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Conducting research studies with vulnerable populations on sensitive topics such as adolescent pregnancy can be challenging depending on methodological approaches and ethical issues that may arise before, during, and after data collection. This methodological paper was developed based on experiences and lessons learned from a critical ethnographic study conducted to determine and understand the cultural and personal meaning of unintended adolescent pregnancy in the Rwandan context and to explore the perceived consequences and management of unintended adolescent pregnancy with and for single adolescent mothers. The purpose of this methodological paper is to discuss methodological and ethical challenges encountered while conducting this research, as well as various approaches used to overcome these challenges, and to provide guidance to researchers interested in conducting research about similar or other sensitive topics. Future researchers facing similar challenges should prioritize community engagement strategies, such as building strong relationships with gatekeepers and leaders, to facilitate access to potential participants. Additionally, researchers should engage in continuous ethical reflection and adaptation throughout the study, adjusting strategies if necessary to ensure the well-being and autonomy of participants. As a result of the practical and methodological strategies provided in this reflective paper, researchers could be able to navigate practical, methodological, and ethical challenges effectively while conducting sensitive studies on topics such as adolescent pregnancy. [ABSTRACT FROM AUTHOR]

Pregnancy loss is arguably a traumatic and stressful life event that potentially impacts the emotional and behavioral health of those who experience it, especially adolescents. Research assessing this relationship has primarily focused on adult women populations. Using data from National Longitudinal Study of Adolescent to Adult Health, a cross-sectional research design was employed to investigate whether pregnancy loss outcomes are associated with depressive mood and suicidal behavior (i.e., suicidal thoughts and suicide attempt) among adolescent girls (N = 6, 913). We also investigated the mediating effect of depressive mood. Initially, an all-encompassing pregnancy loss variable was used, which included abortions and miscarriages. Acknowledging the differences between these pregnancy loss outcomes, we created separate measures for each. Using the all-encompassing pregnancy loss variable, findings from logistic regression analyses showed that pregnancy loss is positively and significantly associated with depressive mood and suicidal behaviors. Depressive mood mediated the relationship between pregnancy loss and suicidal behaviors. Miscarriage was positively and significantly associated with suicidal thoughts as well as attempting suicide. Depressive mood mediated the relationship between miscarriage and suicidal thoughts, while only partially mediating the relationship between miscarriage and suicide attempt. No significant effects were observed for abortion on outcomes of interest. Cross-sectional analyses were performed limiting our ability to make casual inferences. Pregnancy loss is associated with depressive mood and suicidal behavior, especially among adolescent girls who experience a miscarriage. Adolescent pregnancy and pregnancy loss should remain a focus of scholars and health professionals. • Pregnancy loss is associated with depressive mood and suicidal behavior. • Miscarriage is associated with depressive mood and suicidal behavior. • Depressive mood plays an important role among girls who experience pregnancy loss. • Abortion was not associated with negative emotional or suicidal outcomes. [ABSTRACT FROM AUTHOR]

Promoting sex education is key to addressing the adverse sexual health outcomes among adolescents. The successful adoption and implementation of Reproductive Health Education (RHE) in schools depends on the support of curriculum owners and other stakeholders such as parents. The study explored socio-demographic and psychosocial factors influencing parents’ intentions to support the adoption and implementation of RHE in primary and high schools in Ghana. A cross-sectional survey was conducted with 387 (Mean age = 43.6 years) parents in the Upper East region of Ghana. Pearson’s correlation and regression analyses were used to examine socio-demographic and psychosocial factors influencing the stated intention to support the adoption and implementation of RHE in schools. Parent’s intention was best predicted by descriptive norms (β = .24, p < .001), and injunctive norms (β = .20, p < .001) towards supporting RHE. Other factors that predicted intention to support were beliefs about the outcomes of teaching both abstinence-only education and RHE. The findings point to the need to involve and gain support from religious leaders in the development and roll-out processes of RHE programmes. Moreover, they highlight the need for effective RHE programmes with the potential to yield positive sexual and reproductive health outcomes among adolescents and young people. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent pregnancy remains a contentious issue despite improvements in quality of life and increased access to sexual education. The average age of first pregnancy has shifted due to financial instability among young people, leading to delayed pregnancies until financial stability is achieved. Teenage mothers face social stigma, and early sexual initiation not only increases the risk of pregnancy but also sexually transmitted infections (STIs). Often, adolescent pregnancies are unwanted, resulting in delayed medical consultation due to fear or ignorance. Aim of the Study: This study aims to investigate the medical and social implications of adolescent pregnancy, emphasizing the importance of early sexual education and comprehensive healthcare support. Description of the State of Knowledge: Adolescent pregnancy, defined as pregnancy between ages 10 and 19, is a global concern with millions of cases annually. It poses significant health risks, including premature birth, low birth weight, and intrauterine growth restriction. Socially, it affects educational attainment and financial stability, with adolescents from lower socioeconomic backgrounds facing greater challenges. Early sexual initiation and risky sexual behaviors further compound the issue, increasing the risk of STIs. Lack of comprehensive sexual education exacerbates these risks, highlighting the need for multidisciplinary support from healthcare professionals. Conclusions: Adolescent pregnancy requires a holistic approach encompassing medical, social, and legal dimensions. Effective sexual education programs, involving gynecologists, pediatricians, and educators, are essential for prevention. Legal frameworks must protect adolescents and address issues of consent and sexual health. Additionally, access to comprehensive healthcare services, including prenatal care and contraception, is crucial for mitigating the adverse effects of adolescent pregnancy on both individuals and society. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16–19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother–infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample – 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers. [ABSTRACT FROM AUTHOR]

Adolescent pregnancy is considered high-risk of health problems that impair their quality of life. Also, many pregnant adolescents are likely to have poor self-management behavior during pregnancy, affecting their health status. This quasi-experimental study aimed to determine the effectiveness of a mobile e-health individual and family self-management program for primiparous pregnant adolescents. Seventy pregnant adolescents who attended a prenatal clinic at a provincial hospital near Bangkok, Thailand, were assigned to the experimental (n = 35) and control group (n = 35). The experimental group received the intervention program and usual care, while the control group received only usual care. The program was held in three sessions over four weeks, and the outcomes were evaluated three times, at baseline, two weeks (time 1), and four weeks (time 2) after completing the program. Data collection took place from July to December 2022 using a personal data form, the Self-Management Behavior Questionnaire on Pregnancy Health of Adolescent Pregnant Women, the Pregnancy Health Status Record Form, and the WHOQOL-BREF-Thai questionnaire. Descriptive statistics, RM-ANCOVA, independent t-test, and chi-square analyzed the data. The findings revealed that four weeks after completion of the program (time 2), there was a statistically significant difference in the mean scores of self-management behavior between the experimental and control groups. Still, there was no statistically significant difference in the mean quality of life scores. In addition, the experimental group's hemoglobin level, hematocrit level, and gestational weight gain were significantly higher than the control group's. Moreover, the number of participants with urinary tract infections in the experimental group was lower, whereas the average fetal weight gain was higher than in the control group. Nurses and midwives can use this program for adolescent pregnancy to improve self-management behaviors, health status, and quality of life. However, further testing is needed before it is widely used. [ABSTRACT FROM AUTHOR]

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

Background: Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. Methods: The records of a total of 960 pregnant women (480 pregnant adolescents aged 15-19 years and 480 pregnant adult women aged 20-26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. Results: Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). Conclusions: This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes. [ABSTRACT FROM AUTHOR]

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

Abstract Background Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. Methods This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20–24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20–24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of

Background: Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. Methods: This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20–24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20–24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05. Results: Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors. Conclusion: This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) aims to prepare adolescents for safe, healthy, and fulfilling lives. The aim of this study was to assess the perspective of key informants regarding CSE content to prevent teenage pregnancy, as well as to identify implementation barriers in predominantly indigenous communities in Chiapas, Mexico. We conducted a descriptive qualitative study using semi-structured interviews to explore three different groups’ perceptions, opinions and experiences. Adhering to grounded theory principles, we performed an inductive analysis and identified categories of interest. A total of 45 key informants (16 school staff members, 15 health personnel and 14 community leaders) were interviewed. School staff members are primarily responsible for CSE. Among all the participants, we identified a lack of training and the presence of prejudices. The information provided to adolescents by the informants was diverse and at times, incomplete. There was limited parental involvement and even opposition to sharing CSE content. Deeply rooted customs and traditions within a patriarchal context posed a significant obstacle to the implementation of CSE in the studied communities. Gaining a deeper understanding of rural and Indigenous contexts can facilitate the identification of barriers and promote the design of targeted strategies to reduce obstacles to pregnancy prevention in vulnerable populations. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

AimDesignMethodsResultsConclusionThis study aimed to assess the lived experiences of adolescent pregnant young women, with a specific focus on the psychosocial aspect of adolescent pregnancy, using a phenomenological approach.Employing the phenomenological research method, semi-structured in-depth interviews were conducted between 3 August and 18 August 2023 with 15 young women (mean age = 21.86 years; SD = 1.06) living in a province in eastern Turkey who had undergone adolescent pregnancy 3–5 years before.The criterion sampling method, a form of purposive sampling, was used to form the sample group. Interviews were carried out until data saturation was reached. All interviews were recorded and transcribed, and thematic analysis was utilised to analyse the data. The study adhered to the COREQ checklist for reporting.Through data analysis, three main categories (reflections on adolescent pregnancy, challenges due to adolescent pregnancy, and effects of adolescent pregnancy) and nine sub-themes (emotions, roles and responsibilities, perception of social support, cognitive, emotional, behavioural, mental, physical, and social) emerged.Our study highlights the adverse psychosocial impact of adolescent pregnancy on young women. Young women who got married at an early age before attaining full physical, social, and psychological maturity grappled with the substantial burdens of adolescent pregnancy and adjusting to their new roles. The study’s implications are significant, emphasising the necessity of addressing the psychosocial facets of adolescent marriage and pregnancy, and gaining valuable insights for the future. [ABSTRACT FROM AUTHOR]

Background. Gestational weight gain (GWG) constitutes an essential aspect of the gestational process. Due to factors such as pregestational body mass index (BMI), nutritional intake, level of physical activity, and psychological aspects, the recommended GWG may not be achieved, leading to adverse neonatal outcomes. Adolescents, due to their physiological and mental developmental stage, are at a higher risk of inappropriate GWG. Our aim is to highlight the importance of GWG in our population and to determine the correlation with perinatal outcomes. Methods. Pregnant adolescents who attended a tertiary care institution for prenatal care were included; maternal data such as preBMI and GWG were used to determine maternal and neonatal outcomes using the chi-square test and OR determination. Results. A total of 202 adolescent pregnant patients were included, comprising those with inadequate GWG (n = 70), adequate GWG (n = 85), and excessive GWG (n = 47). A statistically significant association was found between low BMI and inadequate GWG. Patients with inadequate GWG demonstrated a correlation with IUGR and low birth weight, while patients with excessive GWG gave birth to macrosomic neonates. Conclusion. We concluded that previous habits play a significant role in determining weight gain throughout pregnancy. GWG has a direct impact on neonatal growth and development. [ABSTRACT FROM AUTHOR]

Nicaragua has one of the highest adolescent fertility rates in Latin America and in the Caribbean. However, studies on adolescent pregnancies are limited. This study investigates the mechanism of early fertility among women aged 15 to 24 in northern central and eastern regions (NC-E) and the Pacific region (PAC), using data from the Nicaraguan Demographic and Health Survey 2011/12 (N= 2,600). Structural equation modeling analysis was conducted in NC-E and PAC to examine the associations between exogenous variables (ethnicity and residence), mediators (education, sexuality education, knowledge and attitudes on pregnancy prevention, and sexual behaviors), and outcome (early fertility). The results showed educational attainment and sexual behaviors were crucial mediators of early fertility in NC-E and PAC, whereas sexuality education was only in NC-E. Residence was an exogenous variable in both groups, whereas ethnicity was not. Although educational attainment and sexuality education would improve knowledge, they did not contribute to reducing risky sexual behaviors. Further discussions on ethnic differences and variables measuring the actual decision-making related to risky sexual behaviors are suggested. [ABSTRACT FROM AUTHOR]

Objective: Adolescent pregnancies give rise to high maternal and fetal risk. In our study, we aimed to compare the obstetric and neonatal outcomes of adolescent and non-adolescent pregnancies. Methods: This study included pregnant women who gave birth between 2018 and 2021 at Necmettin Erbakan University Faculty of Medicine, Obstetrics and Gynaecology Department. The study included 15 to 19-year-old pregnant women, and the control group was 20 to 34, in which age-related complications are known to be the lowest. Multiple pregnancies decreased birth weight and increased preterm delivery risk, so they were excluded from the study, along with patients with incomplete data. Participants’ socio-demographic and obstetric characteristics were retrospectively reviewed and determined by analyzing delivery records and patient files. The data was analyzed using the SPSS 26, whereas age, gestational diabetes, pre-eclampsia and APGAR scores were correlated using Pearson or Spearman correlation analyses. The study used 0.05 p-value. Results: The age, gravidity, parity, abortion and educational level of adolescent pregnancies were significantly lower than in the normal age group (p=0.001 for all parameters). The rates of pre-eclampsia, gestational diabetes and preterm prelabor rapture of membranes were lower in adolescent pregnancies (p=0.044, p=0.010, p=0.044, respectively), while the rates of fetal growth restriction and fetal distress were higher (p=0.016 and p=0.010). The rate of vaginal delivery was lower and the rate of vaginal delivery with episiotomy was higher in adolescent pregnancies (p<0.05). There were significant correlations between age, gestational diabetes and pre-eclampsia. ROC analysis showed that the risk of complications in adolescent pregnancies varies with age and is higher in pregnancies under 18.5 years. Conclusion: Adolescent pregnancies differ from those of normal age in some parameters of maternal and neonatal outcomes. However, it can be seen that adolescent pregnancies, especially late adolescent pregnancies, can have outcomes that are comparable to those of normal age groups. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a common mental health issue in resource‐limited settings that negatively affects the well‐being of mothers and children. However, PPD often remains untreated, leading to long‐term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest Ethiopia. Data were collected from 374 adolescent (10–19 years) and 760 adult (20–34 years) mothers 6 weeks after childbirth. Data were analyzed using binary and multiple logistic regression. Adolescent mothers had a significantly higher proportion of PPD (37.4%) than adult mothers (20.1%) and were more likely to report low self‐esteem (13.1% vs. 8.2%) and low social support (28.3% vs. 23.3%). Factors associated with PPD differed between adolescent and adult mothers. Adolescent mothers with PPD were more likely to report household food insecurity, low self‐esteem, low knowledge of postpartum complications, and working in agriculture or professional/technical occupations. For adult mothers, factors associated with PPD included distance to the nearest health facility, medium social support, inadequate dietary diversity, and food insecurity. Results suggest that targeted interventions by age group are needed to reduce the burden of PPD in Ethiopia. [ABSTRACT FROM AUTHOR]

BackgroundMaternal age is increasingly recognized as a predictor of birth outcomes. Given the importance of birth and growth outcomes for children's development, wellbeing and survival, this study examined the effect of maternal age on infant birth and growth outcomes at 6 months and mortality. Additionally, we conducted quantitative bias analysis (QBA) to estimate the role of selection bias and unmeasured confounding on the effect of maternal age on infant mortality.MethodsWe used data from randomized-controlled trials (RCTs) of 21 555 neonates in Burkina Faso conducted in 2019-2020. Newborns of mothers aged 13-19 years (adolescents) and 20-40 years (adults) were enrolled in the study 8-27 days after birth and followed for 6 months. Measurements of child's anthropometric measures were collected at baseline and 6 months. We used multivariable linear regression to compare child anthropometric measures at birth and 6 months, and logistic regression models to obtain the odds ratio (OR) of all-cause mortality. Using multidimensional deterministic analysis, we assessed scenarios in which the difference in selection probability of adolescent and adult mothers with infant mortality at 6 months increased from 0% to 5%, 10%, 15% and 20% if babies born to adolescent mothers more often died during the first week or were of lower weight and hence were not eligible to be included in the original RCT. Using probabilistic bias analysis, we assessed the role of unmeasured confounding by socio-economic status (SES).ResultsBabies born to adolescent mothers on average had lower weight at birth, lower anthropometric measures at baseline, similar growth outcomes from enrolment to 6 months and higher odds of all-cause mortality by 6 months (adjusted OR = 2.17, 95% CI 1.35 to 3.47) compared with those born to adult mothers. In QBA, we found that differential selection of adolescent and adult mothers could bias the observed effect (OR = 2.24, 95% CI 1.41 to 3.57) towards the null [bias-corrected OR range: 2.37 (95% CI 1.49 to 3.77) to 2.84 (95% CI 1.79 to 4.52)], whereas unmeasured confounding by SES could bias the observed effect away from the null (bias-corrected OR: 2.06, 95% CI 1.31 to 2.64).ConclusionsOur findings suggest that delaying the first birth from adolescence to adulthood may improve birth outcomes and reduce mortality of neonates. Babies born to younger mothers, who are smaller at birth, may experience catch-up growth, reducing some of the anthropometric disparities by 6 months of age.

Adolescent pregnancies resulting from premarital sex impacted adolescents, their families, and any potential offspring. Society viewed such pregnancies sas abnormal, careless, and embarrassing. Given that adolescents are still under the of the influence of their families, parental roles were crucial in preventing these pregnancies, despite adolescents increasingly choosing their own friends . In the contemporary digital age, gadget addiction further complicates family dynamics, particularly in managing adolescent behavior. Thus, this study aims to investigate how parents supervise, communicate, and educate their adolescents to prevent teenage pregnancies and other juvenile delinquency. Conducted in Banguntapan District, Bantul Regency, Yogyakarta, in February 2024, this qualitative study involved six women from the Youth Family Development program in Mertosanan Kulon as primary informants and the head of Mertosanan Hamlet as a triangulating informant. All informants were selected using a purposive technique. Data collection was conducted through Focus Group Discussion (FGD)and analyzed using content analysis. Parents can contribute in preventing juvenile misbehavior, particularly when it comes to preventing unmarried pregnancies, by keeping an eye on, talking to, and educating their teenagers—. Fathers play a more crucial role in the upbringing and educatiing boys, while mothers are more critical for girls. Collaborative community efforts and a multidisciplinary educational approach emphasizing parent-adolescent relationships and communication are essential.

Teenage pregnancy remains a global challenge with profound implications, necessitating a thorough exploration of its causes and contributing factors. This study provides a comprehensive review of research studies conducted in Tanzania from 2019 to 2023, contributing to the ongoing discourse on the complex interplay of socio-cultural, economic, and educational factors shaping the experiences of Tanzanian adolescents. Twelve studies, comprising seven journals and five master theses, were purposefully selected to identify commonalities and disparities in their findings. The study systematically examines the identified studies, shedding light on the prevailing factors associated with teenage pregnancies in Tanzania. Several themes emerged from the reviewed literature, with all studies unequivocally pinpointing poor knowledge on sexual and reproductive health as a common factor contributing to teenage pregnancies. Moreover, a substantial majority, 75%, highlighted the significance of low economic status in this context, emphasizing the intersectionality of socio-economic factors. Furthermore, this comparative analysis delves into the nuanced findings of the selected studies, revealing that 50% of the reviewed research identified peer influence as a significant contributor to teenage pregnancies. These findings not only underscore the multifaceted nature of the issue but also highlight the need for targeted interventions addressing both individual knowledge gaps and broader socio-economic challenges.

Abstract Introduction Adolescent pregnancy is defined as pregnancy at the age of 19 or below. Pregnancy and childbirth complications are the most significant cause of death among 15–19-year-old girls. Several studies have indicated that inequitable gender norms can increase the vulnerability of adolescent girls, including violence exposure, early marriage, and adolescent pregnancy. To address these disparities, gender transformative approaches aim to challenge and transform restrictive gender norms, roles, and relations through targeted interventions, promoting progressive changes. This realist review aims to synthesise existing evidence from a broad range of data sources to understand how, why, for whom, and in what contexts gender transformative approaches succeed in reducing adolescent pregnancy in low- and middle-income countries. Method and analysis We employ a five-step realist synthesis approach: (1) clarify the scope of review and assessment of published literature, (2) development of initial programme theories, (3) systematic search for evidence, (4) development of refined programme theories, and (5) expert feedback and dissemination of results. This protocol presents the results of the first three steps and provides details of the next steps. We extracted data from 18 studies and outlined eight initial programme theories on how gender transformative approaches targeting adolescent pregnancy work in the first three steps. These steps were guided by experts in the field of sexual and reproductive health, implementation science, and realist methodology. As a next step, we will systematically search evidence from electronic databases and grey literature to identify additional studies eligible to refine the initial programme theories. Finally, we will propose refined programme theories that explain how gender transformative approaches work, why, for whom, and under which circumstances. Ethics and dissemination Ethics approval is not required because the included studies are published articles and other policy and intervention reports. Key results will be shared with the broader audience via academic papers in open-access journals, conferences, and policy recommendations. The protocol for this realist review is registered in PROSPERO (CRD42023398293).

Background Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated.Methods The records of a total of 960 pregnant women (480 pregnant adolescents aged 15–19 years and 480 pregnant adult women aged 20–26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects.Results Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR).Conclusions This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.

Widespread harmful gender stereotypes against adolescent pregnant school girls (APSGs) often characterise schools, teachers and education officials’ response to pregnancy in schools in sub Saharan Africa. These gender stereotype which underly school exclusion of APSGs include, for example, the stereotype that the girls got pregnant because they engaged in immoral sexual activity. In this regard, the exclusion is seen as a punitive measure—penalising the girls for their immorality and serving as a deterrent to other girls getting pregnant. In line with the theme of this special issue, the study argues that the gender stereotyping and exclusion of APSGs is discriminatory against the girls and by implication women, as it targets them based on their sex, their unique capacity to become pregnant and their actual pregnancy status. It therefore violates the rights to equality and non-discrimination in the area of education which are guaranteed under several international human rights treaties including the Convention on the Elimination of All Forms of Discrimination against Women 1979 (CEDAW) which this study focuses on. This study goes on to bring together the obligations of States Parties to eliminate harmful gender stereotypes These obligations which are scattered across the CEDAW Committee's jurisprudence, provide a clear framework for both upholding the rights of girls and holding States Parties accountable under an international human rights paradigm.

Introduction: Adolescent pregnancy is defined as pregnancy at the age of 19 or below. Pregnancy and childbirth complications are the most significant cause of death among 15–19-year-old girls. Several studies have indicated that inequitable gender norms can increase the vulnerability of adolescent girls, including violence exposure, early marriage, and adolescent pregnancy. To address these disparities, gender transformative approaches aim to challenge and transform restrictive gender norms, roles, and relations through targeted interventions, promoting progressive changes. This realist review aims to synthesise existing evidence from a broad range of data sources to understand how, why, for whom, and in what contexts gender transformative approaches succeed in reducing adolescent pregnancy in low- and middle-income countries. Method and analysis: We employ a five-step realist synthesis approach: (1) clarify the scope of review and assessment of published literature, (2) development of initial programme theories, (3) systematic search for evidence, (4) development of refined programme theories, and (5) expert feedback and dissemination of results. This protocol presents the results of the first three steps and provides details of the next steps. We extracted data from 18 studies and outlined eight initial programme theories on how gender transformative approaches targeting adolescent pregnancy work in the first three steps. These steps were guided by experts in the field of sexual and reproductive health, implementation science, and realist methodology. As a next step, we will systematically search evidence from electronic databases and grey literature to identify additional studies eligible to refine the initial programme theories. Finally, we will propose refined programme theories that explain how gender transformative approaches work, why, for whom, and under which circumstances. Ethics and dissemination: Ethics approval is not required because the included studies are published articles and other policy and intervention reports. Key results will be shared with the broader audience via academic papers in open-access journals, conferences, and policy recommendations. The protocol for this realist review is registered in PROSPERO (CRD42023398293). [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

AbstractLoreto, in the Peruvian Amazon, has one of the highest adolescent pregnancy rates in the country. However, underlying causes of adolescent pregnancy are not fully understood as data are limited in Indigenous and remote Amazonian communities. This study investigated adolescent reproductive health within Loreto using an ecological systems framework. Forty-one semi-structured interviews were conducted in June 2022: community leaders (n = 12) and adolescent participants between 15 and 17 years of age (pregnant girls, n = 11; never pregnant girls, n = 9; and boys, n = 9). We also conducted focus group discussions with community health workers and educators in October 2022 (three focus groups, n = 15). Adolescent reproductive health is complex with multi-layered factors that put girls at higher risk of pregnancy. We found a paradoxical relationship between expected social and gender norms and individual desires. This research provides a contextual understanding of the lived experience of adolescents and young people in the Amazon region of Peru. Our findings suggest the need for greater exploration of the contradictory ideas surrounding adolescent pregnancy and female sexuality. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate associations of formal childcare with maternal and child outcomes in a large sample of adolescent mothers. Background: Forty percent of adolescent girls in Africa are mothers. Increasing evidence shows positive impacts of formal childcare use for adult women, but no known studies in the Global South examine associations for adolescent mothers and their children. Methods: We interviewed 1046 adolescent mothers and completed developmental assessments with their children (n = 1139) in South Africa's Eastern Cape between 2017 and 2019. Questionnaires measured childcare use, maternal and child outcomes and socio‐demographic background variables. Using cross‐sectional data, associations between formal childcare use and outcomes were estimated in multivariate multi‐level analyses that accounted for individual‐level and family‐level clustering. Results: Childcare use was associated with higher odds of being in education or employment (AOR: 4.01, 95% CIs: 2.59–6.21, p <.001), grade promotion (AOR: 2.08, 95% CIs: 1.42–3.05, p <.001) and positive future ideation (AOR: 1.58, 95% CIs: 1.01–2.49, p =.047) but no differences in mental health. Childcare use was also associated with better parenting on all measures: positive parenting (AOR: 1.66, 95% CIs: 1.16–2.38, p =.006), better parental limit‐setting (AOR: 2.00, 95% CIs: 1.37–2.93, p <.001) and better positive discipline (AOR: 1.77, 95% CIs: 1.21–2.59, p =.003). For the children, there were no differences in temperament or illness, but a significant interaction showed stronger associations between childcare use and better cognitive, language and motor scores with increasing child age (AOR: 5.04, 95% CIs: 1.59–15.96, p =.006). Conclusions: Adolescent mothers might benefit substantially from formal childcare, but causal links need to be explored further. Childcare use was also associated with improved parenting and better child development over time, suggesting positive pathways for children. At an average of $9 per month, childcare provisions for adolescent mothers may offer low‐cost opportunities to achieve high returns on health and human capital outcomes in Sub‐Saharan African contexts. [ABSTRACT FROM AUTHOR]

Background: Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compare the obstetric, perinatal, and neonatal outcomes of Turkish and refugee adolescent pregnant women admitted to a tertiary maternity center. Methods: The study was planned as a retrospective cross-sectional. We included adolescent pregnant women who delivered between February 2018 and August 2023. Adolescent pregnant women were divided into two groups, the Turkish group and the Syrian refugee group, and compared with each other. Results: One thousand and fifty-one Turkish and 742 refugee adolescent pregnant women were included in the study. Adolescent pregnancy rates are higher in refugees than in the Turkish group (p < 0.001). We found that maternal age (p < 0.001), preeclampsia rates (p=0.029), gestational age at delivery (p < 0.001), and cesarean delivery rates (p=0.02) were lower in refugee adolescent pregnant women. Furthermore, we found that the anemia rates (p < 0.001) and low birth weight newborn rates (p = 0.011) were higher in refugee adolescent pregnant women. Conclusions. Enhancing the outcomes of adolescent pregnancies among refugees necessitates a heightened focus on education regarding sexual reproduction, increased prenatal follow-ups, and enhanced training in family planning. [ABSTRACT FROM AUTHOR]

Introduction: Doulas have been found to be beneficial to pregnant adolescents during childbirth, but little is known about their role within the larger system of people providing birth support, including family and health care providers. The purpose of this study was to examine, from the perspectives of young mothers, the role of the doula within their broader birth support system. Methods: One hundred pregnant Black adolescents and young women (aged 13 to 21) who were provided perinatal community‐based and racially concordant doula services at no cost to them were interviewed after the birth of their newborn, prior to hospital discharge. Interviews generated birth story narratives and responses to focused questions about their experiences of birth support. Thematic analysis was conducted to examine the role of the doula within the context of the broader system of birth support. Results: Doulas functioned in 2 primary ways within the birth support system by (1) providing tandem support alongside family and health care providers and (2) filling gaps in health care not provided by family and providers. Laboring adolescents sometimes described their family members and doulas working in tandem to provide multiple types of support such as comfort measures, coaching, and help with pushing. They also identified gaps in their care or support filled by the doula, in particular gaps due to family members' physical or emotional unavailability or health care providers' many responsibilities. Discussion: The findings highlight the ways in which doulas support pregnant adolescents during childbirth through their deft navigation of the existing support system. Well‐being was enhanced by the inclusion of the doula in the birth support system. The findings align with existing research that underscores the valuable role doulas play in supporting individuals during childbirth, particularly for those most affected by processes of marginalization. [ABSTRACT FROM AUTHOR]

Owing to the social, economic, health, educational and psychological implications of adolescent pregnancy, there had been many attempts to stop this phenomenon. These efforts, however, do not seem to be succeeding given its acceleration, generally in South Africa. The schooling of many adolescent girls gets disturbed by their pregnancy and others discontinue with schooling postpartum. This exacerbates South Africa’s challenges of unemployment, poverty, intergenerational illiteracy, and general societal vulnerability. The Pregnant Learner Management Policy contributed to the dropout rates as it prohibited adolescent mothers from returning to school before they had spent two years with their babies. It has since been replaced with the National Policy on the Prevention and Management of Learner Pregnancy in Schools, but reintegration remains a challenge. The pregnancy and reintegration challenges are aggravated by institutional, social, economic, cultural, and religious barriers. The pregnancies are due to several factors such as poor and inconsistent uptake of contraceptives, and inadequate parental involvement and guidance on the sexual and reproductive health education of the adolescents. The study used qualitative research techniques to delve deeper into the adolescent pregnancy and school dropout phenomenon; research participants were sampled from the three provinces with the highest number of births that were delivered by adolescents, namely KwaZulu-Natal, Limpopo, and Eastern Cape.

Introduction: Adolescent pregnancy remains a contentious issue despite improvements in quality of life and increased access to sexual education. The average age of first pregnancy has shifted due to financial instability among young people, leading to delayed pregnancies until financial stability is achieved. Teenage mothers face social stigma, and early sexual initiation not only increases the risk of pregnancy but also sexually transmitted infections (STIs). Often, adolescent pregnancies are unwanted, resulting in delayed medical consultation due to fear or ignorance. Aim of the Study: This study aims to investigate the medical and social implications of adolescent pregnancy, emphasizing the importance of early sexual education and comprehensive healthcare support. Description of the State of Knowledge: Adolescent pregnancy, defined as pregnancy between ages 10 and 19, is a global concern with millions of cases annually. It poses significant health risks, including premature birth, low birth weight, and intrauterine growth restriction. Socially, it affects educational attainment and financial stability, with adolescents from lower socioeconomic backgrounds facing greater challenges. Early sexual initiation and risky sexual behaviors further compound the issue, increasing the risk of STIs. Lack of comprehensive sexual education exacerbates these risks, highlighting the need for multidisciplinary support from healthcare professionals. Conclusions: Adolescent pregnancy requires a holistic approach encompassing medical, social, and legal dimensions. Effective sexual education programs, involving gynecologists, pediatricians, and educators, are essential for prevention. Legal frameworks must protect adolescents and address issues of consent and sexual health. Additionally, access to comprehensive healthcare services, including prenatal care and contraception, is crucial for mitigating the adverse effects of adolescent pregnancy on both individuals and society.

Background: Adolescent pregnancy occurs in Approximately 12 million girls aged 15– 19 years and approximately 777,000 girls under 15 years of age give birth each year in developing countries. The most of adolescent pregnancies occur every year, 50% of whom are aged 15-19 years, namely at least 21 million pregnancies and it contributes to maternal and child mortality rates. In Indonesia, it is estimated that around 1,220,900 women are married before the age of 18, placing Indonesia in the 10 countries with the highest absolute number of child marriages in the world). Purpose: To analyze the relationship between parenting styles and the role of peers regarding sexuality with adolescent pregnancy prevention behavior in the Autaqnapoq Health Centre Working Area. Method: This type of research uses an observational research design with a crosssectional approach and instrument used is a questionnaire. The population in this study were all adolescents in the Autaqnapoq Health Centre Working Area. The sample in this study was 93. using purposive sampling techniques. The data was analyzed with Spearman rho test analysis. Results: the research showed that there is a relationship between parenting style with adolescent pregnancy prevention behaviour (p<0.001, r = 0.343). and there is a relationship also between the role of peers with adolescent pregnancy prevention behavior (p<0.000 and r = 0.357). Conclusion: The relationship between parenting styles and the role of peers with Adolescent pregnancy prevention behavior in the Autaqnapoq Lembata Health Centre Working Area. [ABSTRACT FROM AUTHOR]

This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena. [ABSTRACT FROM AUTHOR]

Aims: We estimated the rates and compared the risk factors for pregnancy and abortion between sexually active female and male adolescents with pregnant partner(s). Subject and methods: This nationally representative, anonymous, cross-sectional study analyzed the Taiwan Global School-Based Student Health Survey (GSHS), 2006–2016, for grade 7–12 students from junior and senior high schools, comprehensive schools, vocational high schools, and night schools. We examined the association between covariates (i.e., demographics, sexual behaviors, substance use) and outcomes (i.e., pregnancy and abortion). Results: The rates of sexually active female and male adolescents involved in pregnancy were 17.63% (95% CI = 15.44–19.83%) and 15.91% (14.01–17.82%), respectively. The abortion rates among female and male adolescents involved in pregnancy were 78.79% (73.09–84.48%) and 66.19% (59.79–72.59%), respectively. Female and male adolescents involved in pregnancy were associated with similar risk factors (i.e., night schools, multiple sexual partner(s), early sexual debut, emergency contraceptive pills, and current cigarette smokers). However, males were further associated with contraception non-use. Among those involved in pregnancy, abortion was associated with multiple sexual partners and current cigarette smokers, but males involved in abortion were associated with the sexual debut at ≥ 14 years old and emergency contraception use. Conclusions: Most pregnant Taiwanese adolescents prefer abortion, unlike many Western countries. This study highlights the importance of involving male and female adolescents in preventing adolescent pregnancy and abortion. [ABSTRACT FROM AUTHOR]

Objective: In this research, a randomized controlled trial (RCT) tested the efficacy of two teen pregnancy prevention (TPP) curricula, Reducing the Risk and Love Notes, compared with a group of adolescents in a control condition, on primary pregnancy prevention among youth at high‐risk for teen pregnancy. A secondary purpose was to examine two potential mediators, negative beliefs about teen pregnancy and intentions to follow the sequence of completing education, marrying or establishing a committed relationship, and then having children. Background: Teen pregnancy rates for racial/ethnic minority youth in the United States are disproportionately high compared with White youth. Given the positive view of children in these populations and the drive for youth to form peer relationships and explore their sexuality, meeting these cultural and developmental needs within TPP may be critical. Methods: The study examined the number of reported pregnancies across the first year after the interventions from a three‐arm, cluster RCT engaging 1,448 youth living in poverty between the ages of 14 and 19 years in 23 community‐based organizations in a southeastern U.S. city. Results: At the 1‐year follow‐up, youth in Love Notes report significantly fewer pregnancies compared with the control condition (18 pregnancies, 3.51%), F(2, 1,309) = 4.17, p =.02, d = 0.11. There was no significant difference between Reducing the Risk (31 pregnancies, 6.14%) and the control condition (27 pregnancies, 6.49%) in number of pregnancies. Less favorable attitudes about having a child as a teenager and other attitudes were associated with predicted outcomes. Conclusions: This study provides additional evidence for the efficacy of Love Notes, which embeds sex education into a larger curriculum on life planning and healthy relationship formation and maintenance. Implications. TPP approaches need to add content on planning and relationships to comprehensive sexual education. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the effect of group prenatal care (GPNC) on the empowerment of pregnant adolescents. Methods: In this trial, 294 pregnant adolescents (aged 15-19 years) were randomly assigned into the GPNC (n = 147) and individual prenatal care (IPNC; n = 147) groups, where they received 5 sessions of GPNC (90-120 min) and IPNC, respectively, between the 16th and 40th weeks of pregnancy. The empowerment of participants in the two groups was measured using the Empowerment Scale for Pregnant Women. Data were analysed using various tests. Results: The mean total score of pregnant women's empowerment in both groups after the intervention was 86.46 ± 4.95 and 81.89 ± 4.75, respectively (β = 6.11, 95% confidence interval: 4.89, 7.33; P <0.0001). Conclusion: GPNC can improve pregnant adolescent empowerment. The current study's results can provide a foundation for implementing the GPNC model in Iran. [ABSTRACT FROM AUTHOR]

This study, conducted in urban slum areas in Nigeria, aimed to investigate the determinants of adolescent pregnancy. The research focused on family background, peer pressure, lack of knowledge on human sexuality, sexual abuse, and media influence as potential factors influencing adolescent pregnancy. Employing ex-post facto research and a crosssectional survey method, the study sampled 1305 respondents from six selected states across the six geopolitical zones. Data was collected using a structured questionnaire and tested for reliability with a Cronbach alpha coefficient of 0.93. Findings indicated that family background, peer pressure, lack of knowledge on human sexuality, sexual abuse, and media influence were determinants of adolescent pregnancy. The study recommends parental attendance in sexuality education workshops, contributions to school policies on sexual education, provision of resource materials, and empowerment of NGOs with grants and supportive policies to address the issue effectively. Additionally, the establishment of skills acquisition centers in every local government area is suggested to assist adolescents in acquiring skills for independence. In conclusion, the study affirms the identified factors as determinants of adolescent pregnancy in urban slum areas in Nigeria. [ABSTRACT FROM AUTHOR]

Objective: To compare obstetric and neonatal outcomes of adolescent pregnancies with adult pregnancies at Somdej Phrachao Taksin Maharat Hospital, a tertiary hospital in Tak Province, Thailand. Materials and Methods: A retrospective cohort study was conducted at Somdej Phrachao Taksin Maharat Hospital in Tak province. Singleton pregnant women aged 12 to 34 years who delivered between January 2020 and December 2022 were recruited. Data on pregnancy and neonatal outcomes were collected and analyzed using descriptive and inferential statistics, including one-way ANOVA, Pearson correlation, Spearman's rho correlation, and Pearson chi-square tests. Results: One thousand four hundred sixty-one pregnant women data was collected and divided into three groups, 20 to 34 years with 1,029 participants, 16 to 19 years with 358 participants, and 12 to 15 years with 74 participants. Pregnant women aged 19 or below had significantly higher rates of complications, such as anemia, preterm birth, and caesarean delivery, compared to those over 19 years (p<0.05). Conclusion: Adolescent pregnancies showed more obstetric and neonatal complications. To reduce the problems, enhance sex education, birth control methods for teenagers, and appropriate antenatal care. [ABSTRACT FROM AUTHOR]

Abstract Background Adolescent pregnancy remains a major global health issue, increasing the risk of complications during pregnancy and childbirth in mothers and babies. In Tanzania, adolescent pregnancy threatens girls’ education and makes it difficult for them to obtain a proper job; hence, the majority fall into poverty. Previous studies have developed and conducted reproductive health education for adolescent students; however, they evaluated only the effect immediately after education. Therefore, this study investigated the effects of reproductive health education on attitudes and behaviors toward reproductive health among adolescent girls and boys one year after the intervention in rural Tanzania. Methods A longitudinal quasi-experimental study was conducted with 3295 primary and secondary students (2123 in the intervention group, 1172 in the control group) from three purposefully selected wards in Korogwe District. In the intervention group, the students received reproductive health education. We used paper-based questionnaires to evaluate the effect of the adolescent education program on attitudes and behaviors toward reproductive health education. To analyze the association between the intervention and each outcome, mixed-effect multiple regression analyses was conducted. Results The mean age, primary school proportion, and female proportion of the intervention and the control group was 13.05 (standard deviation (SD) 1.59), 14.14 (SD 1.7), 77.9% and 34.3%, and 54.2% and 52.6%, respectively. There was no statistically significant effect of reproductive health education on adolescent health attitudes and behaviors in the multiple regression analyses (coefficient: − 0.24 (95% confidence interval (CI): − 0.98 to 0.50), coefficient: 0.01 (95%CI: − 0.42 to 0.43)). Conclusion A statistically significant effect of reproductive health education on adolescent health attitudes and behaviors was not found. An effective reproductive health education intervention to improve the attitude and behaviors of reproductive health among Tanzania adolescents in the long term remain to be determined, particularly in real-world settings. Trial registration The National Institute for Medical Research, Tanzania (NIMR/HQ/R.8a/Vol. IX988).

Abstract Background Pregnancy and childbearing in adolescence could negatively affect girls’ health and socio-economic wellbeing across the life course. Previous studies on drivers of adolescent pregnancy in Africa have not fully considered the perspectives of parents/guardians vis-à-vis pregnant and parenting adolescents. Our study addresses this gap by examining pregnant and parenting adolescents’ and parents/guardians’ narratives about factors associated with early and unintended pregnancy. Methodology The descriptive study draws on qualitative data collected as part of a larger mixed-methods cross-sectional survey on the lived experiences of pregnant and parenting adolescents. Data were collected between March and May 2021 in Blantyre, Malawi, using semi-structured interview guides. We interviewed 18 pregnant and parenting adolescent girls, 10 parenting adolescent boys, and 16 parents/guardians of pregnant and parenting adolescents. Recorded interviews were transcribed verbatim into the English language by bilingual transcribers. We used the inductive-thematic analytical approach to summarize the data. Findings The data revealed several interconnected and structural reasons for adolescents’ vulnerability to early and unintended pregnancy. These include adolescents’ limited knowledge and access to contraceptives, poverty, sexual violence, school dropout, COVID-19 school closures, and being young and naively engaging in unprotected sex. While some parents agreed that poverty and school dropout or COVID-19 related school closure could lead to early pregnancies, most considered stubbornness, failure to adhere to abstinence advice and peer influence as responsible for adolescent pregnancies. Conclusion Our findings contribute to the evidence on the continued vulnerability of girls to unintended pregnancy. It highlights how parents and adolescents hold different views on reasons for early and unintended pregnancy, and documents how divergent views between girls and their parents may contribute to the lack of progress in reducing adolescent childbearing. Based on these findings, preventing unintended pregnancies will require altering community attitudes about young people’s use of contraceptives and engaging parents, education sector, civil society organizations and community and religious leaders to develop comprehensive sexuality education programs to empower in- and out-of school adolescents.

Abstract Background Teenage pregnancies continue to disrupt teenage girls’ academic development. As a result, teenage mothers are at risk of unemployment, maternal death, and poverty. Previous research, however, has shown that both individual and environmental factors can have a significant impact on the prevalence of adolescent pregnancy. However, there has been little rigorous research on the impact of these factors on pregnant students’ academic performance. Objectives The purpose of this study was to determine the relationship between environmental (neighbourhood) and individuals (sexual attitudes, peer attachment) factors. It also examined the influence of individual factors on the academic performance of pregnant teens. Methods The study included a cross-sectional study of 400 pregnant adolescent students aged 15–19 years. The target groups were drawn from three major cities in Nigeria. Respondents were identified through targeted snowballing. Pregnant participants were a combination of married and unmarried girls attending school from home. Data were collected using a structured and self-completed questionnaire. Thus, frequency, mean and standard deviation were used for descriptive analysis. Pearson correlation analysis was applied to show the relationship between variables. Results The study found that neighbourhood (r=-.125, p = .12) had a negative and significant relationship with peer attachment. However, there was no significant evidence of a relationship between sexual attitudes and neighbourhood (r=-.040, p = .422). There was, however, a significant relationship between sexual attitudes and academic performance (r = .236, p = .000). There was also a relationship between peer attachment and academic performance (r=-.401, p =

Abstract Background The association of the built environment and the structural availability of services/amenities with adolescent birth rates (ABR) has been overlooked in Latin America. We investigated the association of the availability, and changes in the availability, of services/amenities with ABR in 92 Mexican cities. Methods We estimated ABR using data on live birth registration linked to municipality of residence at the time of birth from 2008–2017. The number of services/amenities were obtained from the National Statistical Directory of Economic Units in 2010, 2015, and 2020 and grouped as follows: education, health care, pharmacies, recreation, and on- and off-premises alcohol outlets. Data were linearly interpolated to obtain yearly estimates. We estimated densities per square km by municipality. We fitted negative binomial hybrid models, including a random intercept for municipality and city, and adjusted for other social environment variables. Results After adjustment a 1-unit increase in the density of recreation facilities, pharmacies, and off-premises alcohol outlets within municipalities was associated with a 5%, 4% and 12% decrease in ABR, respectively. Municipalities with higher density of education, recreational and health care facilities had a lower ABR; in contrast, municipalities with a higher density of on-premises alcohol experienced a higher ABR. Conclusion Our findings highlight the importance of economic drivers and the need to invest in infrastructure, such as pharmacies, medical facilities, schools, and recreation areas and limit the availability of alcohol outlets to increase the impact of current adolescent pregnancy prevention programs.

Abstract Background Adolescent pregnancy is a global public health and social problem that affects both developed and developing countries. Reducing adolescent pregnancy is central to achieving sustainable development goals. In 2021 Nigeria’s Adolescent pregnancy was 106 per 1000 and showed an increasing rate. This study, therefore, aims to explore the literature to map the risk factors and interventions against adolescent pregnancy in Nigeria. Method A scoping review of studies published between January 2007 and December 2022 using PubMed, Web of Science and Africa Journals Online were searched using the keywords' adolescent pregnancy' AND 'Nigeria'. Studies were screened using the eligibility criteria. Results A total of 241 articles, of which 229 were identified through the databases and 12 were identified through hand search. After the full-text review, 28 studies met the inclusion criteria and were included in the final review. In Nigeria, the prevalence of adolescent pregnancy is between 7.5 and 49.5%. Associated factors for adolescent pregnancy in Nigeria are multifactorial, including individual, community, societal, school, family, and peer factors. Policies on adolescent sexual and reproductive health exist in Nigeria. Still, the policies need more sponsorship, implementation, and monitoring, while only some interventions on adolescent pregnancy majorly based on contraceptives and education of health providers are available in Nigeria. Conclusion Associated factors for adolescent Pregnancy in Nigeria are multidimensional, with educational attainment and wealth index being the highest associated factor. Intervention strategies aimed at the educational level have been identified as a critical factor in curbing adolescent pregnancy. Thus, policies on sexual, reproductive, and mental health development specifically targeting adolescents to reduce the cycle of societal dependence by empowering this group economically and educationally are justifiably warranted.