Children Of Adolescent Mothers Research Articles

Exploring Factors Influencing Parent-Adolescent Communication on Sexual and Reproductive Health (SRH)—A Qualitative Study from Bengaluru, India

Background: Sexuality and reproductive health have remained a topic of taboo and disgust in India, owing to its deep-rooted cultural, traditional and religious practices. Lack of right sources of information and negligible communication about sexual and reproductive health (SRH) with trusted adults encourages adolescents to rely on unsafe sources, both online and offline, which could lead to detrimental consequences on their physical and mental health. Methods: This study utilizes a qualitative descriptive design to explore the factors influencing parent-adolescent communication on SRH. It focuses on mothers of adolescent children (10–19 years) from Urban Bengaluru. Data is collected through in-depth interviews of mothers and thematic analysis is performed on the data collected. Results: The qualitative analysis identified five core themes: Knowledge about SRH and gender-based needs, cultural and traditional influences, role of family, role of partner and inhibition of children. The perspectives of parents provided scope for what could be done to facilitate healthy and open communication. Conclusion: This study portrays the factors that hinder free communication between parents and adolescents about SRH. Suggestions for breaking the taboo pertaining to sexuality conversations and future studies have also been mentioned.

Vaccine coverage and timeliness among children of adolescent mothers: A community-based study in the Eastern Cape, South Africa

BackgroundChildren born to adolescent mothers are more vulnerable to infant mortality and morbidity than those born to adult mothers. HIV-exposed children have lower antibody protection against vaccine-preventable diseases at birth compared to unexposed children. In South Africa, 17 % of adolescent girls aged 15–19 years are mothers, yet vaccination coverage and timeliness among their children is underreported. MethodsThis study estimated age-appropriate vaccination coverage and timeliness among children (n = 1080) of adolescent mothers (n = 1015) in the Eastern Cape, South Africa. Mother-child dyads were recruited through healthcare and community-based sampling strategies. Vaccination data were abstracted from 1013 home-based child health records (2017–2019). Coverage is reported for Diphtheria-Tetanus-Pertussis 3rd dose (DTP3), under-1 vaccination among children over 12 months (n = 613) and measles 2nd dose (MCV2) among children over 24 months (n = 382) using proportions with 95 % confidence intervals (95 %CI). Timeliness is defined as receiving each vaccination within 4 weeks of recommended age. Findings are disaggregated by maternal HIV-status. ResultsOverall, 27.3 % of adolescent mothers were living with HIV. Coverage of DTP3 was 85.6 % (95 %CI: 82.6–88.3 %), under-1 coverage was 53.2 % (95 %CI: 49.1–57.2 %), and MCV2 coverage was 62.3 % (95 %CI: 57.2–67.2 %). Vaccination coverage was lower among children of adolescent mothers living with HIV (AMLHIV) than unexposed children (DTP3 80.3 % vs 88.2 % p-value: 0.01; under-1 46.5 % vs 56.4 % p-value: 0.02; MCV2 55.4 % vs 67.1 % p-value: 0.02). Timeliness of vaccinations declined over time from 98.0 % at birth, 70.7 % at 14 weeks, 71.9 % at 9 months and 37.3 % at 18 months. ConclusionVaccination coverage among children of adolescent mothers in the Eastern Cape are below national targets. Children of AMLHIV had lower coverage than HIV-unexposed children. Further research is needed to identify risk factors associated with incomplete and delayed vaccinations among this group, particularly among HIV-exposed children. Enhanced vaccination campaigns may be required for children of adolescent mothers.

Understanding the socio-demographic and programmatic factors associated with adolescent motherhood and its association with child undernutrition in Bangladesh

BackgroundWorldwide, a significant number of girls become mothers during adolescence. In Bangladesh, adolescent childbirth is highly prevalent and has adverse effects on children’s health and undernutrition. We aimed to identify the relationship between the undernutrition of children and adolescent motherhood, the factors associated with adolescent mothers’ age at first birth, and to examine the programmatic factors and gaps influencing children’s undernutrition in Bangladesh.MethodsWe analysed the ‘Bangladesh Demographic and Health Survey’ BDHS-17-18 data and desk review. To examine the factors associated with adolescent motherhood and its impact on child undernutrition, data from 7,643 mother-child pairs were selected. Child stunting, wasting, and underweight were measured according to the World Health Organisation (WHO) median growth guidelines based on z-scores − 2. Univariate, bivariate, simple, and multiple logistic regressions were used for analyse. We followed the systematic procedures for the literature review.ResultsApproximately, 89% of adolescents aged ≤ 19 years were married and 71% of them gave their first childbirth. Children of adolescent mothers (≤ 19 years) were significantly 1.68 times more wasted (aOR: 1.68; 95% CI: 1.08 to 2.64), 1.37 times more underweight (aOR: 1.37; 95% CI: 1.01 to 1.86) and either form 1.32 times more stunting, wasting or underweight (aOR:1.32; 95% Cl: 1.05 to 1.66) compared to the children of adult mothers (> 19 years) after adjusting potential confounders. The factors associated with mothers’ first childbirth during adolescence were the age gap between husband and wife 5–10 years (aOR: 1.81; 95% Cl: 1.57–2.10) and age gap > 10 years (aOR: 2.41; 95% Cl: 1.96–2.97) compared with the age group < 5 years, and husbands’ education (aOR: 1.29; 95% Cl: 1.04–1.61) compared with the uneducated husbands. In the literature review, we found potential gaps in focusing on the Adolescent Sexual and Reproductive Health (ASRH) program in Bangladesh, from thirty-two programmes only half of them focused on adolescents aged 10–19 years, and eleven programmes focused only on girls.ConclusionChildren of adolescent mothers are at risk of wasting, underweight, and any form of undernutrition. For effective policies and interventions in Bangladesh, it is important to emphasise delaying adolescent pregnancy and prioritising child undernutrition.

Sex-specific associations of adolescent motherhood with cognitive function, behavioral problems, and autistic-like traits in offspring and the mediating roles of family conflict and altered brain structure

BackgroundPrevious studies have linked adolescent motherhood to adverse neurodevelopmental outcomes in offspring, yet the sex-specific effect and underlying mechanisms remain unclear.MethodsThis 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.ResultsOur 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.ConclusionsOur 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.

Infant Feeding Practices, Prevalence of Adolescent Motherhood and Malnutrition among Infants in Mangu Local Government Area, Plateau State, Nigeria.

Background: Adolescent motherhood and malnutrition among children are significant challenges in Africa, but there is limited data on the impact of adolescent motherhood on their children's health and nutrition. This study assessed infant feeding practices, prevalence of adolescent motherhood, and malnutrition among infants in Mangu local government area (LGA). Methodology: A cross-sectional survey using multistage sampling was conducted. Validated questionnaires were used to collect socio-demographic data, and appropriate tools were used for anthropometric measurements. Data were compared with established standards. Descriptive statistical tools, chi square, Pearson correlation, and independent sample t-test were used for data analysis, with significance set at p < 0.05. Results: A total of 200 mothers completed the study. The majority of the infants (78.5%) were less than 6 months old, and 21.5% were 6-12 months old. Breastfeeding initiation within 1 hour was reported by 39% of mothers, while 38% practiced prelacteal feeding. Only 28.5% practiced exclusive breastfeeding, and all mothers breastfed their babies. The prevalence of adolescent motherhood was 37.5%. The prevalence of stunting, wasting, and underweight among infants were 29.5%, 12%, and 8.5%, respectively. Children of adolescent mothers had higher rates of severe stunting compared to children of mothers above 19 years of age. There were significant differences (p = 0.017 and p = 0.029) in stunting rates and weight-for-age indices between children of adolescent mothers and mothers above 19 years of age. Conclusion: Adolescent motherhood contributes to chronic malnutrition in children, and there is a high prevalence of malnutrition among infants in Mangu LGA, Plateau State.

Are evidence-based vaccination interventions transferable to Ukrainian migrants? A Polish example

Abstract Background Ukrainian migrants (UM) are among underserved groups with limited access to use vaccination services. The RIVER-EU in Poland aims to identify and tailor the successful intervention which would address health system barriers to MMR/HPV vaccination identified during the 1st phase of the project. Methods Participatory action research approach (PAR) was introduced to bring Researchers, UM and other Stakeholders together to identify and discuss transferability of promising evidence-based vaccination interventions (HPV/MMR). Relevant topic guides were developed; these helped to conduct focus groups discussions and in-depth interviews aimed to assess the extent to which interventions were appropriate and identify facilitators/barriers for the transfer and implementation. Results UM community (mothers of adolescent children and general practitioners [GPs]), Polish GPs, policymakers, experts in vaccinology and gynecological oncology, representatives of the municipality and a non-governmental organization were identified as key stakeholders. To find and mobilize UM appeared to be the challenging task, as they are a diverse, hard-to-reach community. The lack of information about the HPV vaccine was another obstacle to mobilize this group. Engaging GPs was also difficult due to work overload, lack of time, incapacity; the lack of extra compensation negatively affected motivation to be involved. To gain the trust of stakeholders and to build relationships - consistent, transparent, inclusive communication and cooperation was needed; country coordinators played moderators’ role. Conclusions To achieve consensus about the type of a tailor-made intervention requires creating clear communication channels and an open space where stakeholders can voice their opinions. PAR helped to achieve more meaningful insight into the transferability of MMR/HPV vaccination interventions by leveraging the collective wisdom of the researchers, UM community and other Stakeholders.

Negative birth outcomes and stunting among adolescent and non-adolescent mothers in Türkiye.

Adolescent motherhood can cause lifelong health inequalities for mothers and children. To compare the frequency of negative birth outcomes and stunting among children aged ≤ 5 years born to adolescent and non-adolescent mothers. This was a secondary analysis of the Demographic and Health Survey data of 2755 adolescent and non-adolescent mothers aged 15-49 years who had a negative birth outcome and their children aged 0-5 years in Türkiye. The data were analysed using SPSS version 25.0. Term low birthweight and stunting were significantly higher among children of adolescent mothers. Multivariable analysis revealed that lack of education, poverty, and living in eastern Türkiye increased the risk of delivering a term low birthweight infant. The risk of being stunted was 2.22 times higher among women with lower socioeconomic status, and 2.86 times higher among low birthweight infants. Our results show that macroenvironmental factors have a marked impact on maternal and child health, especially among women with lower socioeconomic status. Improving maternal education, income, and other socioeconomic inequalities can help improve maternal and child health in Türkiye.

Breaking Cyclic Intergenerational Literacy Deficits: Describing Linguistic Interactions Between Adolescent Mothers and Their Young Children

Adolescent mothers (AMs) often experience limited academic and financial attainment and higher rates of mental health disorders, which may affect their relationships with their children. Although children of AMs are at higher risk for developmental delays, there is no clear evidence of the relationships between mother characteristics and child outcomes. This descriptive study explored AMs’ and their children’s sociodemographic characteristics and language skills, home literacy environment, and the quality of mother–child interactions. Eight AM–child dyads were recruited from local school districts. Data were collected through questionnaires, standardized measures of language, and mother–child interactions. Most AMs demonstrated below-average language skills and most children had language scores that fell within the average range. AMs demonstrated strong affectionate behaviors, and emerging responsive, encouraging, and teaching behaviors when interacting with their children. This study provides unique data on AMs’ language characteristics that have not been clearly published in the literature.

Development and evaluation of nursing intervention in preventing stunting in children of adolescent mothers: A mixed-methods research protocol.

Background: Adolescent pregnancies are a global problem occurring in many countries. Adolescent pregnancy is a risk factor for stunting in children. Aim: This study was designed to develop and evaluation of nursing interventions to prevent stunting in children of adolescent mothers. Methods: A mixed-methods explanatory sequential design with two phases approach will be applied. Phase I is a qualitative phenomenology descriptive study that will be used. Participants will be adolescent pregnant women from several community health centers (Puskesmas) and healthcare staff in a community public center (Puskesmas) will be selected by purposive sampling. The study will be conducted at community health centers (Puskesmas) in Makassar, South Sulawesi, Indonesia. Data will be gathered through in-depth interviews and focus group discussions and analyzed using thematic analysis. Subsequently, an experimental pre-post-test design with a control group will be used to measure the effectiveness of the nursing intervention on preventing stunting among adolescent mothers in the quantitative phase by behavior toward stunting prevention for adolescent pregnancy and the nutritional status of children. Conclusion: This study will provide insight from both adolescent mothers' and healthcare staff's perspectives on stunting prevention including nutrition of adolescent pregnancy and breastfeeding. We will evaluate the effectiveness and acceptability of nursing intervention in preventing stunting. This will contribute to the international literature on the use of healthcare staff at community health services (puskesmas) to achieve linear growth due to prolonged food insecurity and illnesses in childhood.

Growth failure among children of adolescent mothers at ages 0-5 and 6-12 years in India.

Adolescent motherhood has been linked with poor health outcomes at birth for children, including high neonatal mortality, low birthweight, and small-for-gestational-age rates. However, longer-term growth outcomes in the children of adolescent mothers in low-resource settings remain inadequately studied. We used longitudinal data from the India Human Development Surveys, 2004-2005 and 2011-2012 (n = 12,182) and employed regression and propensity score matching analysis to compare the following growth indicators of children born to adolescent mothers (ages 19 years or below) with those born to older mothers. Growth indicators included height and weight during ages 0-5 years and 6-12 years and change in height and weight between the two periods. In regression-based estimates, children born to adolescent mothers were 0.01 m shorter and weighed 0.2kg less than children of older mothers at ages 0-5 years. At ages 6-12 years, those born to adolescent mothers were 0.02 m shorter and weighed 0.97kg less. The height difference between the two groups increased by 0.01 m and the weight difference grew by 0.77kg over time. Height and weight difference between the two groups worsened among boys over time, while for girls, only the weight gap worsened. The results were similar when using propensity score matching methods. Public policies for reducing child marriage, combined with targeted health, nutrition, and well-being programs for adolescent mothers, are essential for both preventing adolescent childbearing and reducing its impact on growth failure among children in India.

Maternal prenatal and perinatal psychiatric hospitalizations and academic performance in adolescent offspring: a register-based, data linkage, cohort study

IntroductionTo the best of our knowledge, this is the first register-based cohort study to examine the association between maternal psychiatric hospitalizations before, during, and after pregnancy and the risk of lower academic performance in their adolescent children.ObjectivesTo investigate the risk of lower academic attainment in adolescent offspring of mothers with psychiatric hospitalizations before, during, and after pregnancy.MethodsThis administrative health data-based cohort study used linked data obtained from health and educational registries in New South Wales, Australia (n=168, 528). Maternal psychiatric diagnosis before, during, and after pregnancy was measured by using ICD-10. The educational performance of the offspring was assessed by National Assessment Program for Literacy and Numeracy (NAPLAN). A multiple Logistic regression model was employed to investigate the associationResultsAfter controlling for relevant covariates, we found that adolescent children of mothers with psychiatric hospitalizations before, during, and after pregnancy were at increased risk of substandard academic performance in all domains, with the highest odds for numeracy [OR, 2.88 (95%CI 2.50-3.31)] followed by reading [OR, 2.08 (95%CI 1.81-2.38)], spelling [OR, 1.74 (95%CI 1.51-2.01), and writing [OR, 1.56 (95%CI 1.34-1.80). In our sex-stratified analysis, maternal psychiatric hospitalizations demonstrated a stronger impact on the academic performance of females in all academic domains. Severe psychiatric disorders showed greater effects when compared to other psychiatric disorders.ConclusionsEarly intervention strategies that aim to enhance academic performance in the children of mothers with psychiatric diagnoses before, during, and after pregnancy are needed.Disclosure of InterestNone Declared

Raising Adolescent Children as a Developmental Task of Iranian Middle-aged Mothers: A Qualitative Study.

ABSTRACTBackground: Most parents consider adolescence to be the most difficult stage of parenting. Parental practice is a determining factor in adolescents’ outcomes. Mothers play the main role of parenting in Iran. Coinciding the transition of adolescence with the transition of middle-aged mothers can affect the mothers’ parenting practice. The present study aimed at explaining the Iranian mothers’ practice in parenting an adolescent child.Methods: This qualitative conventional content analysis was conducted from July 2018 to November 2019 in Kashan. 21 in-depth semi-structured interviews with mothers of adolescent children were performed using a purposive sampling method. The data were analyzed through conventional content analysis. Data collection and analysis were performed simultaneously using MAXQDAv10 software. Results: Regarding the study objectives, two themes and six main categories were identified. The theme of ‘laying the groundwork for upbringing’ was detected by two main categories: ‘meeting the needs and ‘effective interaction with the adolescent’; also, the theme of ‘individual-social capacity building’ was explained by four main categories: ‘helping to gain independence’, ‘modeling individual-social behavior’, ‘socializing the adolescent’, and ‘preparing to accept future roles’.Conclusion: Mothers’ practice was mainly focused on adolescents’ independence, college education, career prospects, and marriage preparation and respect for older adults. Consistent with this transition to modernity, and contrary to the collectivist values of Iranian society, mothers’ practice was in line with developing adolescents’ independence and building their self-confidence, which is close to the authoritative parenting style.

Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

BackgroundReduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health efforts.MethodsSixty-four adolescent mothers (≤ 21 years of age) provided detailed data on pregnancy, birth and psychosocial risk. Separate regression analyses with (1) birthweight and (2) low birthweight (LBW) as outcomes, and pregnancy complications, prenatal care, maternal age, substance abuse during pregnancy, socioeconomic risk, stressful life events and the child’s sex as independent variables were conducted. Exploratively, a receiver operating characteristic (ROC) analysis was performed to investigate the quality of the discriminatory power of the risk factors.ResultsThe following variables explained variance in birthweight significantly: prenatal care attendance (p = .006), pregnancy complications (p = .006), and maternal substance abuse during pregnancy (p = .044). Prenatal care attendance (p = .023) and complications during pregnancy (p = .027) were identified as significant contributors to LBW. Substance abuse (p = .013), pregnancy complications (p = .022), and prenatal care attendance (p = .044) showed reasonable accuracy in predicting low birthweight in the ROC analysis.ConclusionsAmong high-risk adolescent mothers, both biological factors, such as pregnancy complications, and behavioural factors amenable to intervention, such as substance abuse and insufficient prenatal care, seem to contribute to reduced birthweight in their children, a predisposing factor for poorer health outcomes later in life. More tailored intervention programmes targeting the specific needs of this high-risk group are needed.

The risk of attention deficit hyperactivity disorder symptoms in the adolescent offspring of mothers with anxiety and depressive symptoms. Findings from the raine study

IntroductionWhile there exist some studies that explored the association between maternal anxiety and depressive symptoms and the risk of attention-deficit/hyperactivity disorder (ADHD) in early and late childhood, studies exploring the risk in late adolescence are however lacking.ObjectivesThis is the first study that aimed to investigate the association between maternal anxiety, depressive, as well as comorbid anxiety and depressive symptoms, and the risk of ADHD symptoms in late adolescence.MethodsWe used data from the Raine Study, a birth cohort in Western Australia. The Depression, Anxiety, and Stress Scale (DASS) was used to assess maternal depressive and anxiety symptoms when the child was aged 10. Whereas, the DSM-oriented scales of the child behavior checklist (CBCL) was used to assess ADHD symptoms offspring in adolescents aged 17. Log-binomial regression model was used to explore the associations.ResultsAfter adjusting for relevant covariates, we found an increased risk of ADHD symptoms in the adolescent children of mothers with anxiety [RR 2.84 (95%CI 1.18-6.83)] as well as comorbid anxiety and depressive symptoms [RR 5.60 (95%CI 3.02-10.37)]. No association was seen with maternal depressive symptoms.ConclusionsThis study suggested that adolescent offspring of mothers with anxiety as well as comorbid anxiety and depressive symptoms had an increased risk of ADHD symptoms. Early detection and management for ADHD symptoms in children of mothers with anxiety and comorbid anxiety and depressive symptoms are needed.DisclosureNo significant relationships.

Assessing the Impact of an Intervention Project by the Young women's Christian Association of Malawi on Psychosocial Well-Being of Adolescent Mothers and Their Children in Malawi.

Adolescent mothers in Malawi face psychosocial challenges such as low resilience level, low self-esteem, poor maternal-infant interaction, and exposure to intimate partner violence (IPV). Children of adolescent mothers often face numerous risks such as low birth-weight, stunted growth, infant death, low school enrolment, increased grade repetition, and dropouts that put them at greater risk of poor developmental outcomes and socio-emotional problems. This study assessed the impact of components of a community project conducted by the Young Women's Christian association of Malawi in providing psychosocial support to adolescent mothers and their children. The goals of the project were; (1) to improve early childhood development in babies born to adolescent mothers; and (2) to enhance the psychosocial well-being of adolescent mothers (self-esteem, resilience stress, and parenting skills). This descriptive mixed methods evaluation study comprised an intervention and control groups of adolescent mothers respectively. The project had 3 centers in southern region districts of Malawi. Target population was adolescent mothers 18 years of age and below. At baseline we enrolled 267 mothers and at the end of the project we had 211 mothers. The project involved monthly meetings with adolescent mothers imparting knowledge and skills and early childhood education activities. From July 2017 to June 2019, 58 sessions were conducted. In the first year the control group had no meetings, however they received the intervention in the second year. Overall results in the intervention group showed statistically significant increase in knowledge on parenting skills (p < 0.01), nutritional practice (p < 0.01), motor skills and cognitive functions in children (p < 0.01) as well as expressive language and socio-emotional capacities in children (p < 0.01), while the change in confidence and psychosocial well-being was not statistically significant (p = 0.8823). Community projects such as these enhance parenting skills and improve development of children born to adolescent mothers. Improving psychosocial support is complex and requires further research and a more holistic approach.

Elevated prevalence of antisocial behavior in adolescent children whose mothers misuse opioids

BackgroundPast studies show that illicit opioid use may impair parents’ ability to care for their children. However, few studies have examined adverse outcomes in adolescent children of mothers who misuse opioids. MethodsData come from the National Survey on Drug Use and Health’s nationally representative matched sample of mothers and their adolescent children who resided in the same household. The outcome of interest was whether adolescents engaged in aggressive or antisocial behaviors in the past year. Using logistic regression, adolescent children whose mothers engaged in past-year opioid misuse were respectively compared to children whose mothers used other illicit drugs, had an alcohol use disorder, or had no misuse of substances. To control for confounding, propensity scores were used to match the three other maternal substance use groups to mothers who misused opioids on a number of measured confounding variables. ResultsThe odds of antisocial behaviors were 1.6 times higher among adolescent children whose mother engaged in past-year opioid misuse than matched adolescent children whose mothers reported no illicit substance use. There was no significant difference in antisocial behaviors between adolescents whose mothers misused opioids and either adolescents whose mothers used illicit drugs or had an alcohol use disorder. ConclusionAs the United States seeks to respond to the needs of families impacted by its ongoing opioid crisis, it is likely that services will be needed not only for parents who misuse opioids, but also for their children, who are at elevated risk for adverse behavioral outcomes.

Linking Attachment and Executive Function Systems: Exploring Associations in a Sample of Children of Young Mothers

Attachment and executive function (EF) are two related systems that develop early in life and may mediate associations between care experiences and later functioning. Though theoretically related, the associations between attachment and EF have not been fully explored among children experiencing adversity. In the current study, we took a person-centered approach to examining attachment representations and EF among children of adolescent mothers. Using Latent Profile Analysis, we identified three groups of attachment representations: a “secure” group, an “insecure-avoidant” group, and an “insecure-disorganized” group. We then explored differences in EF performance across the identified groups. Our results indicated that the “secure” group generally outperformed the “insecure-disorganized” and “insecure-avoidant” groups. Though the “insecure-avoidant” group generally outperformed the “insecure-disorganized” group, significant differences were found only on one task. Our findings document links between attachment and EF among children experiencing adversity and may suggest that prevention or intervention efforts to support the development of secure attachments will also foster optimal EF, those higher-order cognitive processes that drive goal-directed behavior.

Why Are Adolescent Mothers More iikely to Have Stunted and Underweight Children Than Adult Mothers? A Path Analysis Using Data from 30,000 Bangladeshi Mothers, 1996–2014

Abstract Objectives Adolescent pregnancy is a major global concern due to its adverse effects on maternal and child health and wellbeing. Bangladesh has one of the highest rates of adolescent pregnancy globally. We sought to examine trends in adolescent pregnancy and associated factors in Bangladesh in the last two decades, and to understand why children of adolescent mothers are at high risk of poor growth. Methods Data were from 6 rounds of Bangladesh Demographic and Health Survey (1996–2014). Women aged 15–49 years who gave birth in the 5 years preceding each survey (n = 30,331) were classified based on age at first birth: ≤19 years (adolescence), 20–24 years (young adulthood), and ≥25 years (adulthood). Trend analysis was used to assess the progress over time. Multivariable regression and structural equation models were used to understand how adolescent pregnancy is linked to child undernutrition through maternal nutritional status, education and bargaining power, health service use, child feeding and living conditions. Results Adolescent pregnancy has declined slowly, from 84% in 1996 to 73% in 2014. Children born to adolescent mothers had lower z-scores for height-for-age (mean difference: −0·64 SD), weight-for-age (−0·45 SD), and higher prevalence of stunting (18 percentage points [pp]) and underweight (12pp) than children born to adult mothers. Compared to adult mothers, adolescent mothers were shorter (−0·8 cm), lighter (−6.9 kg), more likely to be underweight (+14pp), had lower education (−4·3 years), less decision-making power (−9pp), and lived in poorer households (−0·79 SD) with poorer sanitation (−23pp) (all P &amp;lt; 0.05). Adolescent mothers were less likely to access ANC (−20pp), institutional delivery (−42pp), postnatal care services (−24pp) and had poorer complementary feeding practices (−15pp). In path analyses, these intermediate factors explained 66% of the association between adolescent pregnancy and child anthropometry, with the strongest links being through women's weight, education, socioeconomic status and complementary feeding practices. Conclusions Adolescent pregnancy is still the norm in Bangladesh. Policies and programs to address poverty and improve women's education can help to improve women's health, reduce early childbearing and break the intergenerational cycle of poverty and undernutrition. Funding Sources A4NH at IFPRI.

Changing trends in measles vaccination status between 2004 and 2014 among children aged 12-23 months in Bangladesh.

To assess the current measles vaccination status in Bangladesh, explain changing differentials in measles vaccination, and determine contexts that may improve measles vaccination coverage. Secondary data analysis of datasets (2004-2014) from the nationally representative Bangladesh Demographic and Health Surveys that followed stratified, multi-stage cluster sampling design conducted both in urban and rural contexts. 5468 children aged 12-23months were surveyed, of whom 892 (16%) reported non-compliance to measles vaccine. After simultaneous adjusting for covariates in multivariate logistic regression, children who came from a poor socio-economic background, who had mothers with no formal schooling, who were underweight, of higher birth order (≥4), who had adolescent mothers, who had a history of home delivery and who had no exposure to media were observed to be significantly associated with lack of measles vaccination. Measles vaccination coverage among children of adolescent mothers was consistently low. Despite lack of media exposure, measles vaccination status gradually increased from 26% in 2004 to 33% in 2014. Lack of maternal education was no longer associated with measles vaccination status in 2007, 2011 and 2014. Stunted children continued to be associated with lack of measles immunisation in 2014. Children with higher birth order demonstrated 53% excess risk for not being immunised with measles vaccine. Mothers with no exposure to mass media were two times more likely to have children without measles immunisation as indicated by BDHS 2014 data. Our findings will help policy makers formulate strategies for expanding measles vaccination coverage in order to achieve further reduction in disease burden and mortality in Bangladesh.

Adolescent mothers with babies in neonatal ICU: phenomenological reflections on life and death

Adolescent motherhood is a relevant subject for the reality of health services in Brazil, considering that this phenomenon has an important impact on adolescents' lives. Children of adolescent mothers may be a potential audience for the Neonatal Intensive Care Units, a setting of strong emotions, where mothers are facing the illness and death of their babies. This study aims to understand the experience of motherhood for adolescent mothers of infants hospitalized in Neonatal ICU, from the heideggerian Hermeneutic Phenomenology. The sample is composed of five adolescents aged 15 to 19. The construction of the data came from a triggering question: How is it for you to be a teenager and the mother of a baby hospitalized in the Neonatal Intensive Care Unit? The analysis was based on the heideggerian hermeneutic phenomenology. The narratives of adolescents shed light on some facets of the phenomenon under study: the place of family relationships; the ruptures and changes arising from motherhood; the fear raised by the neonatal ICU environment; becoming a mother by the child care; the presence of religion as a defense and the fear of dealing with the finitude of the baby.