Search

Objectives. We sought to describe the reproductive health of adolescent girls perinatally infected with HIV, Methods. We estimated the incidence of first pregnancy, genital infections, and abnormal cervical cytology for 638 girls aged 13 years and older in the Pediatric AIDS Clinical Trials Group protocol 219C. Results. Thirty-eight girls became pregnant, for a first pregnancy rate of 18.8/ 1000 person-years; 7 of these girls had additional pregnancies (95% confidence interval [Cl] = 13.3, 25.7). Thirty-two pregnancies resulted in live births. All girls received antiretroviral therapy during pregnancy. One infant was HIV infected, 29 were uninfected. and 2 had unknown infection status, for a rate of mother-to-child transmission of HIV in infants with known infection status of 3.3% (95% CI = 0.1, 18.6). Condylomata and trichomoniasis were the most frequent genital infections. Forty-eight (47.5%) of 101 girls with Papanicolaou test examinations had abnormal cervical cylology, including atypical cells of undetermined significance (n= 181, low-grade squamous intraepithelial lesions (SIL; n = 27), and high-grade SIL (n = 3). Many abnormalities persisted despite intervention. Conclusions. Pregnancy rates were lower and cervical abnormalities were higher than among non-HIV-infected adolescents. These findings underscore the importance of Papanicolaou tests and promotion of safer sexual practices in this population. {Am J Public Health. 2007;97:1047-1052. doi:10.2105/AJPH.2005.071910> [ABSTRACT FROM AUTHOR]

Abstract: We evaluated a comprehensive program of prenatal and postpartum nurse home visitation for socially disadvantaged women bearing first children. Eighty-five per ¢ of the participating women were either teenagers (< 19 years at registration), unmarried, or of low socioeconomic status. Women were randomly assigned to either nurse home visitation or comparison services (free transportation for prenatal and well-child care and/or sensory and developmental screening for the child). During the first four years after delivery of their first child, in contrast to their counterparts in the comparison group, nurse-visited White women who had not graduated from high school when they registered in the study returned to school more rapidly; nurse-visited, poor, unmarried White women showed an 82 per ¢ increase in the number of months they were employed, had 43 per ¢ fewer subsequent pregnancies, and postponed the birth of second children an average of 12 months longer. [ABSTRACT FROM AUTHOR]

A study of premarital pregnancy in all women under 30 living in a single county who first married in 1968 is reported. The proportion of brides pregnant at marriage declined with higher age at marriage and with increased education. During the year of study the out-of-wedlock births were only about one-third of the total premarital pregnancies. [ABSTRACT FROM AUTHOR]

We sought to determine which factors influence the association between menarche and conception among adolescent study participants (n = 1030), who demonstrated an earlier age of menarche than did national samples. Age at first sexual intercourse (coitarche) mediated the relationship between age at menarche and first pregnancy among White girls, whereas gynecologic age at coitarche (age at coitarche minus age at menarche) and age at menarche explained the timing of the first pregnancy among Black and Hispanic girls. Pregnancy prevention interventions to delay coitarche should also include reproductive education and contraception. (Am J Public Health. 2008;98:1822-1824. doi:10.2105/AJPH.2007.120444) [ABSTRACT FROM AUTHOR]

Abstract: This analysis compares the rates of spontaneous abortion among women living in the vicinity of a lead smelter with those of women living in a town where blood lead levels were low. Data derive from the obstetric histories of both groups of women obtained while seeking prenatal care for a later pregnancy. A total of 639 women (304 exposed, 335 unexposed) had at least one previous pregnancy and lived at the same address since their first pregnancy. The geometric mean blood lead concentrations in the sample at the time of the interviews were 0.77 µ mol/L in the exposed town and 0.25 µ mol/L in the unexposed town. The rates of spontaneous abortions in first pregnancies were similar, with 16.4 percent of women in the exposed town and 14.0 percent in the unexposed town reporting loss. The adjusted odds ratio relating town of residence to spontaneous abortion was 1.1 (95% CI = 0.9, 1.4). This analysis represents the first systematic attempt to seek an association between environmental lead exposure and spontaneous abortion. As such, the failure to find a positive association strongly suggests that at the levels of exposure represented in our sample, such an association does not exist. (Am J Public Health 1990; 80:33-35.) [ABSTRACT FROM AUTHOR]

The article examines the social and attitudinal factors associated with the use of contraceptive and early reconception among black teenagers after an illegitimate birth. The researchers interviewed 289 black, unmarried girls below 19 years old immediately after the termination of their first pregnancy. A review of the chart 2 years after the interview was done to determine contraceptive use and marital status. Results of the study indicated that subjects who married after their first pregnancy were more likely to conceive again within 1 year. The results also suggested that family pressure may be a significant factor in the choice of contraception method. The use of contraception at 1 year was not proven to be related to social situational factors in this population.