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Cosquer M, Jousselme C, Falissard B, Lefebvre A. The experience of adolescence process among French teenager pregnancies: a mixed-methods study. Int J Qual Stud Health Well-being 2024; 19:2386715. [PMID: 39099139 DOI: 10.1080/17482631.2024.2386715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/27/2024] [Indexed: 08/06/2024] Open
Abstract
PURPOSE Teenage pregnancy remains a significant global public health concern worldwide. However, it presents a complex phenomenon in developed countries, carrying potential short- and long-term consequences for both mothers and children. METHODS This mixed method study used data from the French cross-sectional study "Portraits of adolescents", which included 6000 girls aged between 13 and 17 years. The quantitative approach involved comparisons between a subgroup with an history of pregnancy and their peers, examining their lived-experience and mental health. The qualitative approach investigated the question "What does being a teenager mean for you?" specifically for the girls who reported an history of pregnancy. RESULTS Teenage pregnancies presented elevated rates of mental health disorders, including dark thoughts, depression, self-harm, participating in dangerous games, attempting suicide and increased use of psychoactive substances. With limited support, in comparison to their peers. The qualitative approach revealed three major themes: "being in action", "a way of feeling", and "quality of relationship". CONCLUSION This vulnerable subgroup of adolescents suggests the need for a coordinated multidisciplinary healthcare approach, given their limited parental and friend support, with a high risk of experiencing poor mental health. Additionally, these findings portray a "silent sufferer" population characterized by difficulties recognizing or managing emotions due to difficulties in expressing their emotional distress.
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Affiliation(s)
- Mireille Cosquer
- CESP, U1018, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France
- Academic Department, Foundation Vallée Hospital, Gentilly, France
| | - Catherine Jousselme
- CESP, U1018, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France
- Academic Department, Foundation Vallée Hospital, Gentilly, France
| | - Bruno Falissard
- CESP, U1018, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France
- Academic Department, Foundation Vallée Hospital, Gentilly, France
| | - Aline Lefebvre
- Academic Department, Foundation Vallée Hospital, Gentilly, France
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR 3571 CNRS, University Paris Diderot, Paris, France
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Fernandes CM, Conceição GMDS, da Silva ZP, Nampo FK, Chiaravalloti F. Socioeconomic factors increase the risk of teenage pregnancy: spatial and temporal analysis in a Brazilian municipality. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240040. [PMID: 39082476 PMCID: PMC11290768 DOI: 10.1590/1980-549720240040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE To evaluate the distribution of the proportion of teenage mothers (PTM) in time and space and its relationship with socioeconomic indicators and social vulnerability. METHODS An ecological study was carried out with teenage mothers living in 322 census tracts in Foz do Iguaçu (state of Paraná, Brazil) between 2013 and 2019. Spatial clusters of teenage mothers were identified by spatial scanning and grouped into strata with different prevalence. The association between these strata and the individual social vulnerability of the mothers was evaluated using the Pearson's Chi-square test. Linear regression models were adjusted to evaluate the association between PTM and socioeconomic factors by census tract and temporal trend in PTM in different strata. RESULTS We identified five high prevalence clusters in peripheral regions and six with low prevalence in the central region of the municipality. Proportionally, there were more teenage mothers with a worse vulnerability index in the high prevalence stratum than in the low prevalence stratum. Places with worse socioeconomic conditions present higher PTM, a profile that did not change over time. For the increase of one unit in the Brazilian Deprivation Index and proportion of women responsible for the household, the PTM increased, respectively, by 3.8 (95%CI 3.1-4.4) and 0.086% (95%CI 0.03-0.14). There was a reduction in the global PTM in part of the period, which occurred later in the higher prevalence strata, but the proportions were stable again in the last years of study. CONCLUSION Teenage pregnancy is concentrated in regions with worse socioeconomic conditions and greater maternal vulnerability and its behavior over time occurred differently in these areas.
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Affiliation(s)
- Camila Meireles Fernandes
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
| | | | - Zilda Pereira da Silva
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
| | - Fernando Kenji Nampo
- Universidade Federal da Integração Latino-Americana, Latin American Institute of Life and Natural Sciences – Foz do Iguaçu (PR), Brazil
| | - Francisco Chiaravalloti
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
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Fontoura-Matias J, Chakhunashvili DG, Copley S, Dembiński Ł, Drosdzol-Cop A, Hadjipanayis A, Reali L, Mazur A. Teenage parents and their children-position paper of the European academy of paediatrics and the European confederation of primary care paediatricians. Front Pediatr 2024; 12:1418552. [PMID: 39119191 PMCID: PMC11306122 DOI: 10.3389/fped.2024.1418552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Teenage parenthood presents multifaceted implications, affecting adolescent parents, their children, and extended families. Despite a decrease in teenage pregnancy rates across Europe, the phenomenon continues to present significant challenges, impacting not only the adolescent parents but also their offspring and extended families. Methods A comprehensive literature review was conducted. Key factors influencing teenage pregnancies, including socioeconomic background, family structure, and access to sex education and contraception, were examined. This review was supplemented by expert opinions from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP). Results The triad of mother, father, and child presents individual distinct healthcare needs and vulnerabilities, highlighting the importance of specialized support and healthcare. This paper explores the psychological, social, and educational repercussions of teenage parenthood on both parents and their children, including higher risks of postpartum depression, school dropout, and repeat pregnancies. Furthermore, it underscores the critical role that paediatricians and primary care providers play in supporting these young families. Discussion The position paper advocates for comprehensive care for adolescent parents and their children. It recommends preventive measures such as proper sex education and access to contraception to reduce unplanned teenage pregnancies. Additionally, it emphasizes the need for specialized healthcare and support for teenage parents to address their unique challenges and improve outcomes for both parents and their children.
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Affiliation(s)
- José Fontoura-Matias
- Young European Academy of Paediatrics, Brussels, Belgium
- Department of Paediatrics, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Gynecology-Obstetrics and Paediatrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Davit George Chakhunashvili
- Young European Academy of Paediatrics, Brussels, Belgium
- I. Tsitsishvili Children’s New Clinic, Tbilisi, Georgia
| | - Sian Copley
- Young European Academy of Paediatrics, Brussels, Belgium
- Department of Paediatric Gastroenterology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
- European Academy of Pediatrics, Brussels, Belgium
| | - Agnieszka Drosdzol-Cop
- Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, Katowice, Poland
| | - Adamos Hadjipanayis
- European Academy of Pediatrics, Brussels, Belgium
- Medical School, European University Cyprus, Nicosia, Cyprus
| | - Laura Reali
- European Confederation of Primary Care Paediatricians, Lyon, France
| | - Artur Mazur
- European Academy of Pediatrics, Brussels, Belgium
- Medical Faculty, University of Rzeszów, Rzeszów, Poland
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Smith H, Wilson M, Donovan B, Jones J, Butler T, Nathan S, Simpson P. Factors associated with unintended pregnancy and contraceptive practices in justice-involved adolescent girls in Australia. PLoS One 2024; 19:e0304825. [PMID: 38889164 PMCID: PMC11185493 DOI: 10.1371/journal.pone.0304825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/17/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Despite a decline in unintended teenage pregnancy in Australia, rates remain higher amongst justice-involved adolescent girls, who are more likely to be from disadvantaged socio-economic backgrounds, have histories of abuse, substance use and/or mental health issues. Furthermore, exposure to the criminal justice system may alter access to education and employment and opportunities, potentially resulting in distinct risk-factor profiles. We examine factors associated with unintended pregnancy, non-contraceptive use and Long-Acting Reversible Contraception (LARC) in a sample of sexually active, justice-involved adolescent girls from Western Australia and Queensland. METHODS Data from the Mental Health, Sexual Health and Reproductive Health of Young People in Contact with the Criminal Justice System (MeH-JOSH) Study was analysed on 118 sexually active adolescent girls. Participants were aged between 14 and 17 years, purposefully sampled based on justice-system involvement and completed an anonymous telephone survey. We constructed two multivariate models taking reproductive outcomes as the dependent variables. RESULTS Over one quarter (26%, 30/118) reported a past unintended pregnancy, 54 did not use any contraception at their last sexual encounter, and 17 reported LARC use. Following adjustments in the multivariate analysis, lifetime ecstasy use was associated with both unintended pregnancy (aOR 3.795, p = 0.022) and non-contraception use (aOR 4.562, p = 0.004). A history of physical abuse was also associated with both any contraception (aOR 3.024, p = 0.041) and LARC use (aOR 4.892, p = 0.050). Identifying as Aboriginal & Torres Strait Islander, education/employment status and geographic location appeared to have no association. CONCLUSION Our findings suggest that justice-involved adolescent girls have distinct risk factors associated with unplanned pregnancy and contraception use compared to the general population, but more research is required to understand the mechanisms and contexts underlying these risk factors. How exposure to physical violence may encourage contraception and LARC use, in particular, warrants further attention as does the association with ecstasy use.
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Affiliation(s)
- Helene Smith
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Mandy Wilson
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Basil Donovan
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Jocelyn Jones
- National Drug & Research Institute, Curtin University, Perth, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Sally Nathan
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Paul Simpson
- School of Population Health, University of New South Wales, Sydney, Australia
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Gage AJ, Wood FE, Gay R, Akilimali P. Effects of the Momentum project on postpartum family planning norms and behaviors among married and unmarried adolescent and young first-time mothers in Kinshasa: A quasi-experimental study. PLoS One 2024; 19:e0300342. [PMID: 38547207 PMCID: PMC10977807 DOI: 10.1371/journal.pone.0300342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
This study evaluated the effect of Momentum-an integrated family planning, maternal and newborn health, and nutrition intervention-on postpartum family planning norms and behaviors among ever married and never-married first-time mothers age 15-24 in Kinshasa, Democratic Republic of the Congo. Using data collected in 2018 and 2020, we conducted an intent-to-treat analysis among 1,927 first-time mothers who were about six-months pregnant at enrollment. Difference-in-differences models were run for panel data and treatment effects models with inverse-probability weighting for endline-only outcomes. Average treatment effects (ATE) were estimated. Momentum had positive effects on partner discussion of family planning in the early postpartum period (ever married 15-19: ATE = 0.179, 95% CI = 0.098, 0.261; never married 15-19: ATE = 0.131, 95% CI = 0.029, 0.232; ever married 20-24: ATE = 0.233, 95% CI = 0.164, 0.302; never married 20-24: ATE = 0.241, 95% CI = 0.121, 0.362) and discussion with a health worker, and on obtaining a contraceptive method in the early postpartum period, except among never married adolescents. Among adolescents, intervention effects on modern contraceptive use within 12 months of childbirth/pregnancy loss were larger for the never married (ATE = 0.251, 95% CI = 0.122, 0.380) than the ever married (ATE = 0.114, 95% CI = 0.020, 0.208). Full intervention exposure had consistently larger effects on contraceptive behaviors than partial exposure, except among ever married adolescents. Momentum had no effect on normative expectations about postpartum family planning use among adolescents, and on descriptive norms and personal agency among those who were never married. Results for normative outcomes and personal agency underscored the intersectionality between young maternal age and marital status. Future programs should improve personal agency and foster normative change in support of postpartum family planning uptake and tailor interventions to different age and marital status subsets of first-time mothers.
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Affiliation(s)
- Anastasia J. Gage
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Los Angeles, United States of America
| | - Francine E. Wood
- Department of Medicine, Center on Gender Equity and Health, University of California, San Diego, La Jolla, California, United States of America
| | - Rianne Gay
- Tulane International, LLC, Kinshasa, Democratic Republic of the Congo
| | - Pierre Akilimali
- Department of Biostatistics and Epidemiology, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Abdul Rahim K, Egglestone NJ, Tsagareli IG, Usmani W, Meherali S, Lassi ZS. Mental health outcomes beyond the post-partum period among adolescent mothers: a systematic review and meta-analysis. Health Psychol Behav Med 2024; 12:2305741. [PMID: 38313449 PMCID: PMC10836488 DOI: 10.1080/21642850.2024.2305741] [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: 08/25/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
Background Adolescence is the most crucial part of life. The vulnerability of adolescent mothers is even more pronounced and can affect various health aspects. While they suffer from social and emotional stresses shortly after giving birth, the long-term effect after the post-partum period of adolescent pregnancy on the mental outcomes holds prime importance. Thus, this systematic review aims to ascertain the association between adolescent pregnancy on mental health outcomes. Methods The search strategy was run in June 2023 on databases including PubMed, CINAHL, Scopus, Psych Info, and Embase . Quality assessment of the studies was done using the National Institute of Health (NIH)'s National Heart, Lung and Blood Institute (NHLBI) tool for observational studies. For studies that measured similar outcomes, a meta-analysis was conducted. Findings The search strategy yielded 21 results from all databases and cross-referencing. Of these, all except for one (case-control) were cross-sectional and cohort studies. The pooled analysis found a significant association between adolescent pregnancy and depression (RR 1.34; 95% CI 1.05, 1.72, 6 studies, heterogeneity: Chi2 P 0.01; I2 = 60%); however, no association was found in anxiety (RR 1.05; 95% CI 0.26, 4.14, 2 studies; heterogeneity: Chi² P = 0.0003; I2 = 93%) and suicidal ideation (RR 3.21; 95% CI 0.17, 59.33; 3 studies; heterogeneity: Chi2 P < 0.00001; I2 = 98%). Implication These findings suggest that the mental health needs of adolescent mothers must be addressed and innovative and effective interventions that support and address the mental health needs of adolescent mothers are needed to improve their mental health.
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Affiliation(s)
- Komal Abdul Rahim
- Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan
- Dean’s Office, Medical College, Aga Khan University, Karachi, Pakistan
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | | | - Wania Usmani
- Public Health Information Development Unit, Torrens University Australia, Adelaide, Australia
| | | | - Zohra S. Lassi
- Adelaide Medical School, Robinsons Research Institute University of Adelaide, Adelaide, Australia
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, Australia
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Kathono J, Nyongesa V, Mwaniga S, Obonyo G, Yator O, Wambugu M, Banerjee J, Breuer E, Duffy M, Lai J, Levy M, Njuguna S, Kumar M. Adolescent perspectives on peripartum mental health prevention and promotion from Kenya: Findings from a design thinking approach. PLoS One 2024; 19:e0290868. [PMID: 38165879 PMCID: PMC10760697 DOI: 10.1371/journal.pone.0290868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/17/2023] [Indexed: 01/04/2024] Open
Abstract
In Kenya, approximately one in five girls aged 15-19 years old are pregnant or already a mother. Adolescent girls and young women experience significant mental health vulnerabilities during the pregnancy and postpartum periods, leading to poor antenatal and postnatal care attendance and inferior infant and maternal health outcomes. Pregnant adolescents often experience stigma and disenfranchisement due to their pregnancy status and at the same time lack access to mental health support within health settings, schools, religious institutions, and communities. This paper presents the results of qualitative interviews embedded within the human-centered design (HCD) process used to adapt the Helping Adolescents Thrive (HAT) program for Kenyan peripartum adolescents including young fathers. This qualitative study used two phases. First, a HAT advisory group participated in a series of four workshops to help identify and articulate mental health promotion needs and deepened the team's understanding of youth-centered thinking. Second, qualitative interviews were conducted with 39 pregnant and parenting adolescents to understand their perspectives on mental health prevention and promotion. Pregnant and parenting adolescents articulated different needs including poor support, stigma, and psychological disturbances. Parenting adolescents reported disturbed relationships, managing motherhood, poor health, and social empowerment. Participants highlighted sources of stress including economic challenges, fear of delivery, strained relationships, rejection, and stigma. Participants described psychological disturbances such as feeling stressed, worthless, withdrawn, and suicidal. Coping mechanisms reported by participants included engaging in domestic activities, hobbies, and social networking. Peers, family and spirituality were identified as important sources of support, as well as school integration, livelihoods, support groups and mentorships. Findings from this study can be used to strengthen and adapt HAT program, policy and practice for mental health prevention and promotion for pregnant and parenting adolescents.
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Affiliation(s)
| | | | | | | | - Obadia Yator
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | | | - Erica Breuer
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Malia Duffy
- St Ambrose University, Davenport, Iowa, United States of America
- Health Across Humanity, LLC, Boston, Massachusetts, United States of America
| | - Joanna Lai
- UNICEF Headquarters, New York, NY, United States of America
| | - Marcy Levy
- UNICEF Headquarters, New York, NY, United States of America
| | - Simon Njuguna
- Division of Mental Health, Ministry of Health, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, NY, United States of America
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Pokharel A, Philip S, Pokharel A, Acharya N, Dahal S, Ransing R. Perinatal depression among teenage mothers in a tertiary care teaching hospital of Nepal: A cross-sectional study. Asian J Psychiatr 2023; 90:103810. [PMID: 37913650 DOI: 10.1016/j.ajp.2023.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
The teenage pregnancy has serious adverse effect on physical and mental health of mothers and infants. This cross-sectional study was aimed to assess proportion of perinatal depression and well-being of teenage mothers in Nepal. Perinatal women were evaluated using Mental Health Continuum Short Form, and Edinburgh Postnatal Depression Scale. Of 239 perinatal women, 12 (5%) were teenage with a mean age of 18.17 ± 0.93 years. 33.3% (n = 4) of teenage mothers had depressive symptoms, and 25% (n = 3) had moderate/languishing mental health. A high proportion of depression and poor mental health suggests that screening and supportive care should be provided for teenage mothers.
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Affiliation(s)
- Arpana Pokharel
- Department of Psychiatry, Clinical Neurosciences, and Addiction Medicine, All India Institute of Medical Sciences, Guwahati 781101, India; Department of Psychiatry, Devdaha Medical College, 32907, Nepal
| | - Sharad Philip
- Department of Psychiatry, Clinical Neurosciences, and Addiction Medicine, All India Institute of Medical Sciences, Guwahati 781101, India
| | - Aruna Pokharel
- Department of Obstetrics and Gynecology, Devdaha Medical College, 32907, Nepal
| | - Nisha Acharya
- Medical Department, Rapti Academy of Health Sciences, Dang, Ghorahi 22400, Nepal
| | - Salina Dahal
- Medical Department, Rapti Academy of Health Sciences, Dang, Ghorahi 22400, Nepal
| | - Ramdas Ransing
- Department of Psychiatry, Clinical Neurosciences, and Addiction Medicine, All India Institute of Medical Sciences, Guwahati 781101, India; Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Thailand.
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O'Flaherty M, Kalucza S, Bon J. Does Anyone Suffer From Teenage Motherhood? Mental Health Effects of Teen Motherhood in Great Britain Are Small and Homogeneous. Demography 2023; 60:707-729. [PMID: 37226980 DOI: 10.1215/00703370-10788364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Teen mothers experience disadvantage across a wide range of outcomes. However, previous research is equivocal with respect to possible long-term mental health consequences of teen motherhood and has not adequately considered the possibility that effects on mental health may be heterogeneous. Drawing on data from the 1970 British Birth Cohort Study, this article applies a novel statistical machine-learning approach-Bayesian Additive Regression Trees-to estimate the effects of teen motherhood on mental health outcomes at ages 30, 34, and 42. We extend previous work by estimating not only sample-average effects but also individual-specific estimates. Our results show that sample-average mental health effects of teen motherhood are substantively small at all time points, apart from age 30 comparisons to women who first became mothers at age 25‒30. Moreover, we find that these effects are largely homogeneous for all women in the sample-indicating that there are no subgroups in the data who experience important detrimental mental health consequences. We conclude that there are likely no mental health benefits to policy and interventions that aim to prevent teen motherhood.
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Affiliation(s)
- Martin O'Flaherty
- Institute for Social Science Research and Australian Research Council Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia
| | - Sara Kalucza
- Department of Sociology and Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | - Joshua Bon
- School of Mathematical Sciences and Centre for Data Science, Queensland University of Technology, Brisbane, Australia
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Moisan C, Bélanger R, Calvin J, Shipaluk L, Fraser S, Morin V, Muckle G. Exploring ambivalence toward pregnancy among young Inuit women. CULTURE, HEALTH & SEXUALITY 2023; 25:94-109. [PMID: 35015967 DOI: 10.1080/13691058.2021.2022211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Ambivalence toward pregnancy is an important predictor of early pregnancy as documented in diverse Western societies. Inuit women from Nunavik, a northern region of Quebec, Canada, experience a high rate of early pregnancy, yet no study has explored their attitudes toward pregnancy. Grounded in a participatory approach, this study aimed to explore ambivalence toward pregnancy, among other pregnancy-related attitudes, and identify themes underlying ambivalence among young Inuit women from Nunavik. We conducted semi-structured interviews with 15 women aged 16 to 20 years, who became pregnant during the year preceding the interview. We used an inductive approach to analyse the data. Eleven participants were identified as ambivalent toward pregnancy while three were characterised as having a favourable attitude, and one as unfavourable. Four themes related to ambivalence were identified: the value of childbearing/motherhood; the use of contraceptives; the likelihood of becoming pregnant; and the ideal age to become pregnant. A better understanding of young women's attitudes toward pregnancy could contribute to the development of culturally relevant programmes to more effectively support adolescents, pregnant adolescents and young mothers, and to lead to better care.
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Affiliation(s)
- Caroline Moisan
- Population Health and Optimal Health Practices Research Branch, CHU de Québec Research Center - Université Laval, Quebec City, Canada
- School of Psychology, Université Laval, Quebec City, Canada
| | - Richard Bélanger
- Population Health and Optimal Health Practices Research Branch, CHU de Québec Research Center - Université Laval, Quebec City, Canada
- Department of Paediatrics, Centre mère-enfant Soleil, CHU de Québec - Université Laval, Quebec City, Canada
| | | | | | - Sarah Fraser
- School of Psychology, Université de Montréal, Montréal, Canada
| | - Véronique Morin
- Nunavik Regional Board of Health and Social Services, Nunavik, Canada
| | - Gina Muckle
- Population Health and Optimal Health Practices Research Branch, CHU de Québec Research Center - Université Laval, Quebec City, Canada
- School of Psychology, Université Laval, Quebec City, Canada
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Silver IA, Brookstein AJ, D'Amato C. Juvenile incarceration in an adult correctional facility as a risk factor for adolescent childrearing? J Adolesc 2023; 95:56-69. [PMID: 36199241 DOI: 10.1002/jad.12096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/29/2022] [Accepted: 09/10/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Recent trends in reproductive rights have contributed to lasting concerns about adolescent childrearing in American society. Beyond being generally unprepared when raising a child, having a child during adolescence is associated with a variety of environmental, social, and psychological consequences for both the parents and the child. It is important to understand the factors contributing to adolescent childrearing. Although research has identified many factors that contribute to adolescent childrearing, a notable gap remains when considering the role of the correctional system and, in particular, the age-specific effects of confining adolescents in adult correctional facilities. METHODS The current study examined the age-specific effects of time spent in adult correctional facilities from 13 to 34 years of age on childrearing between 14 and 35 years of age using the National Longitudinal Survey of Youth-1997 (NLSY97). The NLSY97 is a nationally representative sample of Males (51%) and Females (49%) born in the United States. Respondents of the NLSY97 were interviewed about life events beginning at age 7 and continued to participate in the study as recently as 2021. RESULTS The results of the lagged growth curve models suggest that the time spent incarcerated between 13 and 17 years of age heightens the risk of childrearing between 14 and 18 years of age, an effect that is not observed during adulthood. CONCLUSION Overall, the results suggest that the conditions adolescents are exposed to during incarceration in an adult correctional facility could contribute to a heightened likelihood of adolescent childrearing.
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Affiliation(s)
- Ian A Silver
- Division of Applied Justice Research, Center for Courts and Corrections Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Adrienne J Brookstein
- The Department of Criminal Justice, Temple University, Philadelphia, Pennsylvania, USA
| | - Christopher D'Amato
- College of Education, Criminal Justice, and Human Services, Corrections Institute, University of Cincinnati, Cincinnati, Ohio, USA
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Ntshayintshayi PN, Sehularo LA, Mokgaola IO, Sepeng NV. Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict. Health SA 2022; 27:1880. [PMID: 36483505 PMCID: PMC9724101 DOI: 10.4102/hsag.v27i0.1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/01/2022] [Indexed: 11/06/2022] Open
Abstract
Background Pregnant teenagers usually experience psychosocial challenges such as a great amount of stress when they have to deal with an unwanted pregnancy, unpreparedness for parenthood and a lack of income as well as labour and birth complications. These are further complicated by the stigma from their families, friends and community. Unaddressed psychosocial challenges during teenage pregnancy can adversely affect the health outcomes of both mother and the child. Aim This study explores and describes the psychosocial challenges faced by pregnant teenagers in the Ditsobotla subdistrict. Setting The study was conducted in three health centres in the Ditsobotla subdistrict. Methods A qualitative-exploratory-descriptive and contextual research design was used. Non-probability purposive and convenience sampling techniques were used to select the participants. Semistructured individual interviews through WhatsApp video calls were used to collect data, which were analysed using conventional content analysis. Results Three themes emerged from the findings of the study, namely psychological challenges, social challenges and suggestions to address psychosocial challenges faced by pregnant teenagers. Conclusion The findings established that pregnant teenagers in the Ditsobotla subdistrict are faced with psychosocial challenges which negatively impact their psychological health and social life. Suggestions made in this study have the potential to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict if implemented. Contributions The findings of this study provide important information that may be used to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict.
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Affiliation(s)
- Peaceful N. Ntshayintshayi
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
| | - Leepile A. Sehularo
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
| | - Isaac O. Mokgaola
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
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13
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Braoudé I, Radjack R. [Psychosocial factors of vulnerability in teenage pregnancy]. Soins Psychiatr 2022; 43:22-24. [PMID: 36731978 DOI: 10.1016/j.spsy.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Teenage pregnancy remains a major public health problem worldwide. They present somatic, psychological, developmental and socioeconomic risks and consequences for adolescents and their unborn children. A review of the international scientific literature exploring the psychosocial factors of vulnerability at each stage of pregnancy shows that sustainable, multidisciplinary and culturally appropriate support is necessary.
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Affiliation(s)
- Ilan Braoudé
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin, AP-HP, 97 boulevard de Port-Royal, 75014 Paris, France; Team DevPsy, Centre de recherche en épidémiologie et santé des populations, Université Paris-Saclay, UVSQ, Inserm, 16 avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France.
| | - Rahmeth Radjack
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin, AP-HP, 97 boulevard de Port-Royal, 75014 Paris, France; Team DevPsy, Centre de recherche en épidémiologie et santé des populations, Université Paris-Saclay, UVSQ, Inserm, 16 avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France
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14
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Psychopathological and Psychosocial Risk Profile, Styles of Interaction and Mentalization of Adolescent and Young Mother-Infant Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084737. [PMID: 35457605 PMCID: PMC9027302 DOI: 10.3390/ijerph19084737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 12/10/2022]
Abstract
This study examined the psychopathological and psychosocial risk profile and the quality of mother–infant interaction in 98 adolescent and young mother–infant dyads. At their infant’s age of 3 months, mothers filled in a socio-demographic form and completed a test battery: EPDS for depression, STAY-I for anxiety, PSI-SF for parenting stress, MPSS for social support, AAI for maternal attachment and reflective functioning, CECA for adverse childhood experiences, Care-Index and Mind-mindedness coding system for mother–infant interaction. Results showed that motherhood in adolescence was associated with several psychosocial risk factors. Adolescent and young mothers have depression (25%), anxiety (29%) and insecure attachment (65%), with low reflective functioning, of whom 18% have disorganized attachment. A total of 54% of the mothers had at least one adverse childhood experience. Furthermore, adolescent mothers had low sensitivity and mind-mindedness and high intrusiveness, and their infant had low responsiveness and high passive behaviors. Mothers under 18 have experienced more sexual abuse, are more likely to be single and have been followed by child social services more than mothers aged 18–21. Adolescent mothers have a high-risk psychopathological and psychosocial profile that affects their ability to mentalize and build an adequate relationship with the child. It appears to be important to support the adolescent mother–child relationship.
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van Tintelen AMG, Bolt SH, Dalmijn E, Jansen DEMC. Life after teenage childbearing: A long-term view on teenage mothers' wellbeing. J Reprod Infant Psychol 2021:1-15. [PMID: 34965803 DOI: 10.1080/02646838.2021.2013456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND This study aims to address the lack of information about the long-term wellbeing of (former) teenage mothers in the Netherlands. It provides data which policymakers can use to ensure that support programmesmeet the needs of teenage mothers. METHODS Women who had given birth before the age of twenty were recruited online by Fiom, expertise centre on unintended pregnancy (December 2018-February 2019; N = 248). Survey data were obtained to assess how they perceived their wellbeing, employment, education, housing, and social support. Respondents were divided into three groups: 0-3 years after teenage childbearing (short term), 4-12 years (medium term), >12 years (long term). Results were analysed using univariate and bivariate descriptions in SPSS. RESULTS Almost 80% of respondents reported that they were doing well and were satisfied with their lives, 63% had a job, and 17% were students. Short-term mothers worked fewer hours per week, received more benefits, and were less satisfied with their living conditions compared to medium- and long-term mothers. 36% Of the respondents smoked cigarettes. Most support was given by family (83%), mainly by female relatives. About 24% received formal support from social workers or institutions. CONCLUSIONS Respondents, on average, reported they were doing well and were satisfied with their lives, in both the short and long term. These results suggest that as the years pass, teenage mothers overcome difficulties. Regarding income and housing, however, short-term mothers were in a less favourable position. Tailored interventions are recommended to address smoking among (former) teenage mothers.
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Affiliation(s)
| | - Sophie H Bolt
- Research Department, Fiom, 's-Hertogenbosch, The Netherlands
| | - Eline Dalmijn
- Research Department, Fiom, 's-Hertogenbosch, The Netherlands
| | - Danielle E M C Jansen
- Department of Health Sciences, University of Groningen, Department of Sociology and Interuniversity Center for Social Science Theory and Methodology (Ics), Groningen, The Netherlands.,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Huang LY, Chen WJ, Yang YN, Wu CY, Wu PL, Tey SL, Yang SN, Liu HK. Maternal Age, the Disparity across Regions and Their Correlation to Sudden Infant Death Syndrome in Taiwan: A Nationwide Cohort Study. CHILDREN-BASEL 2021; 8:children8090771. [PMID: 34572203 PMCID: PMC8471108 DOI: 10.3390/children8090771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Sudden infant death syndrome (SIDS) has always been a regrettable issue for families. After sleeping in the supine position was proposed, the incidence of SIDS declined dramatically worldwide. However, SIDS still accounts for the top 10 causes of infant deaths in Taiwan. Recognizing the risk factors and attempting to minimize these cases are imperative. We obtained information on cases with SIDS from the National Health Insurance Research Database in Taiwan and interconnected it with the Taiwan Maternal and Child Health Database to acquire infant-maternal basal characteristics between 2004 and 2017. The SIDS subjects were matched 1:10 considering gestational age to normal infants. After case selection, a total of 953 SIDS cases were included. Compared with healthy infants, SIDS infants had younger parents, lower birth weight, and lower Apgar scores. After adjusting for potential confounders, infants with mothers aged <20 years had 2.81 times higher risk of SIDS. Moreover, infants in the non-eastern region had a significantly lower risk of SIDS than those in the eastern region. We concluded that infants of young mothers (especially maternal age <20 years) and infants in the eastern region of Taiwan had a higher risk of SIDS than their counterparts.
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Affiliation(s)
- Lin-Yi Huang
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
| | - Wan-Ju Chen
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
| | - Yung-Ning Yang
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chien-Yi Wu
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Pei-Ling Wu
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Shu-Leei Tey
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - San-Nan Yang
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Hsien-Kuan Liu
- Department of Pediatrics, E-DA Hospital, Kaohsiung 82445, Taiwan; (L.-Y.H.); (W.-J.C.); (Y.-N.Y.); (C.-Y.W.); (P.-L.W.); (S.-L.T.); (S.-N.Y.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Correspondence: ; Tel.: +886-978060068
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Kumar M, Huang KY. Impact of being an adolescent mother on subsequent maternal health, parenting, and child development in Kenyan low-income and high adversity informal settlement context. PLoS One 2021; 16:e0248836. [PMID: 33793592 PMCID: PMC8016237 DOI: 10.1371/journal.pone.0248836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 03/05/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Women who have experienced adolescent pregnancy and early motherhood are disproportionately affected in terms of their health and parenting capabilities, as well as their offspring's health. Guided by Stress Process and Social Determinants of Health (SDH) Frameworks, which posit that multiple sources of stressors and structural determinants of adolescent pregnancy influence adolescent mothers' subsequent health and quality of parenting (Xavier et al 2018, McLoyd 1998, Conger et al 2010, Gipson et al 2008). These dynamics then further impact offspring's outcomes. Using an Integrated Stress-SDH Process for Health Disparities model and we test on whether early motherhood is associated with and subsequent maternal and child health from two informal settlements in Nairobi. METHODS A cross-sectional design with 394 mothers of 2-16 years old children who sought maternal and child health services at Kariobangi and Kangemi public health centers between October 2015 to April 2016 were recruited. Participating mothers were asked questions related to their adolescent pregnancy history, their current health, wellbeing, and parenting practices, and their child's health. Structural equation modeling (SEM) was utilized to examine hypothesized mediational pathways that adolescent pregnancy history has negative influences on women's health and parenting during adulthood, which also influence their child's health and development. RESULTS Our study supports that women with a history of adolescent motherhood have poor physical and mental health outcomes as adults after adjusting for demographic confounders. SEM results partially support the Stress-SDH Process model that history of adolescent pregnancy had negative consequences on women's adulthood health, which also negatively impacted offspring's physical and mental health. CONCLUSION Consistent with the Stress Process and SDH literature, we found consistent cross-cultural literature that adolescent pregnancy set the stage for, subsequent poor maternal health and child outcomes. Although history of adolescent pregnancy and motherhood was not necessarily associated with negative parenting, consistent with parenting literature, negative parenting was associated with poor child mental health. Findings suggest importance of providing integrated care that address health and parenting needs to optimize offspring's development in instances of early motherhood.
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Affiliation(s)
- Manasi Kumar
- Department of Psychiatry, University of Nairobi, Research Fellow, University College London, London, United Kingdom
| | - Keng Yen Huang
- Department of Population Health, New York University School of Medicine, New York, NY, United States of America
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18
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Toska E, Laurenzi CA, Roberts KJ, Cluver L, Sherr L. Adolescent mothers affected by HIV and their children: A scoping review of evidence and experiences from sub-Saharan Africa. Glob Public Health 2020; 15:1655-1673. [PMID: 32507031 DOI: 10.1080/17441692.2020.1775867] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
While adolescents have received increasing attention in the global HIV response and international strategies and commitments, adolescent mothers and their children remain largely overlooked in research, funding and, programming for health-related outcomes. We conducted an extensive scoping review of current evidence on the experiences of adolescent mothers affected by HIV and their children in this region. We included published literature and conference abstracts, complemented by consultations with key stakeholders, and a review of documents through grey literature searching. First, we summarise the experiences of adolescent mothers and their children related to HIV and key health and development indicators. The syndemic of early motherhood and HIV in sub-Saharan Africa increases the vulnerability of adolescent mothers and their children. We then highlight lessons from a series of promising programmes focused on supporting adolescent mothers through novel approaches. In sub-Saharan Africa, supporting adolescent mothers living in high HIV-risk communities is critical not only to eliminate HIV/AIDS, but also to attain the Sustainable Development Goals. While research on and programming for adolescent mothers and their children is growing, the complex needs for this vulnerable group remain unmet. We conclude with evidence gaps and programming priorities for adolescent mothers affected by HIV and their children.
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Affiliation(s)
- Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa.,Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Christina A Laurenzi
- Institute for Life Course Health Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | | | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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Wong SPW, Twynstra J, Gilliland JA, Cook JL, Seabrook JA. Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample. J Pediatr Adolesc Gynecol 2020; 33:153-159. [PMID: 31634579 DOI: 10.1016/j.jpag.2019.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/06/2019] [Accepted: 10/13/2019] [Indexed: 01/17/2023]
Abstract
STUDY OBJECTIVE To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors. DESIGN Retrospective cohort study using perinatal and neonatal databases. SETTING Tertiary care hospital in SWO. PARTICIPANTS Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older. INTERVENTIONS None. MAIN OUTCOME MEASURES Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia. RESULTS Of 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P < .001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P < .001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P < .001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates. CONCLUSION Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.
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Affiliation(s)
- Stephanie P W Wong
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography, Western University, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada
| | - Jocelynn L Cook
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada.
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20
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Lucas G, Olander EK, Ayers S, Salmon D. No straight lines - young women's perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography. BMC WOMENS HEALTH 2019; 19:152. [PMID: 31806005 PMCID: PMC6896260 DOI: 10.1186/s12905-019-0848-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/14/2019] [Indexed: 01/28/2023]
Abstract
Background Young mothers face mental health challenges during and after pregnancy including increased rates of depression compared to older mothers. While the prevention of teenage pregnancy in countries such as the United States and the United Kingdom has been a focus for policy and research in recent decades, the need to understand young women’s own experiences has been highlighted. The aim of this meta-ethnography was to examine young women’s perceptions of their mental health and wellbeing during and after pregnancy to provide new understandings of those experiences. Methods A systematic review and meta-ethnographic synthesis of qualitative research was conducted. Seven databases were systematically searched and forward and backward searching conducted. Papers were included if they were from Organisation for Economic Co-operation and Development countries and explored mental health and wellbeing experiences of young mothers (age under 20 in pregnancy; under 25 at time of research) as a primary research question – or where evidence about mental health and wellbeing from participants was foregrounded. Nineteen papers were identified and the Critical Appraisal Skills Programme checklist for qualitative research used to appraise the evidence. Following the seven-step process of meta-ethnography, key constructs were examined within each study and then translated into one another. Results Seven translated themes were identified forming a new line of argument wherein mental health and wellbeing was analysed as relating to individual bodily experiences; tied into past and present relationships; underpinned by economic insecurity and entangled with feelings of societal surveillance. There were ‘no straight lines’ in young women’s experiences, which were more complex than dominant narratives around overcoming adversity suggest. Conclusions The synthesis concludes that health and social care professionals need to reflect on the operation of power and stigma in young women’s lives and its impact on wellbeing. It adds to understanding of young women’s mental health and wellbeing during and after pregnancy as located in physical and structural factors rather than individual capacities alone.
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Affiliation(s)
- Grace Lucas
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Debra Salmon
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
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Bischoff M, Howland V, Klinger-König J, Tomczyk S, Schmidt S, Zygmunt M, Heckmann M, van den Berg N, Bethke B, Corleis J, Günther S, Liutkus K, Stentzel U, Neumann A, Penndorf P, Ludwig T, Hammer E, Winter T, Grabe HJ. Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child's health. BMC Psychiatry 2019; 19:371. [PMID: 31775668 PMCID: PMC6880484 DOI: 10.1186/s12888-019-2279-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As early as pregnancy, maternal mental stress impinges on the child's development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child's needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity. METHODS A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child's mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals. DISCUSSION The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child's and mothers' mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner. TRIAL REGISTRATION German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111-1230-9826. Registered 01 April 2019.
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Affiliation(s)
- M. Bischoff
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - V. Howland
- Department of Neonatology and Paediatric Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - J. Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - S. Tomczyk
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - S. Schmidt
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - M. Zygmunt
- Clinic and Polyclinic for Obstetrics and Gynecology, University Medicine Greifswald, Greifswald, Germany
| | - M. Heckmann
- Department of Neonatology and Paediatric Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - N. van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - B. Bethke
- Department of Health, Nursing and Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - J. Corleis
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - S. Günther
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - K. Liutkus
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - U. Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - A. Neumann
- Department of Health, Nursing and Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - P. Penndorf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - T. Ludwig
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - E. Hammer
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - T. Winter
- Integrated Research Biobank, University Medicine Greifswald, Greifswald, Germany
| | - H. J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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