when controlling for covariates. Hispanic immigrant fathers were less likely than US-born White fathers to engage in each of the father involvement outcomes (p ≤ 0.05), with the disparity in reading to their child persisting even after controlling for all covariates. Conclusions for Practice We found marked socio-economic and cultural differences between Hispanic immigrant and US-born Hispanic and White fathers which contribute to disparities in father involvement with their young children. Hispanic immigrant status is an important determinant of involved fathering and should be taken into account when planning public health policies and programs.
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Amjad S, MacDonald I, Chambers T, Osornio-Vargas A, Chandra S, Voaklander D, Ospina MB. Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2019; 33:88-99. [PMID: 30516287 DOI: 10.1111/ppe.12529] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/24/2018] [Accepted: 10/31/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adverse outcomes in adolescent pregnancies have been attributed to both biological immaturity and social determinants of health (SDOH). The present systematic review evaluated the evidence on the association between SDOH and adverse maternal and birth outcomes in adolescent mothers. METHODS Comprehensive literature searches were conducted to identify observational studies evaluating the relationship between SDOH and adverse adolescent pregnancy outcomes. Study selection, risk of bias appraisal, and data extraction of study characteristics were independently performed by two reviewers. Pooled odds ratios (pOR) with 95% confidence intervals (95% CI) were calculated to assess the association between SDOH and adverse birth outcomes. RESULTS Thirty-one studies met the inclusion criteria. The most frequently evaluated SDOH was race while the most commonly reported maternal and birth outcomes were caesarean section and preterm birth (PTB), respectively. The risk of bias of included studies was fair on the Newcastle-Ottawa Scale. Meta-analyses of retrospective cohort studies showed that, compared to White adolescent mothers, African American teens had increased odds of PTB (pOR 1.67; 95% CI 1.59, 1.75) and low birthweight (pOR 1.53; 95% CI 1.45, 1.62). Rural residence was consistently linked with PTB while low maternal socio-economic (SES) and illiteracy were found to increase the risk of adolescent maternal mortality and LBW infants. CONCLUSION Social determinants of health contribute to the risk of adverse pregnancy outcomes in adolescent mothers. African American race, rural residence, inadequate education, and low SES are markers for poor pregnancy outcomes in adolescent mothers. Further research needs to be done to understand the underlying causal pathways to inequalities in adolescent pregnancy outcomes.
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Affiliation(s)
- Sana Amjad
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Isaiah MacDonald
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Thane Chambers
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | | | - Sujata Chandra
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Don Voaklander
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Maria B Ospina
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
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Maternal socioeconomic factors and the risk of premature birth and low birth weight in Cyprus: a case-control study. Reprod Health 2018; 15:157. [PMID: 30231873 PMCID: PMC6146509 DOI: 10.1186/s12978-018-0603-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/12/2018] [Indexed: 11/14/2022] Open
Abstract
Background Prematurity and low birth weight are significant predictors of perinatal morbidity and mortality and are influenced by the overall health and socioeconomic status of the pregnant mother. Although Cyprus is characterized by the highest prematurity rate in Europe (13.1% in 2014), the relationship between maternal health and socioeconomic characteristics with prematurity and low birth weight has never been investigated. We aimed to investigate the association of maternal demographic, clinical and socioeconomic characteristics with premature delivery and low neonatal birth weight in Cyprus. Methods In a case-control design, questionnaire data were collected from 348 women who gave birth prematurely (cases) and 349 women who gave birth at term (controls). Information was obtained on gestation duration and birth weight as well as maternal demographic, socioeconomic and clinical profiles, including parameters such as smoking, body mass index, alcohol consumption, presence of gestational diabetes and mental health factors. Results Premature delivery was associated with greater maternal age (OR: 1.12, 95% CI: 1.06–1.18), absence of gestational diabetes (OR: 0.53, 95% CI: 0.30–0.97), long working hours (OR: 3.77, 95% CI: 2.08–6.84) and emotional stress (OR: 8.5, 95% CI: 3.03–23.89). Within the cases group, emotional stress was also associated with lower birth-weight (β: -323.68 (95% CI: -570.36, − 77.00). Conclusions The findings of this study demonstrate the positive association of maternal psychological factors, working conditions as well as maternal age with prematurity and low birth weight in Cyprus. Additional, prospective, studies are needed in the country to further investigate these associations and inform public health intervention measures. Electronic supplementary material The online version of this article (10.1186/s12978-018-0603-7) contains supplementary material, which is available to authorized users.
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“Our lives aren't over”: A strengths-based perspective on stigma, discrimination, and coping among young parents. J Adolesc 2018; 66:91-100. [DOI: 10.1016/j.adolescence.2018.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 05/16/2018] [Accepted: 05/20/2018] [Indexed: 12/31/2022]
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Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru. PLoS One 2018; 13:e0192764. [PMID: 29649229 PMCID: PMC5896907 DOI: 10.1371/journal.pone.0192764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/25/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. Methods/Principal findings A cross-sectional study enrolling women aged 18–25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%–49.3%), and 17.4% (95%CI: 13.1%– 21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14–3.30) after controlling for confounders. Conclusions There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.
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Giurgescu C, Fahmy L, Slaughter-Acey J, Nowak A, Caldwell C, Misra DP. Can support from the father of the baby buffer the adverse effects of depressive symptoms on risk of preterm birth in Black families? AIMS Public Health 2018; 5:89-98. [PMID: 30083571 PMCID: PMC6070463 DOI: 10.3934/publichealth.2018.1.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/16/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND While maternal depressive symptoms during pregnancy have been linked to preterm birth (PTB; birth before 37 completed weeks of gestation), little has been reported on potential buffering factors, particularly specific to Black women who are at much higher risk. We examined the association between depressive symptoms and PTB in pregnant Black women, with father of the baby (FOB) support as a potential buffering factor. METHODS Data were obtained from the life-course influences on fetal environments study (2009-2011), a cohort of 1,410 Black women in metropolitan Detroit, Michigan (71% response rate) using maternal interviews and medical record abstraction collected during the postpartum hospitalization. The 20-item Center for Epidemiologic Studies Depression (CES-D) scale was used to measure depressive symptoms. The 14-item social networks in adult relations questionnaire was used to assess the mother's relationship with the FOB. Logistic regression was used to explore the interaction between CES-D and FOB support with regard to PTB risk. We adjusted for maternal advanced age, income, education level, smoking status, hypertension, prenatal care and BMI. RESULTS The PTB rate in this cohort was 17.7%. Among women with FOB scale < 60 (less support), the odd ratio (OR) of PTB for women with CES-D scores ≥ 23 (severe depressive symptoms) as compared to CES-D scores < 23 (no severe depressive symptoms) was 2.57 [95% confidence interval (CI): 1.68, 3.94; p < 0.001]. Among women with FOB scores ≥ 60 (more support), the odds of PTB in women with CES-D scores ≥ 23 did not significantly differ from the odds of PTB in women with CES-D scores < 23 (OR = 1.34; 95% CI: 0.74, 2.44; p = 0.3). After adjustment for covariates, among women with FOB scores < 60, the OR of PTB for women with CES-D scores ≥ 23 compared to < 23 was 2.79 (95% CI: 1.75, 4.45; p < 0.001). Among women with FOB scores ≥ 60, the odds of PTB in women with CES-D scores ≥ 23 was not statistically significantly different compared to the odds of PTB in women with CES-D scores < 23 (OR = 1.21; 95% CI: 0.62, 2.35; p = 0.6). The interaction term was statistically significant (p = 0.04). DISCUSSION/CONCLUSIONS The adverse effect of depressive symptoms on risk of PTB may be buffered by factors such as a supportive relationship with the FOB.
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Affiliation(s)
| | - Lara Fahmy
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, Detroit
| | | | | | - Cleopatra Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
| | - Dawn P Misra
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, Detroit
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Kim THM, Rotondi M, Connolly J, Tamim H. Characteristics of Social Support Among Teenage, Optimal Age, and Advanced Age Women in Canada: An Analysis of the National Longitudinal Survey of Children and Youth. Matern Child Health J 2018; 21:1417-1427. [PMID: 28102501 DOI: 10.1007/s10995-016-2249-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Social support is highly valued and beneficial for women, especially after childbirth. The objective was to examine the differences of social support reported among teen, optimal age, and advanced age women, and to identify the characteristics associated with social support separately for each age group. Methods This was a cross-sectional analysis of the National Longitudinal Survey of Children and Youth. Primiparous women with infants were grouped into: teen (15-19 years), optimal age (20-34 years), and advanced age (35 years and older). The outcome was social support (Social Provisions Scale), and demographic, socio-economic, health, community, and infant characteristics were considered for stepwise linear regression, separately for the groups. Results Total of 455,022 mothers was analyzed. Teens had the lowest social support (Mean = 17.56) compared to other groups (Means = 19.07 and 19.05; p < 0.001). Teens' volunteer involvement was associated with an increase in social support (Adjβ 2.77; 95%CI 0.86, 4.68), and depression was associated with a decrease (Adjβ -0.12; 95%CI -0.22, -0.02). Optimal age women's support significantly increased with maternal age (Adjβ 0.07; 95%CI 0.02,0.12), working status (Adjβ 0.60; 95%CI 0.13,1.07), and with chronic condition(s) (Adjβ 0.59; 95%CI 0.16,1.02), while it decreased with depression (Adjβ -0.05; 95%CI -0.10, -0.01) and ever-immigrants (Adjβ -1.67; 95%CI -2.29, -1.04). Use of childcare was associated with increased support among women in advanced age group (Adjβ 1.58; 95%CI 0.12, 3.04). For all groups, social support was significantly associated with neighbourhood safety. Conclusion The characteristics associated with social support varied among the three age groups. The findings may help promote awareness of the essential needs to increase support, especially for teens.
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Affiliation(s)
- Theresa H M Kim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada.
| | - Michael Rotondi
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada
| | - Jennifer Connolly
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada
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Yussif AS, Lassey A, Ganyaglo GYK, Kantelhardt EJ, Kielstein H. The long-term effects of adolescent pregnancies in a community in Northern Ghana on subsequent pregnancies and births of the young mothers. Reprod Health 2017; 14:178. [PMID: 29284506 PMCID: PMC5747083 DOI: 10.1186/s12978-017-0443-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
Abstract
Background In Ghana, adolescents represent 22% of the total population. The rates of adolescent pregnancies are high. Of all births registered in the country in 2014, 30% were by adolescents, and 14% of adolescents aged between 15 and 19 years had begun childbearing. Pregnancies and deliveries of adolescents are accompanied by more risks as compared to older women. The aim of the study was to explore the long-term effects of adolescent pregnancies on subsequent pregnancies and births and on the socioeconomic status of the women. Method A cross-sectional interviewer-performed survey of a purposive sample of 400 women in one community of Northern Ghana was conducted. Relationships between the age at first pregnancy and complications such as cesarean section, preterm or stillbirth and others were explored in 143 patients using the statistical program SPSS (Statistical Package for the Social Sciences). Result Results show that adolescent women (<19 years at their first pregnancy) have an 80% higher risk for a cesarean section for the first and subsequent births as compared to older women (≥ 19 years). Furthermore, younger mothers have a 45% higher risk of stillbirths and a 30% increased risk of losing their baby within the first 6 weeks after birth. There was no difference in the socioeconomic status between the two age groups. Conclusion Adolescent pregnancies are risk factors for the outcome of subsequent pregnancies of these mothers. This study, for the first time, shows that not only the first pregnancy and birth of very young women are negatively influenced by the early pregnancy but also subsequent pregnancies and births. While this study is of a purposive sample of women in one community, the clinical relevance of this study should not only be interesting for healthcare practitioners in Northern Ghana and other African regions but also for prevention campaigns in these regions.
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Affiliation(s)
- Anne-Sophie Yussif
- Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| | - Anyetei Lassey
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | | | - Eva J Kantelhardt
- Faculty of Medicine, Department of Gynecology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany.
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Jackson DB. The Interplay Between Early Father Involvement and Neonatal Medical Risk in the Prediction of Infant Neurodevelopment. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:106-115. [PMID: 27873045 DOI: 10.1007/s11121-016-0734-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The current study examines the association between early father involvement and infant neurodevelopment, and whether neonatal medical risk moderates this association. Data from approximately 6000 fathers and their children were obtained from the Early Childhood Longitudinal Study: Birth Cohort (ECLS-B). Hierarchical regression was employed to analyze the data. The findings reveal that the association between early father involvement and infant neurodevelopment is contingent on both the timing of involvement (i.e., prenatal/perinatal or infancy) and offspring medical status at birth. The neurodevelopment of medically at-risk neonates was enhanced when fathers were involved during the gestational period and at the time of their birth. This relationship was not detected, however, in the case of infants who did not experience medical risks as neonates. Neonatal medical risk appears to be an important moderating factor in the link between father involvement during pregnancy and childbirth and infant neurodevelopment. Practitioners should continue to make efforts to involve fathers during gestation and childbirth. The findings of the present study suggest that doing so may protect against neurodevelopmental delays in neonates with medical risks.
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Exploring the Concept of Degrees of Maternal Morbidity as a Tool for Surveillance of Maternal Health in Latin American and Caribbean Settings. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8271042. [PMID: 29201915 PMCID: PMC5671683 DOI: 10.1155/2017/8271042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 06/12/2017] [Accepted: 09/14/2017] [Indexed: 01/30/2023]
Abstract
Objectives To assess a birth registry to explore maternal mortality and morbidity and their association with other factors. Study Design Exploratory multicentre cross-sectional analysis with over 700 thousand childbirths from twelve Latin American and Caribbean countries between 2009 and 2012. The WHO criteria for maternal morbidity were employed to split women, following a gradient of severity of conditions, into (1) maternal death (MD); (2) maternal near miss (MNM); (3) potentially life-threatening conditions (PLTC); (4) less severe maternal morbidity (LSMM); (5) any maternal morbidity; and (6) women with no maternal morbidity. Their prevalence and estimated risks of adverse maternal outcomes were assessed. Results 712,081 childbirths had a prevalence of MD and MNM of 0.14% and 3.1%, respectively, while 38% of women had experienced morbidity. Previous maternal morbidity was associated with higher risk of adverse maternal outcomes and also the extremes of reproductive ages, nonwhite ethnicity, no stable partner, no prenatal care, smoking, drug and alcohol use, elective C-section, or induction of labour. Poorer perinatal outcomes were proportional to the severity of maternal outcomes. Conclusions The findings corroborate WHO concept regarding continuum of maternal morbidity, reinforcing its importance in preventing adverse maternal outcomes and improving maternal healthcare in different settings.
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Izadirad H, Niknami S, Zareban I, Hidarnia A. Effects of Social Support and Self-Efficacy on Maternal Prenatal Cares Among the First-Time Pregnant Women, Iranshahr, Iran. J Family Reprod Health 2017; 11:67-73. [PMID: 29282413 PMCID: PMC5742666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective: Social support and perceived self-efficacy affect health-related behaviors and play an important role on mothers' adaptability with pregnancy. This paper aims to study the impact of educational interventions based on social support and perceived self-efficacy on maternal prenatal care. Materials and methods: The present study is a before after experimental study in which 90 first-time pregnant women were randomly selected and divided into two 45- participants experimental and control groups. Data were collected from 21 January to 20 May 2016. Determining the validity and reliability of the questionnaire, we used the panel of experts and Cronbach's alpha. The data collected from the two groups were compared before and 3 months after intervention and were analyzed by SPSS 18. Results: Unlike the control subjects, there was a significant difference in maternal prenatal cares before and after an educational intervention between the scores of social support and perceived self-efficacy in the experimental group (p < 0.05). Before intervention, the average score of the experimental group was 12.62 ± 2.63 that rose to 17.71 ± 1.56, three months after the educational intervention, which is statistically significant (p < 0.05). There was a direct and positive relation between self-efficacy and maternal prenatal cares (p = 0.000, r = 0.538). Social support and self-efficacy predicted the variance of maternal cares by 69.2%. Conclusion: Developing an educational program based on social support and perceived self-efficacy on maternal prenatal cares is helpful and efficient. The health system, family and society are in charge of making facilities and opportunities to improve social support and perceived self-efficacy in pregnant women, resulting in improved maternal prenatal cares.
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Affiliation(s)
- Hossien Izadirad
- Department of Health Education and promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shamsoddin Niknami
- Department of Health Education and promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Iraj Zareban
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Hidarnia
- Department of Health Education and promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Anderson KG. Establishment of Legal Paternity for Children of Unmarried American Women : Trade-Offs in Male Commitment to Paternal Investment. HUMAN NATURE (HAWTHORNE, N.Y.) 2017; 28:168-200. [PMID: 28205120 PMCID: PMC5466473 DOI: 10.1007/s12110-017-9284-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The establishment of a legal father for children of unmarried parents reflects both high paternity confidence and male willingness to commit to paternal investment. Whether an unmarried man voluntarily acknowledges paternity after a child is born has important consequences for both the mother and child. This paper brings to bear a life history perspective on paternity establishment, noting that men face trade-offs between mating and parental effort and that women will adjust their investment in children based on expected male investment. I predict that paternity establishment will be more likely when the mother has high socioeconomic status, when maternal health is good, and when the child is male, low parity, or a singleton (versus multiple) birth. I further predict that establishment of paternity will be associated with increased maternal investment in offspring, resulting in healthier babies with higher birthweights who are more likely to be breastfed. These predictions are tested using data on 5.4 million births in the United States from 2009 through 2013. Overall the results are consistent with the hypothesis that the trade-offs men face between reproductive and parental investment influence whether men voluntarily acknowledge paternity when a child is born.
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Affiliation(s)
- Kermyt G Anderson
- Department of Anthropology, University of Oklahoma, 521 Dale Hall Tower, 455 West Lindsey, Norman, OK, 73131, USA.
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Jackson DB, Newsome J, Beaver KM. Does early paternal involvement predict offspring developmental diagnoses? Early Hum Dev 2016; 103:9-16. [PMID: 27434724 DOI: 10.1016/j.earlhumdev.2016.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND A long line of research has illustrated that fathers play an important role in the development of their children. Few studies, however, have examined the impact of paternal involvement at the earliest stages of life on developmental diagnoses in childhood. AIMS The present study extends this line of research by exploring the possibility that paternal involvement prenatally, postnatally, and at the time of birth may influence offspring risk for various diagnoses in childhood. STUDY DESIGN A quasi-experimental, propensity score matching design was used to create treatment and control groups to assess the relationship between paternal involvement at each stage of development and developmental diagnoses. SUBJECTS Approximately 6000 children, and a subsample of fathers, who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). OUTCOME MEASURES Activity, attention and learning, speech or language, and other diagnoses in early childhood, and overall number of diagnoses at 4years of age. RESULTS We find no consistent evidence that low paternal involvement prenatally or postnatally increases the risk of various developmental diagnoses by age 4. However, children whose fathers were absent at the time of their birth were at significantly greater risk of incurring various developmental diagnoses, as well as a significantly greater number of developmental diagnoses. CONCLUSIONS The findings expand our understanding of exactly how early paternal influence begins and the specific dimensions of early father behaviors that are related to the risk of various developmental diagnoses. Ultimately, these results have important implications concerning father involvement during the earliest stages of the life course.
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Affiliation(s)
| | - Jamie Newsome
- The University of Texas at San Antonio, United States
| | - Kevin M Beaver
- Florida State University, United States; King Abdulaziz University, Saudi Arabia
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Aziato L, Hindin MJ, Maya ET, Manu A, Amuasi SA, Lawerh RM, Ankomah A. Adolescents' Responses to an Unintended Pregnancy in Ghana: A Qualitative Study. J Pediatr Adolesc Gynecol 2016; 29:653-658. [PMID: 27346553 DOI: 10.1016/j.jpag.2016.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE To investigate the experiences and perceptions of adolescents who have experienced a recent pregnancy and undergone a termination of pregnancy. DESIGN A vignette-based focus group approach was used to have adolescents reflect on scenarios that happen to others during an unwanted pregnancy. SETTING The study was conducted in public health facilities in the 3 major urban areas of Ghana-Accra, Kumasi, and Tamale. PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES Adolescents, aged 10-19 years, who had a recent termination of pregnancy were recruited from public health facilities in the 3 sites. Fifteen focus groups were conducted and digitally recorded in English, Twi, Ga, and Dagbani. Transcripts were transcribed and translated, and thematic analysis was used for the analysis. RESULTS Adolescents reported that the characters in the vignettes would feel sadness, depression, and regret from an unintended pregnancy and some male partners would "deny" the pregnancy or suggest an abortion. They suggested some parents would "be angry" and "sack" their children for becoming pregnant while others would "support" them. Parents might send the pregnant girl to a distant friend or grandparents until she delivers to avoid shame and gossip. Health professionals might encourage the pregnant girl or insult/gossip about the girl. CONCLUSION Adolescent unintended pregnancies in Ghana are met with a range of reactions and these reactions influence the pregnancy choices young women make for continuation or termination of pregnancy.
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Affiliation(s)
- Lydia Aziato
- Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, Accra, Ghana.
| | - Michelle J Hindin
- World Health Organization, Department of Reproductive Health, Geneva, Switzerland
| | - Ernest Tei Maya
- Department of Population Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Abubakar Manu
- Department of Population Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Susan Ama Amuasi
- Department of Population Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Rachel Mahoe Lawerh
- Department of Organization and Human Resource Management, University of Ghana Business School, Accra, Ghana
| | - Augustine Ankomah
- Department of Population Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Is the Presence of the Father of the Baby during First Prenatal Ultrasound Study Visit Associated with Improved Pregnancy Outcomes in Adolescents and Young Adults? Int J Pediatr 2016; 2016:4632628. [PMID: 27795715 PMCID: PMC5067308 DOI: 10.1155/2016/4632628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/15/2016] [Indexed: 12/01/2022] Open
Abstract
This study examined whether the presence of the father of the baby (FOB) at the first prenatal ultrasound study (US) visit of pregnant adolescents and young adults (AYA) is a marker for improved pregnancy outcomes. Charts of 400 pregnant AYA aged 14–22 years seen at an academic maternity hospital were assessed retrospectively for support persons brought to prenatal US visits. Logistic regression analysis was used to examine the association between FOB presence and gestational age and birth weight. Of 400 charts with support person recorded, 298 charts with first US visit data, singleton birth, and complete gestational data available were analyzed. FOB was present at 30.2% of visits, while the parent of the mother was present at 34.2% of visits. With FOB present, 3.3% of infants were born preterm (gestational age < 37 weeks) compared with 10.5% of infants with FOB absent (p = 0.04). Patients with FOB present also had significantly earlier gestational age at the first US visit (15 weeks) than those who did not (19 weeks; p = 0.02). For AYA, the presence of FOB at initial prenatal US visits is a predictor of improved pregnancy outcome and likely represents increased support during the pregnancy.
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Does Neighborhood Risk Explain Racial Disparities in Low Birth Weight among Infants Born to Adolescent Mothers? J Pediatr Adolesc Gynecol 2016; 29:122-9. [PMID: 26307240 PMCID: PMC4762741 DOI: 10.1016/j.jpag.2015.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/28/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE To test associations and interactions between racial identification, neighborhood risk, and low birth weight disparities between infants born to African-American and white adolescent mothers. DESIGN Retrospective cross-sectional study. Birth cases were geocoded and linked to census tract information from the 2010 US Census and the 2007-2011 American Community Survey. A "neighborhood risk" index was created using principal component analysis, and mothers were grouped into 3 neighborhood risk levels (low, medium, high). Multilevel models with cross-level interactions were used to identify variation in racial differences in low birth weight outcomes across neighborhood risk levels when controlling for maternal demographic characteristics and pregnancy behaviors (smoking, prenatal care use). SETTING North Carolina, United States. PARTICIPANTS Singleton infants (n = 7923 cases) born to non-Hispanic African American and white adolescent mothers from the North Carolina State Center of Health Statistics for 2011. MAIN OUTCOME MEASURES Low birth weight. RESULTS African American mothers were significantly more likely to have infants of low birth weight than white mothers in this sample (odds ratio = 1.89; 95% confidence interval, 1.53-2.34). Mothers that resided in areas of high neighborhood risk were significantly more likely to have infants of low birth weight than mothers residing in areas of low neighborhood risk (odds ratio = 1.55; 95% confidence interval, 1.25-1.93). Even when controlling for confounding factors, racial disparities in low birth weight odds did not significantly vary according to neighborhood risk level. CONCLUSION Racial disparities can remain in low birth weight odds among infants born to adolescent mothers when controlling for maternal characteristics, pregnancy behaviors, and neighborhood risk.
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Pregnancy Intention and Post-partum Depressive Affect in Louisiana Pregnancy Risk Assessment Monitoring System. Matern Child Health J 2015; 20:1001-13. [DOI: 10.1007/s10995-015-1885-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sekharan VS, Kim THM, Oulman E, Tamim H. Prevalence and characteristics of intended adolescent pregnancy: an analysis of the Canadian maternity experiences survey. Reprod Health 2015; 12:101. [PMID: 26542103 PMCID: PMC4636060 DOI: 10.1186/s12978-015-0093-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/30/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There is limited research focusing on adolescent women who intended to become pregnant, as majority of research examines unintended adolescent pregnancies. The objective was to examine the prevalence and characteristics of Canadian adolescent women who intended to become pregnant. METHODS The analysis was based on the national 2006 Maternity Experiences Survey consisting of women who had a singleton live birth. The sample was restricted to adolescent women between 15 to 19 years of age. The main outcome of this study was the adolescent woman's pregnancy intention. A variety of sociodemographic, maternal, and pregnancy related factors were examined using a multivariable logistic regression. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) were reported for all variables. RESULTS The sample size was 290, weighted to represent 2224 adolescent women. Based on the adjusted model, the odds of experiencing an intended pregnancy were increased if the adolescent woman was between 18-19 years old (OR 2.62, 95 % CI 1.05, 6.57), had a partner (OR 2.37, 95 % CI 1.12, 4.99), experienced no violence/abuse (OR 3.08, 95 % CI 1.38, 6.86), and consumed no alcohol before pregnancy (OR 3.17, 95 % CI 1.56, 6.45). Additionally, adolescent women who reported drug use prior to pregnancy were more likely to have an intended pregnancy (OR 0.39, 95 % CI 0.16, 0.95). CONCLUSION The findings from this study can be used as the basis for future research to investigate the characteristics and needs represented by this group of adolescents and to aid in the development of effective policies and programs.
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Affiliation(s)
- Vineeth S Sekharan
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada, M3J 1P3.
| | - Theresa H M Kim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada, M3J 1P3.
| | - Elizaveta Oulman
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada, M3J 1P3.
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada, M3J 1P3.
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