What Constitutes Risk of Future Maltreatment Among Young Mothers? An Examination of Child Protection Investigations in Ontario, Canada

Moderate to heavy alcohol use during pregnancy (≥3 drinks/occasion) is linked to a range of adverse offspring outcomes. Prior studies suggest that adolescent and young adult mothers may be particularly vulnerable to these risky drinking behaviors during and after pregnancy. This study used latent class growth analysis (LCGA) to examine changes in risky drinking from prepregnancy to postpregnancy and identified prepregnancy predictors representing cognitive and social factors to inform prevention. Participants included 432 adolescent and young adult mothers (aged 13 to 24; 78% Black) assessed annually since childhood in the Pittsburgh Girls Study. Participants prospectively reported frequency of risky drinking (≥3 drinks/occasion) in the year of pregnancy and 2years before and after pregnancy, as well as social-cognitive risk factors for drinking (alcohol expectancies, drinking motives, caregiver, and peer alcohol use). Approximately 11% of young mothers in this community-based sample engaged in risky drinking at least once a month during the year of pregnancy, with greater frequency observed for young adult (vs. adolescent) mothers. LCGA revealed 4 risky drinking trajectories across the perinatal period, including 3 relatively stable trajectories (low, moderate, and high frequency) and 1 distinct trajectory ("postpartum initiators") characterized by increased risky drinking post-childbirth. Peer alcohol use during and after pregnancy distinguished higher risk from lower risk trajectories, controlling for age, race, and age of drinking onset. Exposure to caregiver alcohol use and prepregnancy coping motives for drinking also elevated risk, but only for mothers who became pregnant in early adulthood (vs. adolescence). Adolescent and young adult mothers show heterogeneous risky drinking trajectories from prepregnancy to postpregnancy. Pregnant women in the transitional age of early adulthood who report exposure to caregiver alcohol use, more friends who drink, and coping motives for drinking may have elevated risk for moderate-heavy drinking during the perinatal period and may benefit from targeted intervention.

Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008) were used to compare 284 teen mothers (18 years or younger) and 800 young mothers (19-21 years) and their families with 5752 families where the mother was 22 years or older. Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother) received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10%) and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18%) and few social supports (46% and 41% vs. 37%). Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%). All were equally likely to be victims of domestic violence and to have mental health issues. Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.

BackgroundHolistic attention to adolescent health is needed to sustain the benefits of investment in early childhood development. Any such interventions must make sure to address the needs of adolescent and young adult parents. This study explored the social and demographic maternal variables associated with risk of early childhood development (ECD) delay for children of young mothers in Brazil.MethodsCross-sectional secondary data analysis was done using data from young mothers (aged 13–24) and their children (aged 0–2), collected from community health centers in Brasília, Brazil, between 2017–2018. The Denver Developmental Screening Test II was used to assess risk of ECD delay outcomes. Descriptive analyses were conducted across the full sample and sub-groups of adolescent (13–19) and young adult (20–24) mothers. Multivariable logistic regressions based on theory modelling approach were conducted for the full sample to examine the associations between maternal age and risk of ECD delay, adjusted for a battery of household, maternal, pregnancy, and infant variables.ResultsRisk of ECD delay was found in 17.39% (N = 76) of the children who participated (N = 437). No significant differences in risk of ECD delay were found for children of adolescent mothers compared to children of young adult mothers. Across the full sample, 60.36% (N = 236) of mothers were living in poverty, 73.17% (N = 319) had 9 or more years of education, and 86.14% (N = 373) were not working outside the home at time of data collection. Furthermore, 90.11% (N = 392) did not identify as head of their household and 73.68% (N = 322) were primiparous. Socially-mediated factors such as lower maternal educational attainment, unemployment, and lack of household support were associated with increased risk of ECD delays for children under age 2. Adjusted logistic regression identified multiparity as an independent maternal factor associated with increased risk of ECD delay (AOR = 2.51; 95% CI, 1.23–5.13).ConclusionsMultiparity was the only independent maternal factor associated with ECD delay among children under 2 years old. Other socio-demographic factors relevant to young mothers may influence ECD delays. Ensuring sustained, concurrent attention to children’s and young parent’s developmental needs may improve multi-generational health outcomes.

Mental health issues in adolescent mothers and young adult mothers: the Brazilian context

BackgroundLimited information is available concerning investigating the separate effect of teenage childbirth on medical issues in the antenatal and perinatal periods. Therefore, this study aimed to assess medical problems in antenatal and perinatal periods among early youth, adolescent and young adult mothers in Taiwan.MethodsThis retrospective population-based cohort study was conducted by using data from Taiwan’s National Health Insurance Research Database. A total of 335,590 mothers aged less than 25 years who had singleton births were identified between 2002 and 2011. Univariate and multivariate logistic regression analyses were conducted to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) of each medical problem category in the antenatal and perinatal periods.ResultsCompared with mothers aged 20–24 years, adolescents (16–19 years) and early youth mothers (≤15 years), particularly those aged 10–15, had a significantly higher risk of intrauterine growth retardation (IUGR, OR = 1.37, 95% CI: 1.00–1.89) and preterm delivery (OR = 2.98, 95% CI: 2.48–3.58) after adjusting for demographic characteristics and clinical factors. Additionally, adolescents mothers were at an increased risk of anemia (OR = 1.32, 95% CI: 1.24–1.40), oligohydramnios (OR = 1.21, 95% CI: 1.12–1.32), failed labor induction (OR = 1.33, 95% CI: 1.24–1.43), and fetal distress (OR = 1.20, 95% CI: 1.14–1.26) after adjustment.ConclusionsNot all young mothers in our study experienced the same magnitude of increased medical problems in the antenatal and perinatal periods. However, a sufficiently higher probability of having IUGR and preterm delivery was observed among early youth and adolescent mothers.

Purpose: To describe the association between breastfeeding and postpartum depressive symptoms among a sample of adolescent and young adult mothers and to determine whether breastfeeding difficulty moderates this association.Materials and methods: Data were derived from a prospective cohort of pregnant adolescent and young adult females (ages 14–21) as they transitioned to parenthood. This analysis uses data collected during pregnancy and at 6 months postpartum among mothers (n = 137) who initiated breastfeeding. Multivariable linear regression was used to adjust for prenatal depressive symptoms and other potential confounders.Results: Postpartum depressive symptoms were not significantly associated with breastfeeding duration or breastfeeding at 6 months. Early breastfeeding difficulty moderated the association between depressive symptoms and breastfeeding at 6 months. Among young mothers who were still breastfeeding at 6 months, those who reported no early breastfeeding difficulties had the lowest depressive scores and those who reported much early breastfeeding difficulty had the highest depressive scores at 6 months.Conclusions: Minimizing challenges with breastfeeding may help improve postpartum mental health among adolescent and young adult mothers. Health care providers should help young pregnant women manage expectations about breastfeeding and ensure that they are linked to appropriate professional breastfeeding support during the early postpartum period.

122. Transitions to Parenthood: Maternal Adjustment Sexually Transmitted Infection Risk Among Young African American Mothers

Premature Infants Born to Adolescent Mothers: Health Care Utilization After Initial Discharge

This study relates the experiences of a group of white adolescent mothers with some of the men who have been important to them and to their children. It examines the range and types of participation in family life of different groups of men and describes the mothers feelings about these contributions. Because there is no model pattern of family formation for young white mothers the study presents a range of possible relationships in order to demonstrate the variety of configurations of support that an adolescent mother may encounter. Respondents for this study were 30 primiparous Caucasian women who gave birth before their 20th birthdays and whose children were between the ages of 12 and 27 months at the time of the interview. As the rate of birth of white adolescents has declined the cultural norms that guided the young parents responses to childbearing have altered. The custom for pregnant adolescents to marry is changing. A young mother may live with her parents stepparents siblings boyfriend husband friend various combinations of the above or alone. These combinations provide a wide variety of possible males who could serve as fathers to the child. Among the children in this study all had lived in a household with a male aged 17 or older for at least 2 months at some point during their lives. Not all candidates for fatherhood live in the household. Many mothers had boyfriends each of whom was a potential new legal father to the child. One must also consider absent fathers whether they be exhusbands or biological fathers who never lived with the mother at all. 4 major groups of fathers are discussed: current husbands former boyfriends or exhusbands who are the childrens biological fathers current boyfriends (not the biological fathers) and the babies maternal grandfathers or stepgrandfathers. It becomes clear that the experiences of most children of young mothers are not with 1 father figure but with many. 19 of the children in this study had undergone a change in household-based fathers between the time of birth and the time of the interview and 6 more children could be expected to experience a change within the next 2 years. If changes in nonhousehold fathers are included the numbers are much greater. Defining fatherhood for children of white adolescent mothers is the key question needing exploration.

PATTERNS OF PARENTING BEHAVIOR IN YOUNG MOTHERS* Leanne Whiteside-Mansell, Sandra K. Pope, and Robert H. Bradley** Children of young mothers are thought to be at risk for developmental delay and behavioral problems. In this study, the parenting behaviors of 193 White and African American mothers 15-24 years of age were assessed when their children were 12 and 36 months old. Cluster analysis of 3 dimensions of parenting was used to identify 5 types of parenting patterns. Evidence supporting these parenting clusters included interpretable mean scores; expected differences in children's cognitive and social development; and differences in familial, maternal, and child factors. The strongest discriminating factor-maternal IQ-was associated with more positive parenting behavior patterns. Among the mothers with the lowest IQ scores, the most discriminating factor was the birth of additional children. The results of this study support the assumption that parenting is dynamic and multidimensional. Since the 1960s, when the birth rate among unwed teenagers began increasing and young mothers began shifting away from adoption as an option for providing care for their infants, society has shown accelerated concern for young parents as caregivers. Many young mothers lack financial resources and stable environments; many of their children will spend at least part of their lives in poverty. Children of young mothers are thought to be at risk for developmental delay and behavioral problems because of the low quality of caregiving provided by their young mothers. Although research concerning the direct influence of maternal age on parenting behaviors is mixed (Conger, Yang, & Burgess, 1984; Elster, McAnarney, & Lamb, 1983; Jones, Green, & Krauss, 1980), there is evidence that younger mothers interact differently with their children and are less competent parents than older mothers on some dimensions of parenting. Several studies indicate that young mothers provide less stimulation to their children than older mothers (Brooks-Gunn & Chase-Lansdale, 1991; Carlson, Labarba, Sclafani, & Bowers, 1986; Coll, Vahr, Hoffman, & Oh, 1986; King & Fullard, 1982; Luster & Rhoades, 1989; Parks & Arndt, 1990; Reis, Barbera-Stein, & Bennett, 1986; Schilmoeller & Baranowski, 1985) and, in particular, provide less verbal stimulation to their infants (Coll, Hoffman, & Oh, 1987; Field, Widmayer, Stringer, & Ignatoff, 1980; McAnarney, Lawrence, Ricciuti, Polley, & Szilagyi, 1986; Reis & Herz, 1987; Schilmoeller & Baranowski, 1985; vonWindeguth & Urbano, 1989). In addition, young mothers demonstrate less acceptance of infant behavior (are more punitive) than older mothers (McAnarney et al., 1986; Reis & Herz, 1987). However, Lamb and Ketterlinus (1990), after reviewing the literature, concluded that there is no evidence that young mothers are more likely to neglect or abuse their offspring. Some researchers reason that young women are immature (generally measured by maternal age) and psychologically unprepared to parent. They suggest that young mothers, like adolescents in general, are absorbed with their own needs, have not developed adequate coping mechanisms, and are struggling to gain autonomy (Helm, 1988; Jones et al., 1980). Others argue that age per se may not be the issue. They maintain that young mothers represent a diverse group and that environmental and family factors associated with young parenthood may be more determinative of parenting than the age of the mother (King & Fullard, 1982; Osofsky, Culp, & Ware, 1988; Roosa, Fitzgerald, & Carlson, 1982). Because many young mothers are single, live in poverty, possess few resources, and experience more than normal stresses, it is difficult to separate the influence of environmental factors and young age (Elster et al., 1983; Ketterlinus, Lamb, & Nitz, 1991). In effect, young mothers are often at risk for distress, which makes it more difficult for them to provide nurturant, stimulating care (McLoyd, 1990). …

Purpose: Adolescent girls with mental illness are at heightened risk for unplanned pregnancies, which often disrupts typical psychological development, relationship formation, access to support systems, and school performance. Thus, adolescent mothers face many challenges while parenting in addition to coping with mental health concerns. Without interventions, adolescent mothers may put themselves and their children at risk and face further challenges than their non-parent or older counterparts. Method: The Mom Power program (MP) is a treatment engagement intervention for young mothers and their children, developed through a University-Community Partnership in Michigan. The program is designed to engage young mothers in mental health services, provide developmental and parenting guidance, teach self-care skills, increase social support, and provide hands-on parenting practice. Results: Preliminary feasibility data support MP as an effective intervention for adolescent mothers by reducing selfreported symptoms of Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD). MP is effective at increasing parenting competence, social support and connection to care in a high-risk population of young mothers compared to a demographically similar group of young mothers that did not complete the intervention. Conclusion: Mom Power is a short-term attachment-based psycho-educational parenting and self-care skills group for adolescent mothers. Comprehensive models like the MP Program are vital in reaching out to the needs of young mothers and their babies in an effort to decrease mental health symptoms and increase positive parenting skills

This chapter describes interventions for adolescent and young adult mothers who are pregnant or parenting and have substance abuse problems. It first considers the specific vulnerabilities of substance-using adolescent and young adult mothers, as well as the components of empirically supported interventions that may inform age-appropriate intervention development. It then discusses specific developmental considerations unique to adolescent and young adult mothers, along with the very few treatment models designed for pregnant and/or parenting adolescents and young adults with substance use problems. It also examines individual risk factors affecting parenting, with particular emphasis on the “dual-development hypothesis,” along with comorbid psychopathology in adolescent mothers. The chapter concludes by suggesting directions for future research.

The associations between intimate partner violence (IPV) and mental health among adolescent and young adult mothers were compared. The sample was drawn from the Fragile Families and Child Wellbeing Study and participants were 672 mothers between the ages of 14 and 21. IPV was significantly positively associated with both depression and anxiety among young adult mothers. However, these associations were not found among adolescent mothers. In addition, IPV and marital status were significantly related among young adult mothers, but not adolescent mothers. Results suggest that IPV may have different consequences during different parts of the life course, or that mental health symptoms may be reported only later in life.

The purpose of this study was to determine influence of social economic status on the nutrition status of born to young mothers in Transmara west Narok County, Kenya. Five health facilities were purposively selected in Transmara West Sub County, Narok County by use of analytical cross-sectional study design. A sample size of 246 infants and 246 adolescent mothers were recruited from the health facilities. Quantitative data was analysed using SPPS for windows version 24.0 and ENA for SMART survey 2011. The relationship between nutritional status and other variables was established by use of chi-square test at a significance level of less than 0.05. Most of the mothers were between 16 to 17 years with the youngest mother being 14 years old. The study concluded that the young teenage mothers depended on their families as the main sustenance and others did casual jobs to fend for themselves and their infants.The majority of the adolescent mothers could be classified as of low socio-economic backgrounds. The study recommends that children of young mothers are more vulnerable to malnutrition hence should be given more priority by the government and other stakeholders.

106. Pregnancy and Delivery Outcomes in Adolescent and Young Adult Mothers in the Military Health System