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Varmaghani M, Pourtaheri A, Ahangari H, Tehrani H. The prevalence of adolescent pregnancy and its associated consequences in the Eastern Mediterranean region: a systematic review and meta-analysis. Reprod Health 2024; 21:113. [PMID: 39085959 PMCID: PMC11292957 DOI: 10.1186/s12978-024-01856-4] [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: 11/11/2023] [Accepted: 07/24/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Adolescent pregnancy is one of the public health problems that both mother and baby suffer from its consequences. This study was conducted to estimate the prevalence and consequences of adolescent pregnancy in the Eastern Mediterranean region. METHODS In this systematic review and meta-analysis, four databases (PubMed, ProQuest, Web of Science and Scopus) were systematically searched for relevant articles published from 1990 to 2022. The screening process for articles was conducted in accordance with the PRISMA guidelines. Joanna Briggs checklists were used to assess the quality of included studies. A random effects model was performed for the meta-analysis. Narrative synthesis of adolescent pregnancy prevalence, as well as a meta-analysis of adolescent pregnancy prevalence was performed using STATA 14. RESULTS The review included 12 studies and 94,189 study participants. The prevalence of adolescent pregnancy was [9% (95% CI 6.9, 11.2, p < 0.001)]. Pregnancy outcomes included preeclampsia [12.9%(95% CI 7.3,18.5, p < 0.001)], low birth weight [16.1%(95% CI 7.4-24.8, p < 0.001)], anemia [33%(95% CI 14.4, 51.7, p < 0.001)], and cesarean delivery [15.9%(95% CI 11.1-20.7, p < 0.001)].The results showed that 16.9% of deliveries were cesarean sections. CONCLUSION The study's findings indicate that adolescent pregnancy is prevalent in the Middle East region and is associated with negative outcomes for teenagers. Therefore, it is necessary to carry out effective interventions to reduce adolescent pregnancy.
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Affiliation(s)
- Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Management and Economy Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asma Pourtaheri
- Ph.D. Candidate of Health Education& Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ahangari
- Ph.D. Candidate of Health Education& Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ren T, Zhang L, Liu Y, Zhang Q, Sun Y, Zhou W, Huang L, Wang M, Pu Y, Huang R, Chen J, He H, Zhu T, Wang S, Chen W, Zhang Q, Du W, Luo Q, Li F. Sex-specific associations of adolescent motherhood with cognitive function, behavioral problems, and autistic-like traits in offspring and the mediating roles of family conflict and altered brain structure. BMC Med 2024; 22:226. [PMID: 38840198 PMCID: PMC11155128 DOI: 10.1186/s12916-024-03442-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Previous studies have linked adolescent motherhood to adverse neurodevelopmental outcomes in offspring, yet the sex-specific effect and underlying mechanisms remain unclear. METHODS This study included 6952 children aged 9-11 from the Adolescent Brain Cognitive Development study. The exposed group consisted of children of mothers < 20 years at the time of birth, while the unexposed group was composed of children of mothers aged 20-35 at birth. We employed a generalized linear mixed model to investigate the associations of adolescent motherhood with cognitive, behavioral, and autistic-like traits in offspring. We applied an inverse-probability-weighted marginal structural model to examine the potential mediating factors including adverse perinatal outcomes, family conflict, and brain structure alterations. RESULTS Our results revealed that children of adolescent mothers had significantly lower cognitive scores (β, - 2.11, 95% CI, - 2.90 to - 1.31), increased externalizing problems in male offspring (mean ratio, 1.28, 95% CI, 1.08 to 1.52), and elevated internalizing problems (mean ratio, 1.14, 95% CI, 0.99 to 1.33) and autistic-like traits (mean ratio, 1.22, 95% CI, 1.01 to 1.47) in female. A stressful family environment mediated ~ 70% of the association with internalizing problems in females, ~ 30% with autistic-like traits in females, and ~ 20% with externalizing problems in males. Despite observable brain morphometric changes related to adolescent motherhood, these did not act as mediating factors in our analysis, after adjusting for family environment. No elevated rate of adverse perinatal outcomes was observed in the offspring of adolescent mothers in this study. CONCLUSIONS Our results reveal distinct sex-specific neurodevelopmental outcomes impacts of being born to adolescent mothers, with a substantial mediating effect of family environment on behavioral outcomes. These findings highlight the importance of developing sex-tailored interventions and support the hypothesis that family environment significantly impacts the neurodevelopmental consequences of adolescent motherhood.
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Affiliation(s)
- Tai Ren
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Lingli Zhang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yongjie Liu
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Qingli Zhang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yunjun Sun
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Wei Zhou
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Like Huang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ming Wang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yiwei Pu
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Runqi Huang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Jingyu Chen
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Hua He
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Tailin Zhu
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Susu Wang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Weiran Chen
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Qianlong Zhang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Wenchong Du
- NTU Psychology, School of Social Sciences, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Qiang Luo
- Institute of Science and Technology for Brain-Inspired Intelligence, Ministry of Education-Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, 220 Handan Road, Shanghai, 200433, China.
| | - Fei Li
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
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Liu Z, Sun L, Yang R, Cui S, Yao G, Liu Y, Liu H. Teenage pregnancy: focus on people with mental disorders. Front Psychiatry 2024; 15:1305572. [PMID: 38370558 PMCID: PMC10869549 DOI: 10.3389/fpsyt.2024.1305572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Affiliation(s)
- Zhiwei Liu
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Liang Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Rongchun Yang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Shu Cui
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Gaofeng Yao
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Yun Liu
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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Diabelková J, Rimárová K, Dorko E, Urdzík P, Houžvičková A, Argalášová Ľ. Adolescent Pregnancy Outcomes and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4113. [PMID: 36901128 PMCID: PMC10002018 DOI: 10.3390/ijerph20054113] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
One of the major social and public health problems in the world is adolescent pregnancy. Adolescent pregnancy is strongly associated to less favorable results for both the mother and the newborn. We conducted this research to ascertain the impact of teenage age on neonatal outcomes and also observed the lifestyles of pregnant teenage girls. We conducted a study of 2434 mothers aged ≤19 years (n = 294) or 20-34 years (n = 2140) who gave birth in 2019-2020 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. The data on mothers and newborn infants have been reported from the reports on mothers at childbirth. Women between the ages of 20 and 34 served as the reference group. The teenage mothers were more likely to become pregnant if they were unmarried (OR = 14.2; 95% CI = 9.3-21.6; p < 0.001) and had a basic education or lack of education (OR = 16.8; 95% CI = 11.5-24.6; p < 0.001). Additionally, they were more likely to smoke when pregnant (OR = 5.0; 95% CI = 3.8-6.6; p < 0.001). Low birth weight was more common in newborns born to adolescent mothers than in those born to adult mothers (p < 0.001). Our findings showed that infants of teenage mothers often had lower birth weights (-332.6 g, p < 0.001). Adolescent mothers were associated with lower Apgar scores at the first minute (p = 0.003). As compared with the control group, pregnant teenage girls had a greater prevalence of preterm deliveries in our research (p = 0.004). This study finds significant age-related disparities in neonatal outcomes between mothers. These results might be used to identify vulnerable groups who need special assistance and actions to reduce the probability of negative outcomes for such groups.
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Affiliation(s)
- Jana Diabelková
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Erik Dorko
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Peter Urdzík
- Department of Gynaecology and Obstetrics, Medical Faculty, Louis Pasteur University Hospital, University of Pavol Jozef Šafárik, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Andrea Houžvičková
- Department of Public Health and Hygiene, Medical Faculty, University of Pavol Jozef Šafárik, Šrobárova 2, 041 80 Košice, Slovakia
| | - Ľubica Argalášová
- Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Špitálska 24, 813 72 Bratislava, Slovakia
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DÖNMEZ A, KARAÇAM Z. Reproductive Health Behaviors of Women Married in the Adolescent Period: A Mixed Method Study. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2023. [DOI: 10.30934/kusbed.1142176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: Adolescent marriages are those that take place before the age of 18 years or before maturity and are associated with a wide range of health and psychological problems. This study was carried out to examine the reproductive health behaviour of women who got married during the adolescent period.
Methods: In this study, convergent parallel design, in which the quantitative and qualitative stages of mixed method designs can be applied simultaneously, was used. This research was carried out with 245 women included in the quantitative section and 25 women in the qualitative section. During the collection of the quantitative data, face-to-face interview and semi-structured interview techniques were used. The data were collected using the content analysis method, and descriptive statistics were used in the analysis of quantitative data.
Results: The mean age at first marriage was 16.1±0.9 (range 12–17) years. Quantitative analysis showed that, to have a healthy delivery, women adopted the practices of healthy life during pregnancy (88.7%), for the birth they maintained nutrition, ensured good hygiene and performed pain coping techniques (95.0%) and maintained personal hygiene during post-partum (69.8%). Analysis of the data collected in the in-depth interview on the women’s practices on sexual life and violence against women, five themes were identified ‘healthy sex life, sexual violence, legal procedures, social support and preventive practices’.
Conclusion: Women who got married at adolescent age had problems with their reproductive health characteristics and reproductive health. Midwives can take an active role in meeting the service needs for this vulnerable group, solving reproductive health problems and improving women’s health during service provision.
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Affiliation(s)
- Ayşegül DÖNMEZ
- İzmir Tınaztepe Üniversitesi Sağlık Bilimleri Fakültesi Ebelik Bölümü
| | - Zekiye KARAÇAM
- AYDIN ADNAN MENDERES ÜNİVERSİTESİ, AYDIN SAĞLIK YÜKSEKOKULU, EBELİK BÖLÜMÜ
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Karai A, Gyurkovits Z, Németh G, Orvos H, Paulik E. Adverse Maternal and Perinatal Outcome of Women Aged 40 Years or Over: A Retrospective Study. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDAdvanced maternal age is traditionally described to be 35 years of age or over. In recent years, new trends have suggested that it may be 40 years of age or over; this occurs in Hungary.AIMThe aim of this study was to determine the association between advanced maternal age and various adverse maternal and neonatal outcomes.METHODSA retrospective analysis was performed among women who delivered between 2015 and 2017. All women aged 40 years or over (cases) were involved into the analysis (n = 374). The controls (n = 378) were randomly selected from women aged 25 to 29 years who delivered during the same period considering the number of previous gestations and previous deliveries. The data collected from the medical records comprised the mothers’ demographic and obstetric characteristics and neonatal data. To assess the contribution of maternal age to various maternal and neonatal outcomes, multiple logistic regression analyses were used.RESULTSThe logistic regression analyses showed higher odds of gestational diabetes (AOR, adjusted odds ratio: 2.81), preeclampsia (AOR: 13.05), threatened preterm delivery (AOR: 3.62), and cesarean section (AOR: 3.31) in mothers of higher age. The odds of low birth weight (AOR: 2.56) and intensive care (AOR: 2.03) were significantly higher in older vs. younger mothers, while no significant associations were between maternal age and fetal macrosomia and congenital malformations.CONCLUSIONSConsidering our results, it is important to educate women about the consequences of delayed childbearing and the need of continuous observation within prenatal care.
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CAN GÜRKAN Ö, ERTUĞRUL ABBASOĞLU D. Preconception Risk Factors and Preconception Care Practices in Turkish Women Sample. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.867563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Karaçam Z, Kizilca Çakaloz D, Demir R. The impact of adolescent pregnancy on maternal and infant health in Turkey: Systematic review and meta-analysis. J Gynecol Obstet Hum Reprod 2021; 50:102093. [PMID: 33592347 DOI: 10.1016/j.jogoh.2021.102093] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/02/2021] [Accepted: 02/08/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To examine the impact of adolescent pregnancy on maternal and infant health on the basis of studies conducted in Turkey. MATERIAL AND METHODS Systematic reviews and meta-analyses of cross-sectional and case-control. A systematic scan was performed in January 2020 based on the keywords "adolescent pregnancy or teenage pregnancy and Turkey" in the electronic databases PubMed, Clinical Key, Science Direct, Web of Science, Google Scholar, National Thesis Center, DergiPark, Ulakbim, Turkish Medline and Turkish Clinics. Two of the authors carried out a scan independently of each other, making a selection of articles, performing data extraction and quality assessment procedures under the supervision of the senior researcher. RESULTS The results of a total of 38 studies, of which twenty-three were cross-sectional and 15 were case-control, were compiled for the meta-analysis (adolescents: 20,768; control: 59,481). The results of the meta-analysis showed that the more common effects of adolescent pregnancies were preterm birth (OR: 2.12, p < 0.001), early membrane rupture (OR: 1.49, p < 0.001), anemia (OR: 2.60, p < 0.001), low birthweight/intrauterine growth retardation (OR: 2.06, p < 0.001), and fetal distress (OR: 1.78, p = 0.003). On the other hand, it was observed in the meta-analysis that childbirth by cesarean section (OR: 0.70, p < 0.001), gestational diabetes (OR: 0.35, p < 0.001), placenta previa (OR: 0.52, p = 0.01), polyhydramnios (OR: 0.52, p = 0.04) and macrosomia (OR: 0.54, p < 0.001) were less common among adolescents compared to adults. CONCLUSION Our review revealed that adolescent pregnancy had an adverse impact on maternal and infant health in terms of preterm childbirth, early membrane rupture, anemia, low birthweight/intrauterine growth retardation, low Apgar scores and fetal distress.
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Affiliation(s)
- Zekiye Karaçam
- Aydın Adnan Menderes University, Faculty of Health Sciences, Division of Midwifery, Aydın, Turkey.
| | - Damla Kizilca Çakaloz
- Aydın Adnan Menderes University, Faculty of Health Sciences, Division of Midwifery, Aydın, Turkey.
| | - Rukiye Demir
- Aydın Adnan Menderes University, Health Sciences Institute, Division of Midwifery, Aydın, Turkey.
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Macedo TC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, Laganà AS, Bianco B. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol 2020; 248:177-186. [DOI: 10.1016/j.ejogrb.2020.03.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
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Solanke BL, Salau OR, Popoola OE, Adebiyi MO, Ajao OO. Socio-demographic factors associated with delayed childbearing in Nigeria. BMC Res Notes 2019; 12:374. [PMID: 31262350 PMCID: PMC6604434 DOI: 10.1186/s13104-019-4414-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 06/26/2019] [Indexed: 11/21/2022] Open
Abstract
Objective Delayed childbearing is an emerging public health issue in developing countries compared with more developed countries, where it is already a major clinical and public health concern. Previous studies have mostly focused on either the health risks associated with delayed childbearing or the reasons for it with little done around the socio-demographic factors associated with it in developing countries. The objective of the study was to examine associated socio-demographic factors of delayed childbearing in Nigeria. Results The study used secondary data pooled from 2003 to 2013 Nigeria Demographic and Health Surveys. The outcome variable was delayed childbearing. The explanatory variables are selected individual socio-demographic characteristics and community characteristics. A weighted sample size of 20,550 women was analysed. Results showed a prevalence of 8.0% delayed childbearing in Nigeria. Socio-demographic factors such as higher maternal education, age at first marriage of 25 years or older, modern contraceptive use, and remarriage status were significantly associated with delayed childbearing. Significant associations were also observed with high community literacy level and high proportion of women who ever used modern contraceptive in the community.
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Affiliation(s)
- Bola Lukman Solanke
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | | | | | - Munirat Olayinka Adebiyi
- Obafemi Awolowo University Teaching Hospital Complex, Obafemi Awolowo University, Ile-Ife, Nigeria
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Karataşlı V, Kanmaz AG, İnan AH, Budak A, Beyan E. Maternal and neonatal outcomes of adolescent pregnancy. J Gynecol Obstet Hum Reprod 2019; 48:347-350. [PMID: 30794955 DOI: 10.1016/j.jogoh.2019.02.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/29/2019] [Accepted: 02/19/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To examine the maternal and neonatal outcomes of adolescent pregnancies. METHODS Deliveries that occurred in a high-volume tertiary center between January 2013 and December 2016 were retrospectively analyzed. We studied pregnant women who were under 19 years of age at the time at which they gave birth, and who underwent regular follow-up. Pregnancies associated with chromosomal abnormalities, early pregnancy losses (before 20 weeks), and ectopic pregnancies were excluded. RESULTS In all, 101 pregnant women aged <15 years and 3611 aged 15-19 years were enrolled. The control group contained 13,501 randomly selected pregnant women aged 25-30 years. The median gestational week at delivery was lower in adolescents. Adolescent pregnancies were associated with higher rates of threatened abortion and pre-eclampsia. Gestational diabetes mellitus was less common, whereas the risk for cesarean section was higher, in adolescents. In addition, women aged <15 years were at higher risk for preterm delivery. The rates of <3rd percentile birth weight percentiles by gestational age were 6.9%, 5.1%, 4.2% and <10th percentile were 16.8%, 14.5%, 11% in the three groups, respectively. The 5 min Apgar scores were lower for the babies of adolescents, and the requirement of newborn intensive care was higher for the infants of mothers aged <15 years. CONCLUSION Adolescent pregnancy is a significant issue worldwide. Adverse outcomes differ among study populations, but both preterm delivery and low birth weight are of concern, as are a higher cesarean rate.
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Affiliation(s)
- Volkan Karataşlı
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey.
| | - Ahkam Göksel Kanmaz
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | | | - Adnan Budak
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | - Emrah Beyan
- University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
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Cebert M, Silva S, Stevenson EL. Are There Differences in Marital-Role Quality between Women and Their Male Partners Who Conceived Via IVF and Those Who Did Not? JOURNAL OF BEST PRACTICES IN HEALTH PROFESSIONS DIVERSITY : RESEARCH, EDUCATION AND POLICY 2019; 11:135-149. [PMID: 32879925 PMCID: PMC7462718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Marital-role quality (MRQ) is a predictor of mental well-being, sexual intimacy, and maternal attachment. Data on differences in MRQ during pregnancy between women and their male partners who conceived spontaneously or via IVF are inconclusive. This study compared MRQ across pregnancy in these two groups. METHODS The sample's two groups: (a) 26 women and 26 male partners who conceived via IVF; and (b) 25 women and 20 male partners who conceived spontaneously. All 97 participants completed a MRQ scale during each trimester of pregnancy. Trajectory analyses were conducted to test for between-group differences in the changes in subscales across pregnancy within dyads. RESULTS Scores did not reveal any significant differences in subscales in those who conceived via IVF compared to non-IVF groups across the three trimesters in each dyad. The observed effect sizes were small, with exception that males in the non-IVF comparison group had greater concerns during the first trimester than did males in the IVF group (Cohen d= 0.51, moderate effect size). CONCLUSIONS Though the IVF population perceives pregnancy differently and experiences more anxiety than those who conceive spontaneously, their marital-role quality during pregnancy does not seem to be affected. Their perceptions before conception and in early parenting are worthy of investigation.
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Affiliation(s)
- Morine Cebert
- School of Nursing, Duke University, Durham, North Carolina
| | - Susan Silva
- School of Nursing, Duke University, Durham, North Carolina
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Arya S, Mulla ZD, Plavsic SK. Outcomes of Women Delivering at Very Advanced Maternal Age. J Womens Health (Larchmt) 2018; 27:1378-1384. [DOI: 10.1089/jwh.2018.7027] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sushila Arya
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | - Zuber D. Mulla
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | - Sanja Kupesic Plavsic
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
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14
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Garner AJ, Robertson A, Thornton C, Lee G, Makris A, Middleton S, Sullivan C, Hennessy A. Adolescent Perinatal Outcomes in South West Sydney, Australia. Mayo Clin Proc Innov Qual Outcomes 2018; 2:10-15. [PMID: 30225427 PMCID: PMC6124333 DOI: 10.1016/j.mayocpiqo.2018.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To compare perinatal outcomes, blood pressures throughout pregnancy, rates of hypertensive disorders of pregnancy, preeclampsia, gestational diabetes mellitus, and immediate obstetric outcomes in adolescents younger than 20 years at delivery and those in the 20- to 34-year age group. Patients and Methods Questionnaires were administered to pregnant women at Campbelltown and Liverpool hospitals within South West Sydney, Australia, as part of a broader study of sleep-disordered breathing in pregnancy between February 1, 2009, and February 28, 2013. Data collected included demographic data, blood pressure readings, pregnancy complications, delivery type, and neonatal outcomes. Adolescents were compared with older women using Student t tests and χ2 statistics. Results A total of 103 adolescents were compared with 2291 women aged 20 to 34 years. Adolescents were more likely to be primiparous, had longer average gestations, and had lower pre-pregnancy body mass index. Adolescents had lower rates of cesarean section delivery and gestational diabetes mellitus. There was no significant difference in smoking rates, perinatal mortality rate, small for gestational age, intrauterine growth restriction, Apgar score of less than 7 at 5 minutes, admission to special care nursery, or hypertensive disorder of pregnancy rates. Adolescents had lower booking systolic and diastolic blood pressures, and their highest antenatal systolic blood pressures were lower. Conclusion Adolescents have birth outcomes to similar to those of their older counterparts. Adolescents had lower booking blood pressures. This may have implications for the screening and diagnosis of hypertensive disorders of pregnancy in adolescents.
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Affiliation(s)
- Alexander J. Garner
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
- Correspondence: Address to Alexander J. Garner, MBBS, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Annette Robertson
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Charlene Thornton
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Gaksoo Lee
- Liverpool Hospital, Liverpool, NSW, Australia
| | - Angela Makris
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Sally Middleton
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Colin Sullivan
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Gerlich J, Benecke N, Peters-Weist AS, Heinrich S, Roller D, Genuneit J, Weinmayr G, Windstetter D, Dressel H, Range U, Nowak D, von Mutius E, Radon K, Vogelberg C. Pregnancy and perinatal conditions and atopic disease prevalence in childhood and adulthood. Allergy 2018; 73:1064-1074. [PMID: 29193127 DOI: 10.1111/all.13372] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Previous studies showed controversial results for the influence of pregnancy-related and perinatal factors on subsequent respiratory and atopic diseases in children. The aim of this study was to assess the association between perinatal variables and the prevalence of asthma, bronchial hyperreactivity (BHR), flexural eczema (FE), allergic rhinitis, and sensitization in childhood and early adulthood. METHODS The studied population was first examined in Munich and Dresden in 1995/1996 at age 9-11 years. Participants were followed until age 19-24 years using questionnaires and clinical examinations. Associations between perinatal data and subsequent atopic diseases were examined using logistic regression analyses adjusting for potential confounders. RESULTS Cesarean section was statistically significantly associated with BHR in early adulthood (odds ratio 4.8 [95% confidence interval 1.5-15.2]), while assisted birth was associated with presence of asthma symptoms in childhood (2.2 [1.2-3.9]), FE symptoms (2.2 [1.2-4.3]) and doctor's diagnosis of atopic dermatitis (1.9 [1.0-3.4]) in childhood, and sensitization in early adulthood (2.2 [1.1-4.3]). Lower birth length (1.9 [1.1-3.2]), lower birthweight (0.5 [0.3-0.9]), and higher birthweight (0.6 [0.4-1.0]) were predictive of sensitization in early adulthood compared to average birth length and birthweight, respectively. None of the other perinatal factors showed statistically significant associations with the outcomes. CONCLUSIONS Our results indicate that children who are born by cesarean section and especially by assisted birth, might be at greater risk for developing asthma, FE, and sensitization and should hence be monitored. Prenatal maternal stress might partly explain these associations, which should be further investigated.
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Affiliation(s)
- J. Gerlich
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
- Comprehensive Pneumology Center Munich; German Center for Lung Research; Munich Germany
| | - N. Benecke
- Paediatric Department; University Hospital Carl Gustav Carus, TU Dresden; Dresden Germany
| | - A. S. Peters-Weist
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
| | - S. Heinrich
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
| | - D. Roller
- Paediatric Department; University Hospital Carl Gustav Carus, TU Dresden; Dresden Germany
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - G. Weinmayr
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - D. Windstetter
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
| | - H. Dressel
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
- Institute for Epidemiology, Biostatistics and Prevention; Zürich University; Zürich Switzerland
| | - U. Range
- Institute for Medical Informatics and Biometry; Medical Faculty; “Carl Gustav Carus”, TU; Dresden Germany
| | - D. Nowak
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
- Comprehensive Pneumology Center Munich; German Center for Lung Research; Munich Germany
| | - E. von Mutius
- Comprehensive Pneumology Center Munich; German Center for Lung Research; Munich Germany
- Dr v Haunersches Kinderspital; University Hospital, LMU Munich; Munich Germany
| | - K. Radon
- Institute and Clinic for Occupational, Social, and Environmental Medicine; University Hospital, LMU Munich; Munich Germany
- Comprehensive Pneumology Center Munich; German Center for Lung Research; Munich Germany
| | - C. Vogelberg
- Paediatric Department; University Hospital Carl Gustav Carus, TU Dresden; Dresden Germany
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Patel R, Moffatt JD, Mourmoura E, Demaison L, Seed PT, Poston L, Tribe RM. Effect of reproductive ageing on pregnant mouse uterus and cervix. J Physiol 2017; 595:2065-2084. [PMID: 28083928 PMCID: PMC5350451 DOI: 10.1113/jp273350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/13/2016] [Indexed: 12/30/2022] Open
Abstract
KEY POINTS Older pregnant women have a greater risk of operative delivery, still birth and post-term induction. This suggests that maternal age can influence the timing of birth and processes of parturition. We have found that increasing maternal age in C57BL/6J mice is associated with prolongation of gestation and length of labour. Older pregnant mice also had delayed progesterone withdrawal and impaired myometrial function. Uterine ageing and labour dysfunction should be investigated further in older primigravid women. ABSTRACT Advanced maternal age (≥35 years) is associated with increased rates of operative delivery, stillbirth and post-term labour induction. The physiological causes remain uncertain, although impaired myometrial function has been implicated. To investigate the hypothesis that maternal age directly influences successful parturition, we assessed the timing of birth and fetal outcome in pregnant C57BL/6J mice at 3 months (young) and 5 months (intermediate) vs. 8 months (older) of age using infrared video recording. Serum progesterone profiles, myometrium and cervix function, and mitochondrial electron transport chain complex enzymatic activities were also examined. Older pregnant mice had a longer mean gestation and labour duration (P < 0.001), as well as reduced litter size (P < 0.01) vs. 3-month-old mice. Older mice did not exhibit the same decline in serum progesterone concentrations as younger mice. Cervical tissues from older mice were more distensible than younger mice (P < 0.05). Oxytocin receptor and connexin-43 mRNA expression were reduced in the myometrium from 8-month-old vs. 3-month-old mice (P < 0.05 and P < 0.01 respectively) in tandem with more frequent but shorter duration spontaneous myometrial contractions (P < 0.05) and an attenuated contractile response to oxytocin. Myometrial mitochondrial copy number was reduced in older mice, although there were no age-induced changes to the enzymatic activities of the mitochondrial electron transport chain complexes. In conclusion, 8-month-old mice provide a useful model of reproductive ageing. The present study has identified potential causes of labour dysfunction amenable to investigation in older primigravid women.
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Affiliation(s)
- Rima Patel
- Division of Women's Health, King's College London, Women's Health Academic CentreKing's Health PartnersSt Thomas' HospitalLondonUK
| | - James D. Moffatt
- Division of Biomedical SciencesSt George's University of LondonLondonUK
| | - Evangelia Mourmoura
- Université Joseph FourierLaboratoire de Bioénergétique Fondamentale et AppliquéeGrenobleFrance
| | - Luc Demaison
- Unité de Nutrition Humaine, INRA, UMR 1019, Clermont UniversitéUniversité d'AuvergneClermont‐FerrandFrance
| | - Paul T. Seed
- Division of Women's Health, King's College London, Women's Health Academic CentreKing's Health PartnersSt Thomas' HospitalLondonUK
| | - Lucilla Poston
- Division of Women's Health, King's College London, Women's Health Academic CentreKing's Health PartnersSt Thomas' HospitalLondonUK
| | - Rachel M. Tribe
- Division of Women's Health, King's College London, Women's Health Academic CentreKing's Health PartnersSt Thomas' HospitalLondonUK
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Affiliation(s)
- Bola Lukman Solanke
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
- Demography and Population Studies Programme, University of the Witwatersrand, Johannesburg, South Africa
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Cakmak Celik F, Aygun C, Kucukoduk S, Bek Y. Maternal and neonatal outcomes in advanced maternal age: a retrospective cohort study. J Matern Fetal Neonatal Med 2016; 30:2452-2456. [PMID: 27806665 DOI: 10.1080/14767058.2016.1253058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To describe the effect of extremely advanced maternal age (EAMA) on maternal/neonatal outcomes. METHODS This was a case-control study in which 127 women ≥40 years at the time of delivery out of 2853 singleton hospital deliveries in Ondokuz Mayis University between 1 January 2008 and 31 August 2010 constituted the study group. One hundred and twenty-seven else were chosen randomly out of 2412, 21-35 years old women, via a computer system as controls. Demographic features of 254 mothers and infants as well as maternal and neonatal complications were recorded. RESULTS Mean maternal age was 41.5 ± 1.9 (40-49) years in EAMA group and 28.9 ± 4.2 (21-35) years in controls. Primigravidity was 19.6% in the EAMA group, whereas 37.8% in controls (p = 0.003). No difference was found between groups according to route of delivery, stillbirth, preterm birth, congenital abnormalities, gender of babies, NICU admission and respiratory problems (for all p > 0.05). A 5th min Apgar score <7 was more frequent in babies born to EAMA mothers compared to controls (9.8% versus 4.9%, p = 0.004). CONCLUSION The present study shows that EAMA mothers and their offsprings have similar peri and neonatal risks compared to younger mothers, except lower 5th minute Apgar scores. We conclude that with good perinatal care, EAMA women and their babies can pass through the perinatal period with similar risks of younger women.
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Affiliation(s)
- Fatma Cakmak Celik
- a Faculty of Medicine , Department of Pediatrics, Neonatalogy Division and
| | - Canan Aygun
- a Faculty of Medicine , Department of Pediatrics, Neonatalogy Division and
| | - Sukru Kucukoduk
- a Faculty of Medicine , Department of Pediatrics, Neonatalogy Division and
| | - Yuksel Bek
- b Faculty of Medicine , Department of Biostatistics, Ondokuz Mayis University , Samsun , Turkey
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19
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Zapata-Masias Y, Marqueta B, Gómez Roig MD, Gonzalez-Bosquet E. Obstetric and perinatal outcomes in women ≥40years of age: Associations with fetal growth disorders. Early Hum Dev 2016; 100:17-20. [PMID: 27391869 DOI: 10.1016/j.earlhumdev.2016.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Evidence indicates that advanced maternal age is associated with adverse obstetric and perinatal outcomes. The purpose of this study was to evaluate pregnancy outcomes in women of advanced maternal age (≥40years). METHODS Using a prospective study design, data were collected by the Department of Obstetrics at the San Joan de Deu Hospital of Barcelona during the 1 June 2009 to 31 May 2012 period. The results were compared across three maternal age groups (≥40 [n=654], 35-39 [n=2781], and <35 [n=7893] years). RESULTS Of the 11328 births recorded during the study period, pregnancy-related complications were more common in women ≥40years of age. The most common disorder was diabetes (8.5% in the ≥40, 5.3% in the 35-39, and 3.0% in the <35years age groups). The women ≥40years of age also had significantly more premature births (p=0.001) and cesarean sections (17% in the ≥40, 12.5% in the 35-39, and 7.9% in the <35-year age groups; p=0.001). Intrauterine growth retardation was significantly more frequent in women aged ≥40years (17.4% in the ≥40, 15% in the 35-39, and 14.0% in the <35-year age groups; p=0.03). Fetal macrosomia was significantly more common in women ≥40years (15.4% in the ≥40, 12.6% in the 35-39, and 12% in the <35-year age groups; p=0.03). CONCLUSION Maternal age ≥40years was associated with poorer obstetric and perinatal outcomes and increased the risks of cesarean section, intrauterine growth retardation, and fetal macrosomia.
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Affiliation(s)
- Yesenia Zapata-Masias
- BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Deu, University of Barcelona, Pg. Sant Joan de Deu, nº 2 Esplugues, 08950, Barcelona, Spain.
| | - Belén Marqueta
- BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Deu, University of Barcelona, Pg. Sant Joan de Deu, nº 2 Esplugues, 08950, Barcelona, Spain.
| | - M D Gómez Roig
- BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Deu, University of Barcelona, Pg. Sant Joan de Deu, nº 2 Esplugues, 08950, Barcelona, Spain.
| | - Eduardo Gonzalez-Bosquet
- BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Deu, University of Barcelona, Pg. Sant Joan de Deu, nº 2 Esplugues, 08950, Barcelona, Spain.
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20
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Richards MK, Flanagan MR, Littman AJ, Burke AK, Callegari LS. Primary cesarean section and adverse delivery outcomes among women of very advanced maternal age. J Perinatol 2016; 36:272-7. [PMID: 26741572 DOI: 10.1038/jp.2015.204] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 11/09/2015] [Accepted: 11/19/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess associations between primary cesarean delivery and adverse delivery outcomes with very advanced maternal age. STUDY DESIGN We conducted a population-based cohort study including 78,880 births to mothers 25 years and older with singleton births from 2003 to 2012 using Washington State birth certificates and hospital discharge data, excluding births to women with a prior cesarean section. The primary outcome was mode of delivery. Secondary outcomes included maternal transfusion, chorioamnionitis, severe perineal lacerations and prolonged length of stay. Outcomes of births to women of advanced maternal age (35 to 39, 40 to 44) and very advanced maternal age (45 to 49, ⩾50) were compared with referent births among women aged 25 to 34 years. General linear models with a log-link function were used to calculate unadjusted and adjusted relative risks and 95% confidence intervals (CIs). RESULT Proportions and risks of primary cesarean section increased with age (25 to 34 years, referent: 20.0%; 35 to 39 years: 25.9%, relative risk (RR)=1.25 (95% CI=1.20 to 1.29); 40 to 44 years: 30.9%, RR=1.45 (95% CI=1.40 to 1.50); 45 to 49 years: 35.7%, RR=1.59 (95% CI=1.45 to 1.75); and ⩾50 years: 60.7%, RR=2.44 (95% CI=1.95 to 3.05); P-trend <0.001). Associations did not differ between primiparous and multiparous women. No differences were noted for measures of maternal morbidity, except there was a trend of increasing risk of prolonged length of stay among births to older women (P-trend <0.001). CONCLUSION Primary cesarean delivery risk continues to increase above age 35 regardless of prior vaginal birth, with the highest risk among women aged 50 years and older.
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Affiliation(s)
- M K Richards
- Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - M R Flanagan
- Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - A J Littman
- Seattle Epidemiologic Research and Information Center, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA, USA.,Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.,Health Services Research and Development, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA, USA
| | - A K Burke
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
| | - L S Callegari
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.,Health Services Research and Development, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA, USA.,Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
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21
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Knowledge, attitudes and practices of adolescents in Upper Egypt on gender-based violence, with a focus on early girls' marriage. J Egypt Public Health Assoc 2015; 90:109-14. [PMID: 26544839 DOI: 10.1097/01.epx.0000471203.34165.bd] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A large proportion of the female population all over the world, particularly in developing countries, experience some form of gender-based violence (GBV) during their life. Early marriage, a form of GBV, is particularly highly prevalent in rural Upper Egypt. OBJECTIVES The aim of the current study was to assess the knowledge, attitudes and practices (KAP) of adolescents in Upper Egypt on domestic GBV, with a focus on early girls' marriage. PARTICIPANTS AND METHODS The study was a cross-sectional descriptive household survey targeting 400 randomly selected adolescent boys and girls aged 11-16 years from five villages of Minya Governorate in Upper Egypt. RESULTS The proportion of interviewed adolescents who could identify certain practices as forms of GBV was relatively low: the identified practices were mainly deprivation of work (9.0%), deprivation of inheritance (3.3%), arbitrary neglect and desertion (2.8%), and preventing from visiting relatives (0.5%). Abusive sexual behavior was not identified by any of the study participants as a form of domestic GBV. A total of 112 boys (56.0%) reported that they have been perpetrators in domestic GBV events at least once and 118 girls (59.0%) reported that they have been actual victims of domestic GBV. An overall 65.6% of study participants could correctly identify the legal age of marriage as 18 years, yet only 22.0% identified earlier ages of marriage as a form of domestic GBV. The vast majority of girls and boys reported that they would not agree to get married before the age of 18 years (91.0 and 87.0%, respectively). CONCLUSION AND RECOMMENDATIONS Adolescents in Upper Egypt demonstrated a less than satisfactory knowledge about the forms of GBV. Although early girls' marriage was not universally recognized by adolescents as a form of domestic GBV, they demonstrated satisfactory knowledge about the legal age of marriage, as well as a tendency to abandon the practice. Establishing a community-based awareness program for adolescents of both sexes about GBV with a focus on early girls' marriage is highly recommended.
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Chevrette M, Abenhaim HA. Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States? J Pediatr Adolesc Gynecol 2015; 28:354-61. [PMID: 26148786 DOI: 10.1016/j.jpag.2014.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 09/05/2014] [Accepted: 10/15/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. METHODS We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. RESULTS The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P < .0001) and ethnic distribution of the population were the only variables associated with a difference between mean teen births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. CONCLUSION While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates.
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Affiliation(s)
- Marianne Chevrette
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada
| | - Haim Arie Abenhaim
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.
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23
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Berhan Y, Berhan A. A meta-analysis of socio-demographic factors for perinatal mortality in developing countries: a subgroup analysis of the national surveys and small scale studies. Ethiop J Health Sci 2015; 24 Suppl:41-54. [PMID: 25489182 PMCID: PMC4249208 DOI: 10.4314/ejhs.v24i0.5s] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although the perinatal mortality in low income countries is about five-folds higher than in the high income countries, little is known about the association of socio-demographic factors with perinatal mortality. National and small scale studies so far reported have shown very contradictory results. The objective of this meta-analysis was to assess the association of perinatal mortality with selected sociodemographic factors. METHODS A computer based literature search was conducted mainly in the databases of African Journals Online, MEASURE Demographic and Health Survey (DHS), Google Scholar, HINARI, PUBMED, MEDLINE and the Cochrane Library. The inclusion criteria were: 1) studies that assessed the perinatal mortality in developing countries in relation to socio-demographic predictors and 2) studies published in English and conducted after the year 1990. Subgroup meta-analyses of perinatal mortality were performed for mothers' age, residence, educational level and wealth status. Sensitivity analysis and heterogeneity testing were done. RESULTS In this meta-analysis, several inconsistent associations of perinatal mortality with the selected socio-demographic variables were observed in the primary studies level, both DHS and small scale studies. However, the overall odds ratio (OR) demonstrated statistically significant association of perinatal mortality with low maternal age (OR=1.2) and short birth interval (OR=1.4) but was not influenced by the mothers' residence, low educational level and household wealth index. Very consistently, the highest perinatal mortality rates reported when the birth intervals were either too short (<15 months) or too long (>39 months). CONCLUSION Because of the disagreement among previous studies, the present study demonstrated a small effect size on the increased risk of perinatal mortality among women who were pregnant during teenage ages and gave birth too frequently or after a long interval. Therefore, to confirm the strong predictors of perinatal mortality, further studies on sociodemographic factors are needed.
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Affiliation(s)
- Yifru Berhan
- Hawassa University, College of Medicine and Health Sciences, Department of Gynecology-Obstetrics
| | - Asres Berhan
- Hawassa University, College of Medicine and Health Sciences, Department of Pharmacology
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Kaplanoglu M, Bülbül M, Konca C, Kaplanoglu D, Tabak MS, Ata B. Gynecologic age is an important risk factor for obstetric and perinatal outcomes in adolescent pregnancies. Women Birth 2015. [PMID: 26205092 DOI: 10.1016/j.wombi.2015.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Adolescent pregnancy is an important public health problem. Physiological maturity affects obstetric and perinatal outcomes. Almost all assessments of adolescent pregnancies are based on chronological age. Gynecologic age (GA) is defined as age in years at conception minus age at menarche and it is an indicator of physiological maturity. AIM To compare obstetric and perinatal outcomes between adult and adolescent pregnancies as categorized according to GA. METHODS In this retrospective study, 233 adolescent pregnant women were divided into two groups based on GA≤3 years (101 women) and GA>3 years (132 women). Their obstetric and perinatal results were compared with 202 adult pregnancies who gave birth in the same period. FINDINGS Gestational age at delivery, APGAR scores, birth weight, and incidence of preterm birth, admission to neonatal intensive care unit (NICU), intrauterine growth restriction, low birth weight, and premature rupture of membranes were significantly different between the study groups. Compared to adolescent pregnancies with GA>3 years, adolescent pregnancies with GA≤3 years had significantly lower birth weight, gestational age, APGAR scores, and significantly higher incidence of intrauterine growth restriction, low birth weight and admission to NICU. CONCLUSION Low GA is associated with an increased rate of obstetric and perinatal complications in adolescent pregnancies. Although the main aim is the prevention of adolescent pregnancies, a detailed evaluation of such pregnancies including determination of the gynecological age together with a multidisciplinary approach may decrease potential complications.
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Affiliation(s)
- Mustafa Kaplanoglu
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey.
| | - Mehmet Bülbül
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Capan Konca
- Adiyaman University School of Medicine, Department of Pediatrics, Adiyaman, Turkey
| | - Dilek Kaplanoglu
- Adiyaman University Education and Research Hospital, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Mehmet Selcuk Tabak
- Adiyaman University School of Medicine, Department of Obstetric and Gynecology, Adiyaman, Turkey
| | - Barıs Ata
- Koç University School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Hoffman L, Bann C, Higgins R, Vohr B. Developmental outcomes of extremely preterm infants born to adolescent mothers. Pediatrics 2015; 135:1082-92. [PMID: 25963007 PMCID: PMC4444804 DOI: 10.1542/peds.2014-3880] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers <20 compared with adult mothers ≥20 years and to identify socioeconomic risk factors that affect outcomes. METHODS Retrospective cohort analysis of 211 infants >27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18- to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) ≥75th percentile. RESULTS Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived ≥3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/P ≥75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores <85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P ≥75th percentile (relative risk 1.50, 95% confidence interval 1.08-2.07). Living ≥3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite <70 and neurodevelopmental impairment. CONCLUSIONS ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers.
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Affiliation(s)
- Laurie Hoffman
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island;
| | - Carla Bann
- Statistics and Epidemiology, RTI International, Research Triangle Park, North Carolina; and
| | - Rosemary Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Betty Vohr
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
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Alouini S, Randriambololona D, Randriamboavonjy R. Facteurs de risques de la grossesse, de l’accouchement et du post-partum des adolescentes dans le département du Loiret. ACTA ACUST UNITED AC 2015; 44:443-50. [DOI: 10.1016/j.jgyn.2014.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 06/30/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
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Revisit of risk factors for major obstetric hemorrhage: insights from a large medical center. Arch Gynecol Obstet 2015; 292:819-28. [DOI: 10.1007/s00404-015-3725-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/13/2015] [Indexed: 11/25/2022]
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Cheng HR, Walker LO, Brown A, Lee JY. Gestational weight gain and perinatal outcomes of subgroups of Asian-American women, Texas, 2009. Womens Health Issues 2015; 25:303-11. [PMID: 25840929 DOI: 10.1016/j.whi.2015.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 12/31/2014] [Accepted: 01/12/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Asian-American subgroups are heterogeneous, but few studies had addressed differences on gestational weight gain (GWG) and perinatal outcomes related to GWG among this growing and diverse population. The purposes of this study were to examine whether Asian-American women are at higher risk of inadequate or excessive GWG and adverse perinatal outcomes than non-Hispanic White (NH-White) women, and to compare those risks among Asian-American subgroups. METHODS This retrospective study included all singleton births to NH-Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnam, and NH-White women documented in 2009 Texas birth certificate data (N = 150,674). Data were analyzed using the χ(2) test, t test, multinomial logistic regression, and binary logistic regression. Chinese women were the reference group in the comparisons among Asian subgroups. FINDINGS Asian women had a higher risk of inadequate GWG and gestational diabetes mellitus (GDM) than NH-White women. No difference in the odds of excessive GWG was found among Asian subgroups, although Japanese women had the highest risk of inadequate GWG. After adjusting for confounders, Korean women had the lowest risk of GDM (adjusted odds ratio [AOR], 0.49), whereas Filipino women and Asian Indian had the highest risks of gestational hypertension (AOR, 2.01 and 1.61), cesarean birth (AOR, 1.44 and 1.39), and low birth weight (AOR, 1.94 and 2.51) compared with Chinese women. CONCLUSIONS These results support the heterogeneity of GWG and perinatal outcomes among Asian-American subgroups. The risks of adverse perinatal outcomes should be carefully evaluated separately among Asian-American subpopulations.
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Affiliation(s)
- Hsiu-Rong Cheng
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.
| | | | - Adama Brown
- The University of Texas at Austin, School of Nursing, Austin, Texas
| | - Ju-Young Lee
- The University of Texas at Austin, School of Nursing, Austin, Texas
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Jeha D, Usta I, Ghulmiyyah L, Nassar A. A review of the risks and consequences of adolescent pregnancy. J Neonatal Perinatal Med 2015; 8:P417103117P323W4. [PMID: 25766198 DOI: 10.3233/npm-15814038] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the risks and consequences of young maternal age on both the mother and the newborn. STUDY DESIGN A comprehensive literature review on the risks and consequences of adolescent pregnancy was performed. RESULTS Young maternal age is associated with an increased risk of maternal anemia, infections, eclampsia and preeclampsia, emergency cesarean delivery, postpartum depression and inadequate breastfeeding initiation. Infants of teenage mothers are more likely to be premature and have a low birth weight, and are at an increased risk for respiratory distress syndrome and autism later in life. CONCLUSIONS Adolescent pregnancy is a prevalent phenomenon associated with increased risks of both maternal and neonatal complications during and after pregnancy. Being aware of such adverse outcomes is imperative to improving prenatal and perinatal care. Pregnancy progression can also be influenced by the mother's culture, environment, and economic status; advancement in which may be a possible course for future improvement.
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Affiliation(s)
- D Jeha
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - I Usta
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Ghulmiyyah
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Nassar
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Banchani E, Tenkorang EY. Occupational Types and Antenatal Care Attendance Among Women in Ghana. Health Care Women Int 2014; 35:1040-64. [DOI: 10.1080/07399332.2014.919581] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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