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Bhatta K, Pathak P, Subedi M. Prevalence and Factors Associated With Adolescent Pregnancy Among an Indigenous Ethnic Group in Rural Nepal: A Community-based Cross-sectional Study. J Prev Med Public Health 2024; 57:269-278. [PMID: 38697914 PMCID: PMC11164603 DOI: 10.3961/jpmph.24.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES The Chepang people, an indigenous ethnic group in Nepal, experience substantial marginalization and socioeconomic disadvantages, making their communities among the most vulnerable in the region. This study aimed to determine the prevalence and factors associated with adolescent pregnancy in the Chepang communities of Raksirang Rural Municipality, Makwanpur District, Bagmati Province, Nepal. METHODS A cross-sectional study was conducted from October 2022 to April 2023 among 231 Chepang women selected using simple random sampling from Raksirang Rural Municipality. A semi-structured questionnaire was used for interviewing the mothers. Bivariate and multivariate logistic regression analyses were performed, using odds ratios with 95% confidence intervals (CIs). Variables with a variation inflation factor of more than 2 and a p-value of more than 0.25 were excluded from the final model. RESULTS The study revealed that the prevalence rate of adolescent pregnancy among Chepang women was 71.4% (95% CI, 65.14 to 77.16). A large percentage of participants (72.7%) were married before the age of 18 years. Poor knowledge of adolescent pregnancy (adjusted odds ratio [aOR], 10.3; 95% CI, 8.42 to 14.87), unplanned pregnancy (aOR, 13.3; 95% CI, 10.76 to 19.2), and lack of sex education (aOR, 6.57; 95% CI, 3.85 to 11.27) were significantly associated with adolescent pregnancy. CONCLUSIONS The prevalence of adolescent pregnancy among the Chepang community was high. These findings highlighted the importance of raising awareness about the potential consequences of adolescent pregnancy and implementing comprehensive sexuality education programs for preventing adolescent pregnancies within this community.
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Affiliation(s)
- Kusumsheela Bhatta
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Pratiksha Pathak
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Madhusudan Subedi
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
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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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Miller FA, Dulal S, Rai A, Gram L, Harris-Fry H, Saville NM. "Can't live willingly": A thematic synthesis of qualitative evidence exploring how early marriage and early pregnancy affect experiences of pregnancy in South Asia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002279. [PMID: 37871001 PMCID: PMC10593245 DOI: 10.1371/journal.pgph.0002279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/13/2023] [Indexed: 10/25/2023]
Abstract
In South Asia, early marriage has been associated with a range of adverse outcomes during pregnancy and infancy. This may partly be explained by early marriage leading to a younger maternal age, however it remains unclear which other factors are involved. This review aimed to synthesise the qualitative evidence on experiences of pregnancy following early marriage or early pregnancy in South Asia, to inform our understanding of the mechanisms between early marriage and adverse pregnancy outcomes. We searched MEDLINE, EMBASE, Scopus, Global Index Medicus, CINAHL, PsycINFO, Web of Science, and grey literature on 29/11/2022 to identify papers on experiences of pregnancy among those who married or became pregnant early in South Asia (PROSPERO registration number: CRD42022304336, funded by an MRC doctoral training grant). Seventy-nine papers from six countries were included after screening. We appraised study quality using an adapted version of the Critical Appraisal Skills Programme tool for qualitative research. Reporting of reflexivity and theoretical underpinnings was poor. We synthesised findings thematically, presenting themes alongside illustrative quotes. We categorised poor pregnancy experiences into: care-seeking challenges, mental health difficulties, and poor nutritional status. We identified eight inter-connected themes: restrictive social hierarchies within households, earning social position, disrupted education, social isolation, increased likelihood of and vulnerability to abuse, shaming of pregnant women, normalisation of risk among younger women, and burdensome workloads. Socioeconomic position and caste/ethnic group also intersected with early marriage to shape experiences during pregnancy. While we found differences between regions, the heterogeneity of the included studies limits our ability to draw conclusions across regions. Pregnancy experiences are largely determined by social hierarchies and the quality of relationships within and outside of the household. These factors limit the potential for individual factors, such as education and empowerment, to improve experiences of pregnancy for girls married early.
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Affiliation(s)
- Faith A. Miller
- Institute for Global Health, University College London, London, United Kingdom
| | - Sophiya Dulal
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Anjana Rai
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Lu Gram
- Institute for Global Health, University College London, London, United Kingdom
| | - Helen Harris-Fry
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Naomi M. Saville
- Institute for Global Health, University College London, London, United Kingdom
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Thakuri DS, Bhandari R, Khatri S, Dhungana A, Balami R, Hanson-Hall NA. Effect of Healthy Transitions intervention in improving family planning uptake among adolescents and young women in Western Nepal: A pre-and post-intervention study. PLoS One 2023; 18:e0286705. [PMID: 37294784 PMCID: PMC10256217 DOI: 10.1371/journal.pone.0286705] [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: 04/07/2022] [Accepted: 05/23/2023] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Contraceptive use can prevent unintended pregnancies, early childbearing, and abortion-related deaths. Despite these benefits, the use of modern contraceptives remains low among adolescent girls and young women (AGYW) in Nepal. To address this gap, the Healthy Transitions Project was implemented in Karnali Province, Nepal from February 2019 to September 2021. This study aimed at measuring the effect of Healthy Transitions' intervention on improving knowledge and use of modern family planning methods among AGYW in Nepal. METHODS We used a pre- and post-intervention study design to assess the effect of Healthy Transitions project. A quantitative survey was conducted at baseline and after the first cohort of AGYW had completed the intervention (1 year later). The baseline survey was conducted in 2019 with a cohort of 786 married and unmarried AGYW aged 15-24 years. An end line survey was conducted in 2020 with 565 AGYW who were interviewed at baseline. Data analysis was done using STATA version 15.1. The exact McNemar significance probability value was used to decide the significance of difference between baseline and endline. RESULTS The knowledge and uptake of modern family planning methods have increased in the endline compared to the baseline. AGYW recognised 10 out of the ten modern methods at endline, a significant increase from 7 at baseline (p<0.001). Among AGYW, 99% were aware of sources to obtain family planning methods, compared with 92% at baseline (p< 0.001). The proportion of married AGYW using modern contraceptive methods was significantly higher at the endline 33%, than baseline (26%) (p<0.001). CONCLUSION Our results show that multilevel demand and supply-side interventions, targeting adolescents and young women, their families, community, and health system helped to improve knowledge and use of modern family planning methods among AGYW. The study suggests that these intervention approaches can be adopted to improve family planning use among adolescents and young women in other similar settings.
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Affiliation(s)
| | - Rajan Bhandari
- Save the Children International, Nepal Country Office, Kathmandu, Nepal
| | - Sangita Khatri
- Save the Children International, Nepal Country Office, Kathmandu, Nepal
| | - Adhish Dhungana
- Save the Children International, Nepal Country Office, Kathmandu, Nepal
| | - Roma Balami
- Save the Children International, Nepal Country Office, Kathmandu, Nepal
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Santos JS, Neill S, Mello DFD. Mães adolescentes, autocuidado e cuidado infantil: validação de conteúdo de um calendário histórico de eventos. Rev Esc Enferm USP 2023. [DOI: 10.1590/1980-220x-reeusp-2022-0314pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
RESUMO Objetivo: Validar o conteúdo da ferramenta Event History Calendar Mãe Adolescente: fortalecendo o autocuidado e o cuidado da criança. Método: Estudo metodológico com a técnica Delphi, realizado em duas rodadas, envolvendo 37 especialistas de enfermagem. Na coleta de dados, de dezembro/2019 a agosto/2020, foi utilizado um questionário semiestruturado composto por 47 itens relacionados às duas dimensões da ferramenta: Autocuidado e Cuidado da criança. O Índice de Validade de Conteúdo ≥ 0,80 foi utilizado para avaliar a concordância entre os especialistas. Elementos qualitativos foram analisados quanto à clareza e abrangência do conteúdo. Resultados: Na primeira rodada, 46 itens apresentaram Índice de Validade de Conteúdo ≥ 0,80. Os elementos qualitativos apontaram necessidade de maior clareza para o público adolescente. Após as alterações, a ferramenta apresentou 30 itens. Na segunda rodada, os 30 itens avaliados alcançaram Índice de Validade de Conteúdo ≥ 0,80. As considerações qualitativas foram traduzidas em modificações no conteúdo e sequência na versão final da ferramenta. Conclusão: A ferramenta validada obteve avaliação adequada dos itens de cada dimensão, relacionados ao autocuidado da mãe adolescente e cuidado da criança, com alto grau de compreensibilidade.
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Santos JS, Neill S, Mello DFD. Adolescent mothers, self-care and childcare: content validation of an Event History Calendar. Rev Esc Enferm USP 2023; 57:e20220314. [PMID: 37011286 PMCID: PMC10081628 DOI: 10.1590/1980-220x-reeusp-2022-0314en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/30/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE To validate the content of the tool Event History Calendar Adolescent Mother: strengthening self-care and child care. METHOD Methodological study using the Delphi technique, conducted in two rounds, involving 37 nursing specialists. In data collection, from December/2019 to August/2020, a semi-structured questionnaire composed of 47 items related to the two dimensions of the tool: Self-care and Child Care was used. The Content Validity Index ≥ 0.80 was used to assess agreement among the experts. Qualitative elements were analyzed for clarity and comprehensiveness of content. RESULTS In the first round, 46 items showed Content Validity Index ≥ 0.80. The qualitative elements pointed out more clarity for the adolescent audience. After the changes, the tool presented 30 items. In the second round, the 30 items evaluated achieved Content Validity Index ≥ 0.80. The qualitative considerations were translated into modifications in the content and sequence in the final version of the tool. CONCLUSION The validated tool obtained adequate evaluation of the items of each dimension, related to adolescent mother self-care and child care, with a high degree of comprehensibility.
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Affiliation(s)
- Jaqueline Silva Santos
- Secretaria de Estado de Saúde de Minas Gerais, Superintendência Regional de Saúde de Passos, Passos, MG, Brazil
| | - Sarah Neill
- University of Plymouth, Faculty of Health, School of Nursing and Midwifery, Plymouth, United Kingdom
| | - Débora Falleiros de Mello
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
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Senkyire EK, Boateng D, Boakye FO, Logo DD, Ohaja M. Socio-economic factors associated with adolescent pregnancy and motherhood: Analysis of the 2017 Ghana maternal health survey. PLoS One 2022; 17:e0272131. [PMID: 36584169 PMCID: PMC9803283 DOI: 10.1371/journal.pone.0272131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Adolescent pregnancy and motherhood have been linked to several factors stemming from social, cultural and to a large extent economic issues. This study examined the socio-economic factors associated with adolescent pregnancy and motherhood in Ghana. DESIGN This was a secondary analysis of the 2017 Ghana Maternal Health Survey, which was a nationally representative cross-sectional survey. Data from 4785 adolescents aged between 15-19 years were included in the analysis. Adolescent pregnancy was defined as adolescents who have ever been pregnant, whiles adolescent motherhood was defined as adolescents who have ever given birth. Weighted logistic regression was used to assess the association between the socio-economic variables and adolescent pregnancy and motherhood. RESULTS Of the 25062 women aged between 15 and 49 years included in the 2017 maternal health survey, 4785 (19.1%) were adolescents between 15-19 years. Adolescent pregnancy was reported in 14.6% (CI:13.2% -16.1%) of the respondents, whereas 11.8% (CI: 10.5% -13.1%) of the respondents had ever given birth. In the multivariate regression analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were all significantly associated with adolescent pregnancy and motherhood. The odds of pregnancy and motherhood were significantly higher in the Middle and Coastal zones (p<0.001), and among older adolescents (p<0.001). However, the odds of pregnancy and motherhood was significantly lower among adolescents from households with the highest wealth index (p<0.001), among those who were never married (p<0.001) and among adolescents who had secondary/higher education (p<0.001). CONCLUSION Several socio-economic variables including education, household wealth, marital status and zone of residence were significantly associated with adolescent pregnancy and adolescent motherhood. Sexual and reproductive health education should be intensified among these populations. Adolescent friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age.
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Poudel S, Razee H, Dobbins T, Akombi-Inyang B. Adolescent Pregnancy in South Asia: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15004. [PMID: 36429723 PMCID: PMC9690629 DOI: 10.3390/ijerph192215004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/12/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Adolescent pregnancy is a major health and social concern in South Asia. The aim of this study is to systematically review evidence on the factors associated with adolescent pregnancy in South Asia. This study was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Four electronic databases: EMBASE, PubMed, CINAHL, and Scopus were searched for relevant studies on factors associated with adolescent pregnancy in South Asia published in English between January 2000 and July 2022. The quality of the included studies was assessed using 12 criteria from The National Institute of Health (NIH) Study Quality Assessment Tools for observational studies. Of the 166 articles retrieved, only 15 studies met the eligibility criteria and were included in the final analysis. Consistent factors associated with adolescent pregnancy in South Asia were low maternal education, low socioeconomic status, rural residency, and ethnic minorities. To prevent adolescent pregnancy in South Asia, concerted effort towards promoting health equity by addressing the predisposing factors associated with adolescent pregnancy is essential. This systematic review was registered with PROSPERO [CRD42022340344].
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Cresswell L, Faltyn M, Lawrence C, Tsai Z, Owais S, Savoy C, Lipman E, Van Lieshout RJ. Cognitive and Mental Health of Young Mothers' Offspring: A Meta-analysis. Pediatrics 2022; 150:189768. [PMID: 36281707 DOI: 10.1542/peds.2022-057561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The nature and magnitude of the cognitive and mental health risks among the offspring of young mothers is not fully understood. Our objective is to examine the risk of mental disorders in these offspring. METHODS Five databases (Medline, Embase, Web of Science, PsycINFO, and CINAHL) were searched from their inceptions until February 2022. Studies were eligible if they assessed offspring of young mothers (<21 years), contained a control group, and assessed any cognitive and/or mental health outcomes. Random-effects meta-analysis was used to generate standardized mean differences (SMDs) in infants (0-3 years), children (4-9), adolescents (10-19), and adults (20+). Methodological bias was assessed using the Newcastle-Ottawa Scale. RESULTS 51 outcomes were meta-analyzed. Levels of cognitive and learning problems were higher among the infants (SMD = 0.30 [95% confidence interval 0.0-0.55]) and adolescents (SMD = 0.43 [0.24 to 0.62]) of young mothers. Adolescents had more symptoms of delinquency (SMD = 0.24 [0.12 to 0.36]). As adults, they are more often convicted of violent crimes (SMD = 0.36 [0.22 to 0.50]). Internalizing symptoms were higher in these offspring in childhood (SMD = 0.29 [0.14 to 0.45]) and adulthood (SMD = 0.35 [0.34 to 0.36]). This review uses unadjusted data and is thus unequipped to infer causality. Studies have high attrition and rely heavily on self-report. CONCLUSIONS Young mothers' offspring have more cognitive, externalizing, and internalizing problems across the lifespan than individuals born to mothers ≥21 years of age. They may benefit from early detection and support.
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Affiliation(s)
- Liam Cresswell
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Mateusz Faltyn
- Department of Mathematics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Claire Lawrence
- Reproductive and Developmental Sciences Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Calan Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Bhattarai B, Panthi S, Yadav GK, Gautam S, Acharya R, Neupane D, Khanal N, Khatri B, Neupane K, Adhikari S, Lageju N, Basnet LB, Pyakurel P, Yadav SP. Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001579. [PMID: 36645745 PMCID: PMC9716932 DOI: 10.1136/bmjpo-2022-001579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal. METHODOLOGY A cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37-42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29. RESULTS The low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively. CONCLUSIONS The local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.
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Affiliation(s)
- Bharosha Bhattarai
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sagar Panthi
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gopal Kumar Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Swotantra Gautam
- Department of Internal Medicine, Advent Health, Orlando, Florida, USA
| | - Rochana Acharya
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Durga Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Khanal
- Department of Internal Medicine, Tower Health Reading Hospital, Reading, Pennsylvania, USA
| | - Bharat Khatri
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Krishna Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sugat Adhikari
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Lageju
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Lila Bahadur Basnet
- Curative Service Division, Ministry of Health and Population, Department of Health Services, Kathmandu, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Shankar Prasad Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Miller FA, Marphatia AA, Wells JC, Cortina-Borja M, Manandhar DS, Saville NM. Associations between early marriage and preterm delivery: Evidence from lowland Nepal. Am J Hum Biol 2021; 34:e23709. [PMID: 34862821 DOI: 10.1002/ajhb.23709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Preterm delivery (<37 weeks gestation) is the largest cause of child mortality worldwide. Marriage and pregnancy during adolescence have been associated with an increased risk of preterm delivery. We investigate independent associations of age at marriage and age at first pregnancy with preterm delivery in a cohort of women from rural lowland Nepal. METHODS We analyzed data from 17 974 women in the Low Birth Weight South Asia Trial. Logistic regression models tested associations of age at marriage and age at first pregnancy with preterm delivery, for primigravida (n = 6 243) and multigravida (n = 11 731) women. Models were adjusted for maternal education, maternal caste, and household asset score. RESULTS Ninety percent of participants had married at <18 years and 58% had their first pregnancy at <18 years. 20% of participants delivered preterm. Primigravida participants married at ≤14 years had higher odds of preterm delivery than those married ≥18 years, when adjusting for study design (adjusted odds ratio (aOR) 1.45, 95% CI: 1.15-1.83), confounders (aOR 1.28: 1.01-1.62) and confounders + age at pregnancy (aOR 1.29: 1.00-1.68). Associations were insignificant for multigravida women. No significant associations were observed between age at first pregnancy and preterm delivery. DISCUSSION In this population, early marriage, rather than pregnancy, is a risk factor for preterm delivery. We hypothesize that psychological stress, a driver of preterm delivery which is increased among those marrying young, rather than physiological immaturity, drives this association. Further research into the psychological consequences of child marriage in Nepal is needed.
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Affiliation(s)
- Faith A Miller
- Institute for Global Health (IGH), University College London (UCL), London, UK
| | - Akanksha A Marphatia
- Department of Geography, University of Cambridge, Cambridge, UK.,Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH), University College London (UCL), London, UK
| | - Jonathan C Wells
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH), University College London (UCL), London, UK
| | - Mario Cortina-Borja
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health (ICH), University College London (UCL), London, UK
| | | | - Naomi M Saville
- Institute for Global Health (IGH), University College London (UCL), London, UK
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Erfina Erfina, Widyawati Widyawati, McKenna L, Reisenhofer S, Ismail D. Becoming an adolescent mother: The experiences of young Indonesian new mothers living with their extended families. Midwifery 2021; 104:103170. [PMID: 34736015 DOI: 10.1016/j.midw.2021.103170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/06/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Adolescent motherhood brings many challenges. While much is written about young mothers' transition to motherhood and their support needs, there is little from South-East Asian countries such as Indonesia. The aim of this study was to understand the new motherhood experiences of Indonesian adolescent females living with their extended families. DESIGN Eleven semi-structured interviews were conducted with new adolescent mothers. SETTING a large women and children's hospital in Makassar, South Sulawesi, Indonesia. PARTICIPANTS Purposive sampling was undertaken. Eleven adolescent mother participated in this study. The mean age of the mothers was 17 years, ranging from 16 to 19 years of age. FINDINGS Four themes emerged: demonstrate transfer of knowledge between generations, sharing tasks with extended family, feeling blessed with extended family and local myth and cultural practice related to caring for the baby. Findingsdemonstrated that transfer of knowledge between generations was important for these adolescent mothers. They shared responsibilities with and felt blessed having their extended families, along with local beliefs and cultural practice related to caring fortheir babies. DISCUSSION AND IMPLICATIONS FOR PRACTICE Our findings contribute to understandings of experiences to becoming mothers among Indonesian adolescents living with extended family. Results can be used by healthcare providers, especially nurses and midwives, to develop cultural care interventions and educational program for maternity and psychosocial care for adolescent mothers and their families towards success in the transition period and maternal role attainment.
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Affiliation(s)
- Erfina Erfina
- Department of Maternal Health Nursing Department, Faculty of Nursing, Universitas Hasanuddin, Jl. Perintis Kemerdekaan KM 10, Tamalanrea, Makassar 90245, Indonesia.
| | - Widyawati Widyawati
- Department of Maternal and Pediatric Nursing, School of Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Bulaksumur, Caturtunggal, Kec. Depok, Kabupaten Sleman, Yogyakarta 55281, Indonesia.
| | - Lisa McKenna
- Dean and Head, School of Nursing and Midwifery, La Trobe University, Bundoora VIC 3086, Australia.
| | - Sonia Reisenhofer
- Academic Coordinator (Academic Partnerships), College of Science, Health & Engineering, Director of International, School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia.
| | - Djauhar Ismail
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Bulaksumur, Caturtunggal, Kec. Depok, Kabupaten Sleman, Yogyakarta, Indonesia 55281, Indonesia.
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Ahmed MS. Trend in the utilization of antenatal care during pregnancy among the adolescents in Bangladesh: Evidence from national survey data 2012/2013 and 2019. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Md. Sabbir Ahmed
- Department of Community Health and Hygiene Faculty of Nutrition and Food Science Patuakhali Science and Technology University Patuakhali Bangladesh
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