Neutrosophic DEMATEL to Prioritize Risk Factors in Teenage Pregnancy

An approach of TOPSIS technique for developing supplier selection with group decision making under type-2 neutrosophic number

Education is a fundamental right that should be accessible to all members of the society. However, one of the major contemporary social problem confronting most African Countries in the world is the Teenage Pregnancy. Teenage pregnancy limits girls’ access to higher education in developed and developing countries. Teenage parenthood and pregnancy during adolescence are risk factors for school dropout. Despite the numerous interventions put in place to address the challenge of teenage pregnancy among secondary school students, this problem continues witnessed in Kenyan secondary schools, particularly in Tharaka Nithi County. The low effectiveness in combating teenage pregnancy can be attributed to many factors among them parental influence. Therefore, the purpose of this study was to investigate parental influence on teenage pregnancy among secondary school students in Tharaka Nithi County. Descriptive research design adopted for the study. Data gathered from 15 secondary schools based on school categories using the Cluster sampling procedure. Clusters based on the school national ranking. The target population was 11,936 form three students in Public and Private secondary in schools in Tharaka Nithi, County. A sample size of 410 respondents comprising 30 teachers, and 380 students (300 girls and 80 boys) used. The instruments for data collection used were structured questionnaires and personal interviews. Pilot testing done in two schools in Meru County. The overall reliability coefficient of instruments using Cronbach’s alpha yielded 0.754. Data were analysis by use of descriptive statistics (frequencies, percentages, and standard deviation) and inferential statistics (Chi-square). Data analysis undertaken with the help of the Statistical package for Social Sciences (SPSS) version 26.0 software. The study established that there is a strong positive significant influence of parental influence on teenage pregnancy among secondary school students in Tharaka Nithi County, Kenya. The study recommends that the National and Tharaka Nithi county governments should engage parents in workshops to train them on comprehensive sex education and provide them with educational materials and guidelines. The research findings of the present study can shed light on secondary schools administrators, the Ministry of education policymakers, teachers, parents, and other stakeholders on teenage pregnancy among secondary schools in Tharaka Nithi County, Kenya. This knowledge can inform appropriate measures to mitigate the parental influence on teenage pregnancies. The findings of this study add to the body of knowledge and act as a basis for further research.

ABSTRACTBackgroundRisk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother’s teenage childbearing or an older sister’s teenage pregnancy more strongly predicts teenage pregnancy in a younger sister. MethodsThis study used linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP). The original cohort consisted of 17,115 women born in Manitoba between April 1, 1979 and March 31, 1994, who stayed in the province until at least their 20th birthday, had at least one older sister, and had no missing values on key variables. Propensity score matching (1:2) was used to create balanced cohorts for two logistic regression models; one examining the impact of an older sister’s teenage pregnancy on a younger sister's teenage pregnancy and the other analyzing the effect of the mother’s teenage childbearing on a younger sister's teenage pregnancy odds.ResultsThe adjusted odds of becoming pregnant between ages 14 and 19 for teens with at least one older sister having a teenage pregnancy were 3.06 (99% CI 2.53 - 3.64) times higher than for women whose older sister(s) did not have a teenage pregnancy. Teenage daughters of mothers who had their first child before age 20 had 1.51 (99% CI 1.29 - 1.78) times higher odds of pregnancy than those whose mothers had their first child after age 19. Educational achievement was adjusted for in a sub-population examining the odds of pregnancy between ages 16 and 19. After this adjustment, the odds of teenage pregnancy for teens with at least one older sister who had a teenage pregnancy were reduced to 2.34 (99% CI 1.92-2.86) and the odds of pregnancy for teen daughters of teenage mothers were reduced to 1.35 (99% CI 1.15-1.59).ConclusionGiven that an older sister’s teenage pregnancy has a much stronger impact than a mother’s teenage pregnancy, this study suggests social modeling to be a stronger risk factor for teenage pregnancy than living in an adverse environment created by a mother's adolescent childbearing. This study contributes to understanding of the broader topic “who is influential about what” within the family.

Background: Teenage pregnancy is an obstetric risk factor. They are more likely to suffer from complications of pregnancy, labour and delivery with increased morbidity and mortality in both infants and mothers. Objective: To determine the prevalence of teenage births, demographic characteristics and pregnancy outcome in this group of wome. Methods: This was a 12 months retrospective descriptive study of the pregnancy outcome of teenagers in the Jos University teaching Hospital, Jos, Nigeria between January and December 2003. Results: The prevalence of teenage birth was 5% or 21 per 1000 deliveries. The mean age was 18.20 ± 0.84 years, and mean parity was 1.2 ± 0.82. About 81% of the teenagers had completed only primary and secondary education. Nineteen percent (19%) of them were non-literate. Preterm delivery (24.5%) and vaginal trauma (episiotomies 41.3%) were the maternal morbidity while low birth weight (14.3%) was the common foetal morbidity in the study. The teenagers were similar to the total population in respect of booking status, and perinatal morbidity, but worse of in preterm delivery and low birth weight. There was no much difference, however, in the still birth and caesarean section rates. The maternal and foetal outcomes were generally satisfactory in the study. Conclusion: Teenage mothers constitute 5% of our antenatal patients and appear to be disadvantaged both socially and economically, as they are yet to attain their educational potentials. The older teenage status in addition to booking for antenatal care in pregnancy resulted in better foetal and maternal outcome. Keywords: prevalence, teenage pregnancy, pregnancy outcome Highland Medical Research Journal Vol. 3(2) 2005: 87-97

Smoking occurs frequently during pregnancy, thereby putting mother and child at health risks. Low socio-economic status is a risk factor for smoking. To investigate the relationship between smoking and low income in teenage and adult pregnancy, which is an important measure of poor socioeconomic status. The authors used subject-level data from the US NSDUH database, which contains information on pregnancies and smoking. Teenage pregnancy is associated with higher, whereas adult pregnancy with lower prevalence of smoking, compared to the age-matched female population. The association between income and smoking is age-dependent. Among adults there is an inverse relationship (high income -- low-risk of smoking), while in teenage pregnancy smoking increases with income. To investigate in teenage and adult pregnancy the relationship between smoking and low income, which is an important measure of poor socio-economic status. Higher socioeconomic status may be associated with risky behaviour, thereby increasing both the risk of smoking and early pregnancy.

The recent boom of various integrated decision-making methods has attracted many researchers to the field. The recent integrated Analytic Network Process and Decision Making Trial and Evaluation Laboratory (ANP–DEMATEL) methods were developed based on crisp numbers and fuzzy numbers. However, these numbers are incapable of dealing with the indeterminant and inconsistent information that exists in real-life problems. This paper proposes improvements to the integrated ANP–DEMATEL method by bringing together the neutrosophic numbers, the ANP method, and the DEMATEL method, which are later abbreviated to NS-DANP. The proposed NS-DANP method can handle the indeterminacy elements in the decision-making environment, as the single-valued neutrosophic numbers are used in the decision analysis. This proposed NS-DANP modification method includes linguistic variables representing the single-valued neutrosophic numbers (SVNNs), and also introduces the single-valued neutrosophic weighted averaging (SVNWA) aggregation operator to aggregate the decision makers’ judgments instead of the typical averaging method. The applicability of the proposed method is illustrated by a case study of the coastal erosion problem along the Peninsular Malaysia coastline, where 12 factors were considered. Three experts of coastal erosion from different organizations were invited to elicit their linguistic judgments on the cause–effect of the coastal erosion. The seven-step decision approach was developed to acquire the weightage of each coastal erosion factor. The outcome of this study reveals that coastal development is the riskiest factor toward coastal erosion. The weight of factors and the cause–effect diagram could be very helpful for government and stakeholders to project a better mitigation plan for the coastal erosion problem. Comparative analysis is also provided to check the feasibility of the proposed method.

To determine whether teenage pregnancy and Indigenous status are associated with increased risk of adverse pregnancy outcomes. A cross-sectional descriptive analysis of nulliparous women with singleton pregnancies who delivered at the sole tertiary obstetric hospital in Western Australia between June 2004 and September 2006, using data obtained from computerised midwifery records. Maternal risk factors, pregnancy characteristics, and obstetric and perinatal outcomes for teenage and adult pregnancies. Of the 4896 births reviewed, 560 (11%) were to teenage mothers. Teenagers were more likely to be Indigenous and to experience maternal risk factors such as anaemia and smoking. Indigenous women were more likely than non-Indigenous women to be smokers, with young Indigenous teenagers (aged 12-16 years) being most likely to smoke (odds ratio [OR], 6.29; 95% CI, 3.99-9.92). Perinatal outcomes for teenage and adult births were similar, while adjustment for smoking and Indigenous status changed the observed association for the Indigenous population of preterm delivery < 37 weeks' gestation (OR, 1.31; 95% CI, 1.01-1.71), admission to special care nursery (OR, 1.41; 95% CI, 1.10-1.81) and low birthweight (OR, 1.43; 95% CI, 1.10-1.87). However, older teenagers (aged 17-18 years) were the group at highest risk of stillbirth (OR, 1.99; 95% CI, 1.03-3.76). These results improve our understanding of the obstetric and medical issues associated with teenage pregnancy and birth in WA and how we might tailor our approach to care. Indigenous teenagers need special attention, and there is significant scope for public health interventions around anaemia and smoking in this population.

Young women who are sexual minorities (eg, bisexual and lesbian) are approximately twice as likely as those who are heterosexual to have a teen pregnancy. Therefore, we hypothesized that risk factors for teen pregnancy would vary across sexual orientation groups and that other potential risk factors exist that are unique to sexual minorities. We used multivariable log-binomial models gathered from 7120 young women in the longitudinal cohort known as the Growing Up Today Study to examine the following potential teen pregnancy risk factors: childhood maltreatment, bullying victimization and perpetration, and gender nonconformity. Among sexual minorities, we also examined the following: sexual minority developmental milestones, sexual orientation-related stress, sexual minority outness, and lesbian, gay, and bisexual social activity involvement. Childhood maltreatment and bullying were significant teen pregnancy risk factors among all participants. After adjusting for childhood maltreatment and bullying, the sexual orientation-related teen pregnancy disparities were attenuated; these risk factors explained 45% of the disparity. Among sexual minorities, reaching sexual minority developmental milestones earlier was also associated with an increased teen pregnancy risk. The higher teen pregnancy prevalence among sexual minorities compared with heterosexuals in this cohort was partially explained by childhood maltreatment and bullying, which may, in part, stem from sexual orientation-related discrimination. Teen pregnancy prevention efforts that are focused on risk factors more common among young women who are sexual minorities (eg, childhood maltreatment, bullying) can help to reduce the existing sexual orientation-related teen pregnancy disparity.

OBJECTIVES Young women who are sexual minorities (eg, bisexual and lesbian) are approximately twice as likely as those who are heterosexual to have a teen pregnancy. Therefore, we hypothesized that risk factors for teen pregnancy would vary across sexual orientation groups and that other potential risk factors exist that are unique to sexual minorities. METHODS We used multivariable log-binomial models gathered from 7120 young women in the longitudinal cohort known as the Growing Up Today Study to examine the following potential teen pregnancy risk factors: childhood maltreatment, bullying victimization and perpetration, and gender nonconformity. Among sexual minorities, we also examined the following: sexual minority developmental milestones, sexual orientation–related stress, sexual minority outness, and lesbian, gay, and bisexual social activity involvement. RESULTS Childhood maltreatment and bullying were significant teen pregnancy risk factors among all participants. After adjusting for childhood maltreatment and bullying, the sexual orientation–related teen pregnancy disparities were attenuated; these risk factors explained 45% of the disparity. Among sexual minorities, reaching sexual minority developmental milestones earlier was also associated with an increased teen pregnancy risk. CONCLUSIONS The higher teen pregnancy prevalence among sexual minorities compared with heterosexuals in this cohort was partially explained by childhood maltreatment and bullying, which may, in part, stem from sexual orientation–related discrimination. Teen pregnancy prevention efforts that are focused on risk factors more common among young women who are sexual minorities (eg, childhood maltreatment, bullying) can help to reduce the existing sexual orientation–related teen pregnancy disparity.

Teenage pregnancies still prevalent in rural areas with a low levels of family income. Teenage pregnancy may cause maternal mortality and infant mortality. This study was conducted to analyze the risk factors of teenage pregnancy in the District Saptosari Gunungkidul. This research used analytical observational study with case control design. Data was collected by interview with 46 teenagers, consisted of 23 pregnant teenagers and 23 nonpregnant teenagers in Saptosari Gunungkidul. The samples were taken by simple random sampling method and interviews were conducted with respondents to get the information about the variables studied. The independent variable were premarital sexual activity, religious obedience and social economic. Dependen variable in this study was teenage pregnancy. Data was analyzed using binary logistic regression ( α 0.05 ). The result showed that there was influence of religious obedience on teenage pregnancy. Teenage with low religious obedience had high risk to have teenage pregnancy than those with high level of religious obedience with OR 57,8. Teenage with low social economic had high risk to have teenage pregnancy than those with high social economic (OR: 63,9). The conclusion of this research is risk factors which infl uence the occurrent off teenage pregnancy are religious obedience and social economic.

Evidence from sub-Saharan Africa indicates that 35 percent of pregnancies among 15-19-year (s)-olds were unplanned, unwanted, or untimed and that the teenagers’ relationships were unstable. Teenage pregnancy is a global problem especially in developing countries. Teenage pregnancy is associated with several social issues: poverty, low education levels, and the lack of awareness about sex and pregnancy prevention. The contributing factors for teenage pregnancy are multiple and complex categorised as socio-demographic, familial, cultural, and reproductive behaviour. Different literature reported that factors associated with teenage pregnancy include living in rural areas, not attending school, early marriage, lack of communication between parents and adolescents about sexual and reproductive health (SRH) issues, educational level of the teenagers and family history of teenage pregnancy. A scoping review was conducted from February 2021 to August 2021 using the following specific subject databases: Google scholar, PubMed, EBSCOhost, and research gate. Special attention was paid to keywords during navigation to ensure consistency of searches in each database. English language, studies conducted in sub-Sahara Africa and articles published in the last 10 years (2011–2021), were the three limiters applied in the four databases. The researchers identified eight themes for inclusion in the findings. The themes fell into three major categories: individual related factors, family related factors and external factors. These themes reflect factors associated with teenage pregnancy. The review revealed that there are several risk factors that lead to teenage pregnancy. Therefore, there is urgency for strategic interventions aimed at improving teenage pregnancy through female education and sexual and reproductive health education must also be introduced or reinforced in schools. Policy makers, community leaders and school curriculum can act towards raising the age for marriage to after 20 years and make the methods of contraception accessible to teenagers. Qualitative techniques like focus group discussions in communities could be helpful in reflecting on the root cause of the problem.

BackgroundBacterial vaginosis (BV) is a microbial imbalance (i.e., dysbiosis) that can produce serious medical effects in women at childbearing age. Little is known, however, about the incidence of BV or vaginal microbiota dysbiosis in pregnant teenagers in low and middle-income countries such as Ecuador. The scope of this exploratory analysis was to study the relationship between epidemiologic and microbial risk factors. Among the microbiology risk factors this study investigated five Lactobacillus species, two of them know in preview studies as microbiology risk factors for BV development (Lactobacillus acidophilus and Lactobacillus iners), and the last three known for being associated with a healthy vaginal tract (Lactobacillus crispatus, Lactobacillus gasseri and Lactobacillus jensenii). In addition, fastidious anaerobes known to be microbial risk factors for BV development in pregnant teenagers were searched as well, more exactly, Gardnerella vaginalis, Atopobium vaginae and Mobiluncus mulieris.MethodsNinety-five healthy adolescent pregnant women, visiting a secondary level hospital in Quito, Ecuador, were enrolled into the study in 2015. The enrolled patients were between 10 to 13 weeks of pregnancy. Four epidemiological risk factors were collected in a survey: age, civil status, sexual partners and condom use. Also, vaginal pH was measured as a health risk factor. DNA was extracted from endocervical and exocervical epithelia from all the patients’ samples. PCR analysis was performed in order to characterize the presence of the eight bacterial species known as risk factors for BV development, targeting three anaerobes and five Lactobacillus species. Univariate and multivariate analysis were performed to identify associated factors for the presence of anaerobic species using logistic regression.ResultsThe 95 vaginal microflora samples of these teenagers were analyzed. Two of the bacterial species known to cause BV: A. vaginae (100%) and G. vaginalis (93.7%) were found in high prevalence. Moreover, the most predominant bacterial Lactobacillus species found in the pregnant teenagers’ vaginal tract were L. crispatus (92.6%), L. iners (89.5%) and L. acidophilus (87.4%). In addition, the average vaginal pH measured in the study population was 5.2, and high pH was associated with the presence of the three-anaerobic species (p = 0.001). Finally, L. jensenii’s presence in the study decreased in 72% the occupation of the three anaerobes.DiscussionThis work identified a high pH as a risk factor for BV anaerobes’ presence in adolescent pregnant women. Moreover, this study identified L. crispatus, L. iners and L. acidophilus to be the most abundant species in our study population. From all fastidious anaerobes analyzed in this study, A. vaginae was present in all pregnant teenagers. To conclude, L. jensenii could be a potential healthy vaginal microbiota candidate in pregnant teenagers and should be further analyzed in future studies.

PurposeThe complex network structure causes several disruptions in the supply chain that make risk management essential for supply chain management including halal supply chain (HSM). During risk management, several challenges are associated with the risk assessment phase, such as incomplete and uncertain information about the system. To cater this, the authors propose a risk assessment framework that addresses the issues of uncertainty using neutrosophic theory and demonstrated the applicability of the proposed framework through the case of halal supply chain management (HSCM).Design/methodology/approachThe proposed framework is using the capabilities of the neutrosophic number which can handle uncertain, vague and incomplete information. Initially, the risk related to the HSC is identified through a literature review and expert’s input. Further, the probability and impact of each HSM-related risk are assessed using experts’ input through linguistic terms. These linguistic values are transformed into single-value trapezoidal neutrosophic numbers (SVTNNs). Finally, the severity of each HSM-related risk is determined through the multiplication of the probability and impact of each risk and prioritised the risks based on their severity.FindingsA comprehensive risk assessment framework is developed that could be used under uncertainty. Initially, 16 risks are identified related to the HSM. Further, the identified risks are prioritised using the severity of the risks. The high-priority risk is “raw material status”, “raw material wholesomeness” and “origin of raw material” while “information integrity” and “people integrity” are low-priority risks.Practical implicationsHSM risk can be effectively assessed through the proposed framework. The proposed framework applied neutrosophic numbers to represent real-life situations, and it could be used for other supply chains as well.Originality/valueThe proposed method is effectively addressing the issue of linguistic subjectivity, inconsistent information and uncertainty in the expert’s opinion. A case study of the HSC is adopted to illustrate the efficiency and applicability of the proposed risk framework.

Due to growing risk and complexity of modern decision-making problems, the graded information associated with linguistic terms is suitable to characterize the uncertainty during cognition process. By combining 2-dimensional linguistic variables and interval neutrosophic numbers, we put forward a new concept of 2-dimensional interval neutrosophic linguistic numbers and establish pertinent operational rules. Moreover, we develop an operator for fusing 2-dimensional interval neutrosophic linguistic numbers by means of Choquet integral, by which the relationships among the attributes can be reflected. The established aggregation operator’s properties are also studied. In the sequel, a new group PROMETHEE (preference ranking organization method for enrichment evaluations) II method is created to deal with the group decision problems with 2-dimensional interval neutrosophic linguistic terms.

Despite reduction in the rates of teen pregnancy nationwide, teen pregnancy in the United States remains higher than other industrialized countries. Minority youth are at higher risk for teen pregnancy than their White counterparts. With this in mind, the purpose of this chapter is to examine risk and protective factors for teen pregnancy among racial and ethnic minorities. Risk and protective factors exist on multiple levels and pregnancy prevention programs often target such factors to reduce teen pregnancy. In addition, intervention strategies aimed at reducing teen pregnancy among these populations will also be discussed. Researchers have identified components of successful teen pregnancy prevention programs. New strategies also include focusing on after school programs and technology among others to reduce teen pregnancy among minority youth. Collective efforts of families, schools, and communities are warranted.