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Nam JY, Oh SS, Park EC. The Association Between Adequate Prenatal Care and Severe Maternal Morbidity Among Teenage Pregnancies: A Population-Based Cohort Study. Front Public Health 2022; 10:782143. [PMID: 35712308 PMCID: PMC9192951 DOI: 10.3389/fpubh.2022.782143] [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: 09/23/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study was to examine whether inadequate prenatal care affect the risk of severe maternal morbidity in teenage pregnancies. Methods We included 23,202 delivery cases among adolescent mothers aged between 13 and 19 years old with ≥ 37 weeks' gestational age. Data were derived from the National Health Insurance Service National Delivery Cohort in Korea between 2003 and 2018. We used a generalized estimating equation model while adjusting for numerous covariates to determine the adjusted relative risk (RR) associated with severe maternal morbidity. The main outcome measures were severe maternal morbidity and the Kessner Adequacy of Prenatal Care Index. Results Severe maternal morbidity occurred in 723 (3.1%) of the 23,202 investigated delivery cases. The risk of severe maternal morbidity was 1.8-fold higher among adolescent mothers who had received inadequate prenatal care (RR, 1.81, 95% confidence interval [CI], 1.39–2.37) and 1.6-fold higher among those who had received intermediate prenatal care (RR, 1.59, 95% CI, 1.33–1.87) compared to those with adequate prenatal care. Synergistic effects of inadequate prenatal care and maternal comorbidities affected severe maternal morbidity. Conclusion This study confirmed that inadequate prenatal care is associated with increased risk of severe maternal morbidity among pregnant teenagers. Notably, maternal comorbidity and inadequate prenatal care produced synergistic effects on severe maternal morbidity. Public health policy makers should focus on the development and implementation of programs to ensure that adequate prenatal care and financial/healthcare support is provided to teenage mothers during their pregnancies.
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Affiliation(s)
- Jin Young Nam
- Department of Healthcare Management, Eulji University, Seongnam, South Korea
| | - Sarah Soyeon Oh
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea
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Kassa GM, Arowojolu AO, Odukogbe ATA, Yalew AW. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLoS One 2021; 16:e0257485. [PMID: 34550977 PMCID: PMC8457495 DOI: 10.1371/journal.pone.0257485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adolescent pregnancy is considered a major contributor to maternal and child morbidity and mortality, the greatest concern of developing countries and an important public health issue globally. Adolescents are responsible for eleven percent of births worldwide and they face several pregnancy and childbirth related complications. However, in low-income countries like Ethiopia, there are limited researches conducted to investigate outcomes of adolescent pregnancy. Therefore, this study was conducted to assess the adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia. METHODS A prospective cohort study was conducted in 12 health facilities from seven districts in East Gojjam zone, Northwest Ethiopia. A total of 418 adolescents (15-19 years old) and 836 adult women (20-34 years old) who attended randomly selected health facilities in East Gojjam zone were included. Data were collected starting from admission to the maternity ward for labor and delivery, and postnatal depression was measured at six weeks' postpartum period using the Edinburgh Postnatal Depression Scale. Generalized estimating equations (GEE) was used to account for the within subject correlation and assess the effect of different known factors that could influence the outcome of this study. RESULTS A lower percentage of adolescent (58.4%) than adult (71.2%) women had their first antenatal care booking before 16 weeks of gestation. After adjusting for different confounding factors, the adverse outcome that was significantly associated with adolescent pregnancy was postpartum depression (AOR: 2.29; 95% CI, 1.42, 3.7, p-value = 0.001). Assisted vaginal delivery (AOR: 0.44; 95% CI, 0.23, 0.86, p-value 0.016) and cesarean section (AOR: 0.43; 95% CI, 0.19, 0.97, p-value = 0.042) were significantly lower among adolescent women. CONCLUSIONS Adolescent pregnancy is associated with higher odds of postpartum depression, and lower odds to undergo cesarean section and assisted vaginal delivery than adult women. Perinatal care services should be more adolescent-friendly to ensure early diagnosis and treatment of postpartum depression. School and community-based awareness programs regarding use of contraception to prevent unwanted adolescent pregnancy, early antenatal care booking and adverse pregnancy outcomes of adolescent pregnancy and provision of psychosocial support are recommended.
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Affiliation(s)
- Getachew Mullu Kassa
- Department of Obstetrics and Gynaecology, Pan African University Life and Earth Sciences Institutes, College of Medicine, University of Ibadan, Ibadan, Nigeria
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Ayodele O. Arowojolu
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Akin Tunde A. Odukogbe
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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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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Teenage Pregnancy and Its Adverse Obstetric and Perinatal Outcomes at Lemlem Karl Hospital, Tigray, Ethiopia, 2018. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3124847. [PMID: 32051825 PMCID: PMC6995314 DOI: 10.1155/2020/3124847] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/14/2019] [Accepted: 12/11/2019] [Indexed: 11/18/2022]
Abstract
Introduction One of the major public health issues across the whole world these days is teenage pregnancy which is defined as being pregnant in the age ranging from 13–19 years. About 11% of all births which occurred worldwide accounted for girls aged 15 to 19 years. From these, 95% teenage deliveries occur in low- and middle-income countries. World health 2014 statistics show that complications during pregnancy and childbirth are the second cause of death for 15–19-year-old girls globally. The aim of this study was to determine adverse obstetrical and perinatal outcomes of teenage pregnancy among deliveries at Lemlem Karl General Hospital, Tigray, Ethiopia, 2018. Result This study result showed that 17.5% of the teenagers and 6.8% of the adults deliver low birth weight neonates. From the total teenage mothers, about thirty-five (11.3%) of them had developed pregnancy-induced hypertension, whereas about thirteen (4.2%) of adults develop pregnancy-induced hypertension. Regarding cesarean delivery, forty (12.9%) of those teenage mothers deliver by a cesarean section while 58 (18%) of the adult mothers deliver by cesarean delivery. Teenage pregnancy was significantly associated with adverse obstetric and perinatal outcomes, a cesarean delivery (AOR: 0.57; 95% CI, 0.36–0.90), episiotomy (AOR: 2.01; 95% CI, 1.25–3.39), and low birth weight (AOR: 2.22; 95% CI, 1.13–4.36), and premature delivery were 2.87 (1.49–5.52). This study shows that adverse obstetric and perinatal outcomes were significantly associated with teenagers than adult mothers. Therefore, giving health education on focused ANC is very important to bring change to the teenager at this study area.
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Kara T, Doğan K, Alyanak B, Akaltun İ. An Evaluation of Sociodemographic Characteristics and Pregnancy-Related Psychological Problems in Pregnant Adolescents. ANKARA MEDICAL JOURNAL 2017. [DOI: 10.17098/amj.340100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Luhete PK, Mukuku O, Tambwe AM, Kayamba PKM. [Study of maternal and perinatal prognosis for vaginal delivery in adolescent girls in Lubumbashi, Democratic Republic of the Congo]. Pan Afr Med J 2017; 26:182. [PMID: 28674575 PMCID: PMC5483363 DOI: 10.11604/pamj.2017.26.182.9479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/10/2017] [Indexed: 02/05/2023] Open
Abstract
Introduction L’objectif de cette étude était de déterminer la fréquence et d’évaluer le pronostic maternel et périnatal lors de l’accouchement chez les adolescentes dans la ville de Lubumbashi. Méthodes C’était une étude cas-témoin des accouchées d’une grossesse monofoetale de Décembre 2013 à Mai 2014 dans 10 maternités de référence à Lubumbashi (RD Congo). Les adolescentes (< 20 ans) ont été comparées aux femmes âgées de 20-34 ans. Les paramètres sociodémographiques maternels, la morbi-mortalité maternelle et périnatale ont été analysées. Les statistiques usuelles et la régression logistique ont été utilisées pour analyser les résultats. Le seuil de signification a été fixé à une valeur de p<0,05. Résultats L a fréquence d’accouchement chez les adolescentes était de 7,7%. Nous avons observé que la césarienne (ORa=1,9 (1,1-3,1)), l’épisiotomie (ORa=4,2 (2,9-5,9)), la délivrance pathologique (ORa= 2,7 (1,1-6,5)), l’éclampsie (ORa= 4,4 (1,3-14,5)) et le faible poids de naissance (ORa=2,0 (1,3-3,0)) ont été significativement plus élevés chez les adolescentes que chez les adultes. Conclusion L ’accouchement chez les adolescentes, comparativement à celui de femmes âgées de 20-34 ans, reste associé à un mauvais pronostic. D’où l’organisation des séances de sensibilisation pour une meilleure fréquentation des services consultations prénatales, une optimisation du dépistage, de la surveillance et de la prévention des pathologies de la grossesse chez les adolescentes s’avère importante et urgente. Introduction This study aimed to determine the frequency and to assess maternal and perinatal prognosis for vaginal delivery in adolescent girls in the city of Lubumbashi. Methods We conducted a case-control study of vaginal deliveries in singleton pregnancy in 10 referral hospitals in Lubumbashi (DR Congo) from December 2013 to May 2014. Adolescent girls (< 20 years) were compared to older women aged 20-34 years. Maternal sociodemographic parameters, morbi-maternal and perinatal mortality were analyzed. Usual statistics and logistic regression were used to analyze the results. The significance level was set at p <0.05. Results Vaginal delivery rate among adolescent girls was 7.7%. Cesarean section (OR=1.9 (1.1-3.1)), episiotomy (OR=4.2 (2.9-5.9)), pathological delivery (OR=2.7 (1.1-6.5)), eclampsia (OR=4.4 (1.3-14.5)) and low birth weight (OR=2.0 (1.3-3.0)) were significantly higher among adolescent girls than in adults. Conclusion Vaginal delivery in adolescent girls, compared to that of older women aged 20-34 years, is associated with a poor prognosis. Hence the importance and the urgent need to implement awareness sessions to increase attendance to prenatal consultation services, for screening optimization, monitoring and prevention for pregnancy pathologies in adolescent girls.
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Affiliation(s)
- Prosper Kakudji Luhete
- Département de Gynécologie-Obstétrique, Faculté de Médecine, Université de Lubumbashi, RD Congo
| | - Olivier Mukuku
- Département de Gynécologie-Obstétrique, Faculté de Médecine, Université de Lubumbashi, RD Congo
| | - Albert Mwembo Tambwe
- Département de Gynécologie-Obstétrique, Faculté de Médecine, Université de Lubumbashi, RD Congo
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Huang CC, Huang YT, Wu MP. A nationwide population analysis of antenatal and perinatal complications among nurses and nonmedical working women. Taiwan J Obstet Gynecol 2016; 55:635-640. [PMID: 27751407 DOI: 10.1016/j.tjog.2015.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Limited information is available on health issues during pregnancy and after childbirth among nurses, especially on a nationwide level. This study thus aimed to compare antenatal and perinatal complications between nurses and nonmedical working women in Taiwan. MATERIALS AND METHODS This nationwide population-based study was conducted using data from the Taiwan National Health Insurance Research Database. A total of 44,166 nurses and 442,107 nonmedical working women with full-time employment, aged 20-50 years, who gave birth to singletons were identified between 2007 and 2011. Logistic regression analyses (generalized estimating equation method) were used to compare risks between the two groups. RESULTS Multivariable analyses showed that nurses had a significantly higher risk of anemia [adjusted odds ratio (AOR) 1.37; 95% confidence intervals (CI), 1.31-1.44], placenta previa, and abruptio placentae (AOR, 1.13; 95% CI, 1.07-1.20), and pregnancy-associated hypertensive diseases and preeclampsia (AOR, 1.10; 95% CI, 1.03-1.18) during the antenatal period than nonmedical working women. Moreover, they also experienced an increased risk of malpresentation (AOR, 1.30; 95% CI, 1.26-1.34), dystocia (AOR, 1.09; 95%, CI 1.06-1.13), preterm delivery (AOR, 1.08; 95% CI, 1.03-1.13), premature rupture of membranes (AOR, 1.09; 95% CI, 1.05-1.14), and post-term delivery (AOR, 1.11; 95% CI, 1.07-1.16) during the perinatal period. CONCLUSION Our nationwide population-based study revealed increased risks of antenatal and perinatal complications among nurses compared with those among nonmedical working women. The large-scale observation of the increased antenatal and perinatal complications draws attention to the health issues faced by nursing personnel who represent one of the most important workforces in the healthcare system.
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Affiliation(s)
- Chun-Che Huang
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Yu-Tung Huang
- Master Degree Program in Aging and Long-Term Care, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Ming-Ping Wu
- Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
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Abu-Heija A, Al Haddabi R, Al Bash M, Al Mabaihsi N, Al-Maqbali NS. Early Teenage Pregnancy: Is it Safe? J Obstet Gynaecol India 2016; 66:88-92. [PMID: 27046961 DOI: 10.1007/s13224-014-0649-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/21/2014] [Indexed: 11/25/2022] Open
Abstract
AIM To compare obstetric and perinatal outcomes of early and late teenage pregnancies of Omani nulliparous women with singleton pregnancies cared for and delivered at a tertiary teaching hospital. METHOD In this retrospective study, we reviewed obstetric and perinatal outcomes of early teenage pregnancies (14-16 years), (n = 20) delivered at Sultan Qaboos University Hospital, Muscat, Oman, between 1 July 2006 and 30 June 2013 and compared their outcomes with outcomes of late teenage pregnancies (17-19 years), (n = 287) delivered at the same hospital during same period. RESULTS When compared with late teenage pregnant women, early teenagers were found to have no significant differences in prevalence of very preterm delivery <32 weeks (P = 0.62), preterm rupture of membranes (P = > 0.99), and anemia (P = 0.34). When compared to late teenagers, early teenagers had similar cesarean sections rates (P = >0.99), instrumental delivery rates (P = 0.56) and spontaneous vaginal delivery rates (P > 0.99). Both groups had similar birth weights (P = 0.87), low birth weights, (P = 0.55), and very low birth weights babies (P = 0.56 %). Perinatal mortality rate was similar in both groups. CONCLUSION We may conclude that early teenage pregnant Omani women are not at increased risk of obstetric and perinatal complication compared to older teenagers.
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Affiliation(s)
- Adel Abu-Heija
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Rahma Al Haddabi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Majeda Al Bash
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
| | - Nadia Al Mabaihsi
- Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman
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Muñoz-Henríquez M, Pardo Torres MP. Significado de las prácticas de cuidado cultural en gestantes adolescentes de Barranquilla (Colombia). AQUICHAN 2016. [DOI: 10.5294/aqui.2016.16.1.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: describir el significado de las prácticas de cuidado cultural en un grupo de gestantes adolescentes asistentes al control prenatal del Hospital Niño Jesús de Barranquilla, Colombia, y de su hijo por nacer. Método: estudio cualitativo etnográfico, en el que se aplicó el concepto propuesto por Leininger. Las participantes fueron: 10 gestantes adolescentes entre 15 y 19 años, y 12 enfermeras con experiencia en el área. Las primeras como informantes clave, y las segundas como informantes generales. Resultados: el significado de las prácticas de cuidado cultural, para las gestantes adolescentes, se clasifica en tres temas: 1) prácticas de cuidado transmitidas de generación en generación, predominando la línea femenina; 2) la confianza en Dios y el apoyo de la familia como una forma de cuidarse; 3) dar a luz un hijo sano. Conclusiones: las prácticas de cuidado de las gestantes adolecentes están enraizadas en sus creencias, mitos y valores culturales heredados de generación en generación, lo que muestra patrones de cuidado cultural. Este aspecto debe ser identificado por enfermería para ofrecer cuidados que sean culturalmente congruentes con esta población.
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