The problems associated with adolescent pregnancy in Romania: A cross-sectional study

A qualitative study of the health information seeking behaviour of adolescent girls in Iran indicates that public libraries could help supply information required about puberty

INTRODUCTION

The present study aimed to identify the puberty related information seeking behaviour of adolescent female members of Zarrinshahr public libraries.

METHODOLOGY

Using a phenomenology approach, this study sought to identify the puberty related information seeking behaviours for a population of female adolescent public library patrons located in the Middle East. The data were collected via event based interviews and the samples were selected by purposeful sampling method. After converting the audio to text, the transcripts were imported into MAXQDA 10, they were coded and then, the relevant categories were extracted.

RESULTS

The information needs of girls experiencing puberty were identified and divided into four thematic categories: health issues, psychological issues, religious issues (religious precepts), and issues related to physical activity. Girls get this information from a variety of resources such as people, the Internet, social networks, documents, and libraries. The process of information seeking is so problematic for them because they are faced with content, family, social, and financial barriers and mainly lack Internet literacy and search skills.

CONCLUSION

Health information seeking constitutes the main part of adolescent girls' daily lives. Identification of adolescent girls' health information needs, the main channels of information seeking, and the barriers the girls face while information seeking can help public libraries adopt the right policies regarding the provision of health information services.

Risk factors associated with preterm birth in the Dominican Republic: a case-control study

OBJECTIVES

This study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic.

DESIGN

Case-control study.

SETTINGS

Seven National Reference Hospitals from different regions of the Dominican Republic.

PARTICIPANTS

A probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1 =0.5, P2 =0.6, and β=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports.

PRIMARY OUTCOME MEASURES

A protocol was created to obtain maternal and obstetric information.

RESULTS

The main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=-10.294, p<0.001).

CONCLUSION

Maternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.

Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population-Multicentric Comparative Study with Adult Population

Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

Investigating Caesarean Section Practice among Teenage Romanian Mothers Using Modified Robson Ten Group Classification System

The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different (p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.