Abstract
BackgroundWe assessed whether the reported decrease in fertility rates among 15 to 19 years old Brazilian adolescents has met with a parallel decrease in very young adolescent (10 to 14 years old) fertility rates. So we explored temporal trends for fertility rates among very young adolescents between 2000 and 2012 for Brazil as a whole, its regions and states; and also analyzed the spatial distribution of fertility rates among Brazilian municipalities in the years 2000 and 2012.MethodsWe used data from the Information System on Live Births to calculate the rates. To examine the temporal trends, we used linear regression for time series with Prais-Winsten estimation, including the annual percentage change, for the country, regions, and states. To analyze the spatial distribution among Brazilian municipalities, we calculated the Global Moran Index and created a local Moran significance and cluster map through Local Indicators of Spatial Association (LISA). We also elaborated a thematic map with the rates using empirical Bayesian estimation.ResultsBrazilian very young adolescent fertility rates remained high and stable throughout the 2000 to 2012 period, and significantly decreased in three out of 26 states, and in the federal district. On the other hand, an increase was observed in two Northern and Northeastern states. The rates were spatially dependent in Brazilian municipalities (Moran Index = 0.22 in 2012; p = 0.05). The maps indicated a heterogeneous distribution of the rates, with high-rate clusters predominant in the North and low-rate clusters predominant in the South, Southeast, and Midwest.ConclusionsOur findings indicate that Brazilian very young adolescent fertility rates have not decreased in parallel with adolescent fertility rates as they remain high and did not decrease from 2000 and 2012, even though a few states presented a decrease. Thus, these phenomena probably have distinct underlying causes that warrant further elucidation. Progress in this field is crucial for the development of specific policies and programs focused on very young adolescents.
Highlights
We assessed whether the reported decrease in fertility rates among 15 to 19 years old Brazilian adolescents has met with a parallel decrease in very young adolescent (10 to 14 years old) fertility rates
We investigated the temporal trends in very young adolescents (VYA) fertility rates between 2000 and 2012 for Brazil as a whole, as well as for its regions and states
Unlike what has been observed among adolescents, VYA fertility rates have not decreased and probably require specific and distinct action both in Brazil and worldwide
Summary
We assessed whether the reported decrease in fertility rates among 15 to 19 years old Brazilian adolescents has met with a parallel decrease in very young adolescent (10 to 14 years old) fertility rates. We explored temporal trends for fertility rates among very young adolescents between 2000 and 2012 for Brazil as a whole, its regions and states; and analyzed the spatial distribution of fertility rates among Brazilian municipalities in the years 2000 and 2012. The adolescent fertility rate, defined as births per 1,000 among women aged between 15 and 19, has recently declined in the majority of high and middle-income countries, including the USA [2, 3]. Brazil has followed the same trend, with the adolescent fertility rate decreasing from 80.1 in 2000 to 60.9 in 2010 [4] This decline has occurred with marked regional differences [5], mainly because of income inequality among municipalities [4], much like previously observed for abortion and maternal mortality rates [6, 7]. Maternal death is 4 times higher than among women aged 20 to 24 years [8]
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