Association of parental characteristics with adverse outcomes of adolescent pregnancy

Pooled prevalence and associated factors of teenage pregnancy among women aged 15 to 19 years in sub-Saharan Africa: evidence from 2019 to 2022 demographic and health survey data

BACKGROUND

Teenage pregnancy is becoming one of the most common social and public health problems worldwide, with the highest prevalence in sub-Saharan Africa. Health risks and adverse outcomes of pregnancy and childbirth among adolescent girls are the commonest cause of the global burden of maternal morbidity and mortality. This study is intended to determine the pooled prevalence and determinants of teenage pregnancy in sub-Saharan Africa using the most recent demographic and health survey data (2019-2022).

METHODS

A cross-sectional study was conducted using data from the most recent demographic and health surveys of four countries (Kenya, Tanzania, Gabon, and Cameroon) in sub-Saharan Africa conducted between 2019 and 2022. A total weighted sample of 12,829 teenagers aged 15 to 19 years was included in the study. Data extracted from demographic and health survey data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value ≤ 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.

RESULTS

The pooled prevalence of teenage pregnancy among women aged 15 to 19 years was 18.15% (95% CI: 17.49, 18.83). Teenage pregnancy was positively associated with the respondent's age [AOR = 2.97; 95% CI (2.55, 3.46)], educational status [AOR = 2.21; 95% CI (1.62, 3.03)] and [AOR = 1.80; 95% CI (1.54, 2.12)], wealth status [AOR = 2.61; 95% CI (2.12, 3.22)] and [AOR = 1.65; 95% CI (1.33, 2.05)], relation to the household head [AOR = 2.09; 95% CI (1.60, 2.72)], and unmet need for contraception [AOR = 14.3; 95% CI (11.5, 17.8)]. On the other hand, it was negatively associated with marital status [AOR = 0.08; 95% (0.07, 0.10)], working status [AOR = 0.75; 95% CI (0.64, 0.88)], age at first sex [AOR = 0.68; 95% CI (0.58, 0.80)], contraceptive use [AOR = 0.25; 95% CI (0.20, 0.30)], contraceptive knowledge [AOR = 0.27; 95% CI (0.19, 0.40)], and community contraceptive utilization [AOR = 0.85; 95% CI (0.73, 0.99)].

CONCLUSION

In the current study, one out of six young women aged 15 to 19 experienced teenage pregnancy. Therefore, addressing unmet needs for family planning, improving women's educational status, and giving special attention to teenagers with low educational and economic status are recommended.

The impact of maternal age on foetal growth patterns and newborn size

The association patterns between maternal age and foetal growth parameters as well as newborn size were analysed using a dataset of 4737 singleton term births taking place at the Viennese Danube hospital. Foetal growth patterns were reconstructed by the results of three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33thweek of gestation. In detail, crown-rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal transverse diameter, abdominal anterior-posterior diameter, abdominal circumference, and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. Young teenage mothers (≤15 years), older adolescent mothers (16-19 years), mothers of optimal age range (20-35 years) and mothers of advanced age (>35 years) differed significantly in body height, pre-pregnancy weight status and gestational weight gain. Surprisingly, the foetuses of young adolescent mothers were the largest ones during first trimester. During the second and third trimester however, the foetuses of mothers of optimal age range (20-35 years) and mothers older than 35 years showed larger biometric dimensions than adolescent mothers. According to multiple regression analyses, maternal age was significantly related to Foetal head size (ß =-0.04; 95% CI = -0,08 – 0.01; p=0.034) and abdominal dimensions (ß= 0.03; 95% CI = 0.01-0.05; p=0,011) during the second trimester and to birthweight (ß= -0.03; 95% CI= -4.40 – 0.04; p=0.050). The associations however, are quite weak and the statistical significance is maybe due to the large sample size. At the time of birth, offspring of mothers of optimal age range (20 to 35 years) is significantly larger than that of adolescent mothers and mothers of advanced age. Mothers of advanced age showed the significantly highest (p=<0.0001) prevalence (5.6%) of SGA newborns (<2500g). The small size of newborn among young adolescent mothers may be due to a competition over nutrients between the still growing mothers and the foetuses during the third trimester, while placental ageing may be responsible for smaller size of offspring among mothers of advanced age.

Characterizing Social Determinants of Health for Adolescent Mothers during the Prenatal and Postpartum Periods

PURPOSE

Significant racial disparities and continuing poor birth outcomes make adolescent pregnancy a significant public health concern in the United States despite declining pregnancy rates. Social determinants of health are associated with increased likelihood of pregnancy and poor maternal and child health outcomes. This study aims to characterize specific elements of social determinants of health in a cohort of predominantly Latina adolescent mothers.

METHODS

Between February 2007 and August 2008, 106 pregnant adolescents participated in a study with assessments at 20 to 24 weeks of gestation, and at 3 and 6 months postpartum. Survey questions addressed residential mobility, financial support and childcare, and perceived need for and use of community resources. Comparative analysis assessed differences between adolescents by age (<16 vs. ≥16 years old) and ethnicity (Latina vs. non-Latina).

FINDINGS

Adolescent mothers experienced high rates of residential mobility, with 59.4% moving at least once in the year before their prenatal survey. Participants relied primarily on public aid (94-96%) and their parents (81-85%) for financial support. Latina participants were more likely than non-Latinas to rely on public aid. Although many participants reported needing financial support and housing, few used available services. Younger adolescents relied less often on the father of the baby for support than older adolescents.

CONCLUSIONS

Adolescent mothers' high rates of residential mobility and increasing reliance on public assistance highlight resource gaps that potentially put them and their children at risk for poor outcomes. Targeted efforts to augment systemic support in these domains are a critical component of addressing health disparities for this population.

Prevalence and outcome of teenage hospital births at the Buea Health District, South West Region, Cameroon

BACKGROUND

Teenage pregnancy is a high-risk condition that requires skilled antenatal care for good outcome. World estimates in 2008 report about 16 million births to adolescent mothers, most of them occurring in low and middle-income countries. In Cameroon, about 12% of all births are to adolescent mothers. This study determines the prevalence of hospital teenage deliveries in the Buea Health District and compares the delivery outcomes and demographic characteristics between pregnant teenage mothers (14-19) and adult mothers (20-29 years). We also identify factors associated with adverse pregnancy outcomes.

METHODS

We undertook a retrospective study of case files of patients who gave birth in the Buea Regional Hospital during the period 2009-2012, to determine the prevalence of hospital-delivered teenage pregnancies in the BHR. We also undertook a, cross-sectional study to compare the outcomes of 148 singleton adolescent births with 360 adult births in three health facilities in the Buea Health District during the period March 1 to August 31, 2013.

RESULTS

The prevalence of teenage births was 13.3%. The adverse fetal outcomes imputable to adolescent births were low birth weight (<2,500 g) (OR, 2.79; 95% CI, 1.28-6.09), preterm babies (<37 weeks) (OR: 1.85; 95% CI, 1.01-3.41), low 5 min Apgar score < 7 (OR: 1.66; 95% CI, 0.91-3.0). Adverse maternal outcomes associated with teenage pregnancies were mainly perineal tear (OR, 1.6; 95% CI, 0.95-2.7). Teenage births were not discovered in any significant way to cause preeclampsia/eclampsia, episiotomy, premature rupture of membranes and caesarean section. Maternal factors like age and gravidity were discovered to lead to adverse fetal outcomes in adolescents, while maternal factors like age, unemployment, marital status and gravidity were, for their part, directly responsible for adverse maternal outcomes in adolescents.

CONCLUSION

Teenage pregnancies are quite prevalent in the Buea Health District, and hospital delivery common. Adolescent pregnancies are more likely to lead to adverse fetal and maternal outcomes than adult pregnancies.

Perinatal characteristics among early (10-14 years old) and late (15-19 years old) pregnant adolescents

BACKGROUND

Pregnancy in adolescents is a worldwide health problem and has been mostly common in poor populations. It is not clear if socioeconomic or biological factors are the main determinants of perinatal adverse outcomes in pregnant adolescents. Adolescents under 15 years old may present a high growth rate which may contribute to impair fetal growth. Our aim is to compare perinatal characteristics among early (aged 10 to 14 years) and late (aged 15 to 19 years) pregnant adolescents.

METHODS

A cross-sectional study was performed using data from Pernambuco State 2009, obtained from DATASUS/SISNAC, a Brazilian Government, open-access public health database. Maternal and neonatal outcomes were compared between early (aged 10-14 years) and late (aged 15-19 years) pregnant adolescents. Family income was compared between early and late pregnant adolescents using a sample of 412 subjects evaluated at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) during 2011. Statistical comparisons were made using the chi-square test was used with a significant level of 0.05; bivariate and multivariate analysis were performed. This project was approved by the Institutional Ethics Review Board.

RESULTS

Data from 31,209 pregnant adolescents were analyzed. 29,733 (95.2%) were aged 15 to 19 years and 1,476 (4.7%) were aged 10 to 14 years. There were significant differences with respect to marital status, education level and number of prenatal visits of mothers aged 10 to 14 years compared to 15 to 19 years. Of importance, early adolescents had a greater rate of neonates born premature and with low birth weight. Prematurity and low birth weight remained statistically significant after multivariate analysis.

CONCLUSIONS

Early aged adolescents may have an increased risk of prematurity and low birth weight. These findings highlight the potential role of biological factors in newborn outcomes in pregnant adolescents.

The association of season and temperature with adverse pregnancy outcome in two German states, a time-series analysis

Background

A seasonality of low birth weight (LBW) and preterm birth (PTB) has been described for most regions and there is evidence that this pattern is caused by ambient outdoor temperature. However, the association as such, the direction of effect and the critical time of exposure remain controversial.

Methods

Logistic, time-series regression was performed on nearly 300,000 births from two German states to study the association between season and daily mean temperature and changes in daily proportions of term LBW (tLBW) or PTB. Analyses were adjusted for time-varying factors. Temperature exposures were examined during different periods of pregnancy.

Results

Weak evidence for an association between season of conception, season of birth or ambient outdoor temperature and tLBW or PTB was found. Results of analyses of temperature were not consistent between the two states. Different sources of bias which would have artificially led to stronger findings were detected and are described.

Conclusions

No clear evidence for an association between season of conception, season of birth or temperature and tLBW or PTB was found. In the study of pregnancy outcome different sources of bias can be identified which can potentially explain heterogeneous findings of the past.

EFFECTS OF AGE, ETHNICITY AND HEALTH BEHAVIOURS ON THE PREVALENCE OF ADVERSE BIRTH OUTCOMES IN TAIWAN

This study sampled 8432 singleton first live births from Taiwan's 2005 Birth Registration Database to determine if there were more pre-term or low birth weight deliveries among aboriginal women than there were among Han Chinese women, and if the ‘weathering’ hypothesis applied to aboriginal women in Taiwan. Although the aboriginal women were socially disadvantaged and engaged in more unhealthy behaviours, including smoking, drinking, chewing betel quid and exposure to second-hand smoke, the evidence did not support the hypothesis that these teenaged minority women would have better birth outcomes, as has been demonstrated among teenage African-American women in the United States. Behaviours and not ethnicity were risk factors for teenage aboriginal mothers, who started deleterious health behaviours earlier than did their older counterparts. Teenage mothers had more adverse outcomes regardless of ethnicity and aboriginal mothers had more risky behaviours in all age groups. The prevalence of detrimental health behaviour among teenage mothers in Taiwan is of concern, particularly for aboriginal teenage mothers.

A score for assessing the risk of first-time adolescent pregnancy

BACKGROUND

Adolescent pregnancy is an important health issue. Prevention programs are usually aimed at the prevention of repeat pregnancy, ignoring the adolescents at risk of becoming pregnant for the first time.

OBJECTIVES

To analyse if socio-economic status, family type and mother's age at first pregnancy are risk factors for adolescent pregnancy and to design a risk score of first-time adolescent pregnancy.

METHODS

A case-control study was performed: cases were primiparous adolescents and controls were primiparous adult women. Participants were asked about their socio-economic status and family structure during adolescence and the age at which their mothers' first pregnancy occurred. Odds ratio (OR) and 95% confidence intervals were calculated. A first-time adolescent pregnancy risk score was designed based on a multiple logistic regression model.

RESULTS

Sixty-six adolescents and 140 adults were interviewed. Belonging to a family other than nuclear or extended types was an independent risk factor for adolescent pregnancy (OR 9.37, 95% CI 3.36-38.07). Low socio-economic status and having a mother with history of adolescent pregnancy were not independent risk factors (OR 1.04, 95% CI 0.34-5.11 and OR 1.13, 95% CI 0.42-4.32, respectively), achieving significance only when simultaneously present (OR 6.01, 95% CI 2.36-20.79). The presence of all these factors determined the highest adolescent pregnancy probability (OR 10.49, 95% CI 3.43-51.00). A first-time adolescent pregnancy risk assessment score was designed, with an estimated sensitivity of 75.8% and specificity of 75.0%.

CONCLUSIONS

Adolescent pregnancy is associated with unfavorable precedents that can be used to identify adolescents at increased risk of early pregnancy.

Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan

BACKGROUND

This study was conducted to evaluate the risks of adverse birth outcomes including low birthweight, preterm and small-for-gestational age among teen mothers.

METHODS

Data were collected from the Taiwan Birth Registry between 1985 and 1997. Among a total of 1,185,597 live births born to mothers aged 24 years or less, 151,259 (12.8%) were born to teen mothers aged 19 years or less. Crude odds ratios (ORs), adjusted ORs (AORs), their 95% confidence intervals and test for linear trend of maternal age-specific AOR were estimated using logistic regression analysis.

RESULTS

After controlling for certain birth characteristics and socio-economic factors, the age-specific analysis showed significantly gradient variations in increased risks of adverse birth outcomes among births of teen mothers, where the elevated risk was lessened in older teen mothers. Teen mothers aged 16 years or less were observed to experience particularly high AORs for all adverse birth outcomes of interest.

CONCLUSIONS

Not all teen mothers experienced the same magnitude of increased risk of adverse birth outcomes in Taiwan. Considering all teen mothers as the same group may have overlooked the particularly high risks of adverse birth outcomes among very young teen mothers (16 years or less), who are especially vulnerable to such elevated risks.

The effects of age and aboriginality on the incidence of low birth weight in mountain townships of Taiwan

BACKGROUND

This study aimed to examine the associations between aboriginality, age, demographic and socioeconomic factors of the mother and the risk of low birth weight (LBW) in mountain townships of Taiwan.

METHODS

We analyzed the LBW proportion of single live babies born to 2032 first-time mothers between 2004 and 2005. Data were analyzed using the chi-square test, analysis of variance, the Scheffe test and logistic regression.

RESULTS

About 14.8% of Aboriginal mothers and 18.7% of Aboriginal teen mothers gave birth to infants of LBW. Aboriginal mothers were found to be at higher risk of delivering LBW infants; however, after controlling for marital status and education, the influence of aboriginality and age was no longer significant.

CONCLUSIONS

Marital status and education are more important determinants of LBW than aboriginality and age in mountain townships of Taiwan.

Integral care for pregnant adolescents: impact on offspring

PURPOSE

To assess the impact of integral support on the health of children of adolescent mothers and their children.

METHODS

A prospective study involving 50 adolescent mothers, who had frequent meetings with a multi-professional group throughout pregnancy. After birth, medical followup was provided to mother and child.

RESULTS

Mean schooling proved higher than the national average. After follow-up, the rate of return to education was 24%. These adolescents had good social network support from both family and father of the child. They considered themselves good mothers and felt happier after maternity experience. Adolescents demonstrated a responsible sex life involving family planning and correct use of contraception, yielding extremely low levels of repeat pregnancy. Of the mothers, 48% were employed, working, earning a mean monthly salary of 150% minimum wage. The children of mothers followed by were breastfed longer and had greater vaccination cover than the average for São Paulo State.

CONCLUSIONS

The results suggest that our program promotes education of adolescents and their children; demonstrates the importance of a social support network through the family of the young mother and father of the child; fosters positive maternal social model addressing self-esteem and responsibility; informs mothers on contraception and encourages a responsible sex life, baby care, vaccination, and maternal breastfeeding.

A review on adolescent childbearing in Taiwan: its characteristics, outcomes and risks

In Taiwan, the age-specific fertility rate for adolescent girls aged 15-19 years has remained at 14-18/1,000 births during the past two decades, which is the highest among developed countries in Asia. There was a surprisingly high age-specific fertility rate for married women aged 15-19 years at 726 per 1,000 in 1994, much higher than that of the United States. Adolescent childbearing causes many adverse outcomes including unwanted and unstable marriage, repeated childbearing during adolescence, and increased risks of having low birth weight and preterm births and neonatal mortality. Studies in Taiwan showed that adolescent childbearing is associated with their poor knowledge but open attitude and behaviour on sexuality, the inadequate contraceptive services for the adolescents in need, some risk-taking behaviors, family dysfunction and low socioeconomic status of the adolescents' families. About two-thirds of the fathers of infants born to adolescent girls were adults, even old adults with a low education level Effective strategies for adolescent childbearing prevention range from sex education, the direct provision of contraceptive supplies, and to life options programmes, especially for the adolescents with high risk of adolescent pregnancy. Reducing the incidence of adolescent childbearing by active use of contraception is more important and practical than prohibiting adolescent sexual activity.

Outcome of teenage pregnancy

OBJECTIVE

The objective of the study was to evaluate the obstetric, fetal and neonatal outcomes of teenage pregnancy in a tertiary care teaching hospital.

METHODS

A retrospective case control study was performed over a period of 5 years. Data were retrieved from hospital records. All teenage mothers (aged 13-19 completed years at delivery) delivering in the University Hospital were taken as cases. Next 3 consecutive deliveries in the age group of 20-30 year were selected as controls for each case. For statistical analysis the cases were further subdivided into 2 groups, 17 years (Group A) and 18 -19 years (Group B). Groups were compared for obstetric complications and neonatal outcome. Statistical analysis was done by software package SPSS 10.

RESULTS

The incidence of teenage deliveries in hospital over last 5 years was 4.1%. Majority of the teenagers were primigravida (83.2% vs. 41.4%, p< 0.01). Complications like pregnancy induced hypertension (PIH) (11.4% vs 2.2%, p< 0.01), pre-eclamptic toxemia (PET) (4.3% vs 0.6%, p< 0.01) eclampsia (4.9% vs 0.6%, p< 0.01) and premature onset of labor (26.1% vs 14.6%, p< 0.01) occurred more commonly in teenagers compared to controls. Teenage mothers also had increased incidence of low birth weight (LBW) (50.4% vs 32.3%, p< 0.01), premature delivery (51.8% vs 17.5%, p< 0.01) and neonatal morbidities like perinatal asphyxia (11.7% vs 1.9%, p< 0.01), jaundice (5.7% vs 1.2%, p< 0.01) and respiratory distress syndrome (1.9% vs 0.3%, p< 0.05). Teenage pregnancy was also associated with higher fetal (1.9% vs 0.3%, p< 0.05) and neonatal mortality (3.8% vs 0.5%, p< 0.05).

CONCLUSION

Teenage pregnancy was associated with a significantly higher risk of PIH, PET, eclampsia, premature onset of labor, fetal deaths and premature delivery. Increased neonatal morbidity and mortality were also seen in babies delivered to teenage mothers. Younger teenager group (17 years) was most vulnerable to adverse obstetric and neonatal outcomes.

Preterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural Nepal

Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age <or= 25 years who gave birth to a singleton liveborn infant who was measured within 72 h of delivery were included (n = 1393). There was no difference in the risk of low birthweight (OR = 0.96; 95% CI = 0.90-1.02) or small for gestational age (OR = 1.01; 95% CI = 0.94-1.08) per year of increasing maternal age among primiparae. Young maternal age did not affect the anthropometry or gestational age of the offspring of parity 1 women. Each year of increasing maternal age among primiparae was associated with increases in birth length (0.07 cm; 95% CI = -0.01 to 0.16), head (0.05 cm; 95% CI = 0.01-0.09) and chest circumference (0.07 cm; 95% CI = 0.01-0.12), but not weight (9.0 g; 95% CI = -2.1 to 21.8) of their offspring. Young maternal age was associated with an increased risk of preterm delivery among primiparae (OR = 2.07; 95% CI = 1.26-3.38) that occurred at an age cut-off of <or=18 years relative to those 19-25 years. Thus, we conclude that young maternal age (<or=18 years) increased the risk of preterm delivery, but not intrauterine growth retardation, for the first but not second liveborn infant.

Health needs of adolescents in secondary gynaecological care: results of a questionnaire survey and a review of current issues

The objective of this study was to undertake a survey of all obstetrics and gynaecology units in the United Kingdom to identify current views and facilities for the management of adolescents with gynaecological problems. A postal questionnaire was sent to all 248 departments of obstetrics and gynaecology in the UK. The survey was carried out by the Royal College of Obstetricians and Gynaecologists on behalf of the Royal College of Paediatrics and Child Health Intercollegiate Working Group on Adolescent Health. In total, 137 replies were received, giving a response rate of 55%. Only eight centres were able to quote an exact figure for the number of adolescent attendees and this ranged from 0.0035% to 4.8% of new gynaecological referrals. The cut-off age for paediatric patients ranged from 12 to 18 years. In response to the question regarding the definition of 'adolescence', most units that responded stated the range 12-16 years (81 units) and a further 30 units stated 12-18 years. Despite these large variations and also the lack of certainty of both the age range of adolescents and local criteria, 64 units considered that adolescents in their area had special needs, mainly for family planning issues, teenage pregnancy and drug or alcohol abuse. Sixty-three units (46%) provided family planning clinics for adolescents, 24 (17.5%) had a teenage pregnancy clinic, 22 (16.1%) had an adolescent sexual health clinic and 11 (8%) had a clinic for intersex conditions and developmental disorders. In conclusion, there is no consensus on the age range of the adolescent population and a lack of data on the numbers of adolescents with different obstetric and gynaecological problems. There is a perceived need for better data collection and designated facilities for adolescents who have gynaecological problems. Currently, there are no national guidelines for the management and referral of specialized problems, which should be addressed as a matter of urgency.

Health risks and psychosocial outcomes of early childbearing: a review of the literature

This article presents a review of the literature on the obstetric, medical, and neonatal health risks as well as psychosocial outcomes associated with early childbearing. An important concern in adolescent pregnancies is the increased risk for infant morbidity and mortality as a result of higher incidence of preterm births and low-birthweight infants. Implications for prenatal and postpartum nursing care are discussed. Promising new models to improve care of young mothers and their children, such as home visitation by public health nurses, are presented and features of successful intervention programs outlined.

Family and adolescent childbearing

PURPOSE

To determine the risk factors for adolescent childbearing in Taiwan within the context of family.

METHODS

In this case-control study, the cases were 198 mothers aged < or =19 years with firstborn infants in Taichung City, Taiwan, in 1997. The controls were composed of nonchildbearing adolescents matched with the cases with respect to age and neighborhood for each case. A self-administered structured questionnaire asking about a variety of family factors was used to gather relevant information from the study subjects. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for variables associated with adolescent childbearing were obtained by multiple logistic regression analysis.

RESULTS

There were 162 cases and the same number of controls completing the questionnaire, for a response rate of 81.8%. Compared with the controls, childbearing adolescents were more likely to have all adverse sociodemographic and familial conditions. However, multiple logistic regression analysis showed that adolescents living outside the home (adjusted OR = 2.1, 95% CI 1.0-4.6), single-parent families (adjusted OR = 4.8, 95% CI 1.4-16.1), family dysfunction (adjusted OR = 1.8, 95% CI 1.1-3.1), mother's inadequate education (adjusted OR = 1.4, 95% CI 1.0-2.2), and mother's childbearing in adolescence (adjusted OR = 4.9, 95% CI 2.2-11.0) were the significant risk factors for adolescent childbearing.

CONCLUSIONS

Some familial factors contribute significantly to adolescent childbearing in Taiwan, as reported in other countries; these factors should be taken into consideration for further research and development of prevention programs.

Pregnancy in the adolescent patient. Screening, diagnosis, and initial management

Despite declines in adolescent pregnancy rates in the past decade, unplanned pregnancies among adolescents remain a significant problem in the United States. Clinicians caring for adolescents can be certain to encounter pregnancy in their patients. This article addresses surveillance and diagnosis for pregnancy in the adolescent, management, and referral of the newly-diagnosed pregnant adolescent, early pregnancy complications, common medical conditions affecting pregnancy in adolescents, and management of the postpartum and postabortal adolescent.

Demographic characteristics of fathers of infants born to adolescent mothers in Taiwan

It has been well accepted that effective programs for prevention of adolescent pregnancy should involve adolescent women and their partners. Using data from certificates of live births in Taichung County, Taiwan, in 1994, the demographic characteristics of fathers whose infants were born to adolescent women were compared with a matched group fathers whose infants were born to women aged > or =20 years. Most of the fathers of infants born to adolescent women were adults: 57% of the fathers of infants born to women aged < or =15 years were > or =30 years of age. Fathers of infants born to adolescent women had a lower educational level than that of matched fathers. These demographic characteristics of fathers should be carefully interpreted and taken into consideration in developing intervention programs.