Abstract
ABSTRACTObjective:analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods:a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results:differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; p<0.001), have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001) and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001) than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. Conclusion:this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes.
Highlights
National fertility rates among adolescents are commonly used as an indicator for children and young people’s health
Higher rates are consistently reported for developing nations in sub-Saharan Africa; rates for Brazil are consistently higher than the global rates, with a rate of 68 in 1,000 reported in 2012, which is among the highest rates reported in Latin America and the Caribbean[1]
In Santa Catarina State, during the period 2006 to 2013, there were 115,559 live births to mothers aged 10 to 19 years, representing a proportion of nearly 17% of all live births (n=685,525). 3.8% (n=4,397) of births to adolescent mothers were in the youngest cohort aged 10 to 14 years
Summary
National fertility rates among adolescents are commonly used as an indicator for children and young people’s health. While there has been a decline in the birth rate globally in recent years, pregnancy in adolescence remains a public health concern. The global birth rate, or age-specific fertility rate, for mothers aged 15 to 19 from 2007 to 2012 has been reported as 50 per 1,000. The World Health Organization (WHO) reports that half of all births to adolescent mothers occur in just seven countries, Brazil being one of these[2]. Epidemiological studies indicate that adolescent pregnancies lead to a greater proportion of infants being born preterm and/or with low birth weight, which in turn have been associated with higher mortality rates[4,5,6,7]. Risky lifestyle behaviors, poor adherence to prenatal care and biological immaturity have been suggested as possible explanations for adverse obstetric and perinatal outcomes in this group[4,5,8]
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