Pregnant Adolescent Girls Research Articles

Causative factors for sexual and reproductive health status of pregnant adolescent girls in urban communities of Lagos, Nigeria.

Background The overall goal of this study was to determine the causative factors for pregnancy status in adolescent girls in two communities in the Lagos Island local government area. Methods A mixed methods (quantitative and qualitative) study reviewing routine health facility antenatal care (ANC) records and conducting focus group discussions among 46 pregnant adolescents, exploring their views about sex, contraception, pregnancy and sexual and reproductive health (SRH) services, was carried out. Key informant interviews were also carried out among healthcare workers and community members to assess their perceptions of adolescents' SRH problems. Results Five percent of those accessing ANC services were adolescents. Pregnant adolescents were found to access health services at later stages of their pregnancies due to the shame and stigma associated with their condition. The presence of morbidity in the form of anaemia (33%) and HIV (2.4%) was also found in this population. Social factors such as peer pressure and the desire to develop or maintain a relationship were found to be the major reasons for initiation of sexual activity by the adolescents. There was generally poor knowledge and utilisation of contraceptives, leading to unprotected sex and, thus, unintended pregnancies. Conclusion SRH information and services should be made readily available to adolescents at all levels of care.

Impact of donor and recipient adiposity on placental and fetal growth in adolescent sheep.

The influence of maternal obesity during oocyte development and its putative interaction with nutrient reserves at conception on pregnancy outcome were examined in an adolescent sheep model. Donor ewes were nutritionally managed to achieve contrasting adiposity (control (CD)/obese (ObD)) for 6 weeks prior to superovulation and inseminated by a non-obese sire. Morulae from 6 CD and 7 ObD were transferred in singleton into adolescent recipients of identical age but differing adiposity, classified as relatively fat or thin respectively. Thereafter, all were overnourished to promote rapid growth/adiposity (2 × 2 design, 13/14 pregnancies/group). A fifth recipient group of intermediate adiposity received embryos from another 5 CD, was offered a moderate intake to maintain adiposity throughout gestation and acted as controls for normal pregnancy outcome (optimally treated control (OTC), 19 pregnancies). Donor obesity did not influence ovulation, fertilisation or recovery rates or impact embryo morphology. Gestation length and colostrum yield were unaffected by donor or recipient adiposity and were reduced relative to OTC. Total fetal cotyledon and lamb birth weights were independent of initial donor adiposity but reduced in relatively thin vs relatively fat recipients and lower than those in the OTC group. In spite of high placental efficiency, the incidence of fetal growth restriction was greatest in the thin recipients. Thus, maternal adiposity at conception, but not pre-conception maternal obesity, modestly influences the feto-placental growth trajectory, whereas comparison with the OTC indicates that high gestational intakes to promote rapid maternal growth remain the dominant negative influence on pregnancy outcome in young adolescents. These findings inform dietary advice for pregnant adolescent girls.

Compliance and patterns of iron-folic acid intake among adolescent girls and antenatal women in rural Tamil Nadu

Background: Anemia continues to be a major public health problem in India despite its long-recognized negative impact on health, especially of women. In a scenario where there is little increase in Hb levels even with implementation of various iron supplementation program apart from compliance, their dietary pattern also may play a role. Moreover, majority of the current literature assessed compliance to Iron Folic Acid (IFA) supplements in facility based settings. Objectives: This study aims to identify the compliance to Iron Folic Acid intake and dietary pattern which could influence the absorption of iron among anaemic pregnant women and adolescent girls in a rural area of Tamil Nadu. Methods: This community based cross sectional study was carried out in one of the primary health centres (PHC) in Tamil Nadu during the period of Feb-Mar 2013 among pregnant women and adolescent girls. From the eligible pregnant women and adolescent girls, information regarding socio economic characteristics, practices related to personal hygiene, dietary patterns, consumption of Iron Folic Acid tablets, and reason for non compliance were collected using structured questionnaires during house-to-house visit. Following this, Haemoglobin was estimated among all study participants. Results: Totally 147 (99.3%), 99 (56.6%) pregnant women, adolescent girls were found to be anemic respectively. Out of these, Iron folic acid tablets were consumed by 136 (91.9%), 60 (60.6%) of pregnant women and adolescent girls respectively. Around 90% of the anemic participants consumed IFA tablets during the night time, immediately after food in rice based diet. Pregnant women who were in their third trimester (OR 0.27, 95% CI: 0.10 to 0.69) and high socio economic status (OR 0.10, 95% CI: 0.02 to 0.55) had significant poor compliance compared to women in second trimester and low socio economic status respectively. Among the adolescent girls, increasing age and current school going status had facilitated the consumption of more number of IFA tablets. Conclusion: In this backward district, prevalence of anemia among pregnant women and adolescent girls were extremely high. Compliance to IFA tablets among pregnant women is favourable whereas among adolescent girls is extremely poor. Some of the dietary practices followed in this region could impair the iron absorption level and treatment effect.

Factors Associated with Unwanted Pregnancy among Adolescents in Russia

Study ObjectiveTo identify social and behavioral factors associated with unintended pregnancy among adolescents in Russia. DesignCross-sectional. Setting and ParticipantsThe investigation group consisted of 145 adolescents aged 15-19 years admitted to a youth-friendly clinic for induced abortion. The control group consisted of 77 sexually active never pregnant adolescent girls of similar age admitted for other reasons. InterventionsBoth groups completed a self-administered questionnaire about their occupation, educational level of their mother, family structure and socioeconomic status, relationship with their mother, sexual behavior, and substance use. Main Outcome MeasuresFactors associated with unintended pregnancy. ResultsIn the bivariate analysis pregnant adolescents tended to have a lower educational level, to live in a nonintact family, to prefer stronger alcohol drinks, and to have a younger age at sexual debut and more frequent sexual intercourse. In the log-linear model six factors appeared to be directly linked to pregnancy: mother's lower education, alcohol consumption, nonintact family structure, low academic grades, higher frequency of sexual intercourse, and lower age at sexual debut. ConclusionAlthough the issue of unwanted pregnancy and possible ways to prevent it should be kept in mind in the psychosocial assessment of any adolescent, the results of our study suggest that some adolescents are at increased risk of unwanted pregnancy. This group includes adolescent girls with low educational attainment, living in a disrupted family, and reporting other risk behaviors. These adolescents might specially benefit from specific preventive programs to reduce the number of adverse outcomes.

Unlike pregnant adult women, pregnant adolescent girls cannot maintain glycine flux during late pregnancy because of decreased synthesis from serine

During pregnancy, glycine and serine become more important because they are the primary suppliers of methyl groups for the synthesis of fetal DNA, and more glycine is required for fetal collagen synthesis as pregnancy progresses. In an earlier study, we reported that glycine flux decreased by 39% from the first to the third trimester in pregnant adolescent girls. As serine is a primary precursor for glycine synthesis, the objective of this study was to measure and compare glycine and serine fluxes and inter-conversions in pregnant adolescent girls and adult women in the first and third trimesters. Measurements were made after an overnight fast by continuous intravenous infusions of 2H2-glycine and 15N-serine in eleven adolescent girls (17·4 (se 0·1) years of age) and in ten adult women (25·8 (se 0·5) years of age) for 4 h. Adolescent girls had significantly slower glycine flux and they made less glycine from serine in the third (P<0·05) than in the first trimester. Baby birth length was significantly shorter of adolescent girls (P=0·04) and was significantly associated with third trimester glycine flux. These findings suggest that the pregnant adolescent cannot maintain glycine flux in late pregnancy compared with early pregnancy because of decreased synthesis from serine. It is possible that the inability to maintain glycine synthesis makes her fetus vulnerable to impaired cartilage synthesis, and thus linear growth.

Anaemia in pregnant adolescent girls with malaria and practicing pica.

IntroductionPregnancy during the adolescent period is challenging mainly because of the nutritional demands of both the adolescent and pregnancy period. The risk for anaemia increases especially in developing countries such as Ghana where malaria is endemic and the practice of pica is common. In this study, we sought to determine the prevalence of anaemia, pica practice and malaria infection among pregnant adolescent girls and assess the extent to which these factors are associated.MethodsTwo hundred and sixty five (265) pregnant adolescent girls were recruited from three hospitals in Accra. Haemoglobin levels, malaria infection and the practice of pica were assessed. Pearson's Chi squared tests were used to determine associations and logistic regression analysis was used to determine the odds of being anaemic. Significance was set at p≤0.05.ResultsAnaemia prevalence was 76% with severity ranging from mild (47.8%) to severe (0.8%). About 27.5% were moderately anaemic. Pica was practiced in only 9.1% of the girls. Malaria infection was prevalent in 17.7% of the girls. The logistic regression analysis indicated that pregnant girls with malaria infection were 3.56 times more likely to be anaemic when compared to those without malaria. Also, those who practiced pica were 1.23 times more likely to be anaemic when compared to those who did not practice pica.ConclusionAnaemia is very prevalent in pregnant adolescent girls and is a public health problem. Drastic measures should be taken to reduce the high prevalence.

High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study

BackgroundLimited data document sexually transmitted infections (STIs) among pregnant adolescents in sub-Saharan Africa, where prenatal screening typically includes only HIV and syphilis. Given that HIV incidence in this population is...

Barriers to access reproductive health care for pregnant adolescent girls: a qualitative study in Tanzania.

In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for adolescent girls are inaccessible and conducted this study to gain insights into their perceptions of sexually transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. We conducted nine focus groups among pregnant adolescents aged 15-20years. Data were transcribed, translated and coded for relevant themes using NVivo10 software for qualitative data analysis. Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs.They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, long waiting times, and lack of privacy in the clinics discouraged adolescent girls from seeking reproductive health care. Reproductive health care for adolescent girls who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps.

Evaluation of Anganwadi centres performance under Integrated Child Development Services (ICDS) program in Gujarat State, India during year 2012-13

Background: Even after more than 3 decades of implementation, the success of integrated child development services (ICDS) program in tackling maternal and childhood problems still remain a matter of concern. The present study was conducted to assess issues related to Anganwadi worker (AWW) and Anganwadi center (AWC) including infrastructure facilities. Materials and Methods: A total of 60 AWCs were selected including 46 AWCs from a rural area and 14 AWCs from an urban area during April 2012 to March 2013 from 12 districts of Gujarat. Five AWCs were selected from one district. Information on AWWs background characteristics, along with infrastructure and other services delivered at AWCs were observed and recorded. Results: Majority (66.7%) AWCs building were owned by state and 73.3% AWCs having pucca type of building. Almost two-third (65%) AWWs had >10 years of experience. Induction training was given to only 1 AWW (7.1%) in an urban area. Poor findings were reported for regular health checkups (30%), immunization (10.0%), referral slips availability (18.3%), and referral of sick children (8.3%). Significant number of 6 months to 3 years age group and 3 to 6 years in rural areas received services from Anganwadi. Similarly, significant number of pregnant mothers (P < 0.00), lactating mothers (P < 0.00) and adolescent girls (P < 0.00) in rural areas compared to urban areas received Anganwadi services. Nutrition and health education day was observed in 81.7% AWCs. Conclusion: The performance of AWCs and maternal and child health services delivered by AWCs still needs improvement. Coordinated steps catering to different services provided at the centers are needed to optimize the functioning of the ICDS scheme.

AN ASSESSMENT OF THE IMPLEMENTATION OF THE RE-ENTRY POLICY FOR GIRLS IN SWAZILAND: SCHOOL PRACTICES AND IMPLICATIONS FOR POLICY DEVELOPMENT

Swaziland has no stand-alone re-entry policy. Practices vary from school to school, but generally a pregnant adolescent girl has to drop out of school although those who become pregnant may be allowed to return to write their exams at the same school or they may be advised to find another examination centre. The Swaziland Education and Training Sector Policy of 2011 (EDSEC) explicitly states that ‘every child, irrespective of their life circumstances… has the right to be re-integrated into the same institution that the girl was previously attending.’ The study documents school practices that appear to be informed by ignorance of the provisions of the EDSEC Policy of 2011 and historical developments in national policy; international conventions and declarations the country is signatory to, with missed opportunities. Schools are not coping with the evolving and expanding role in helping children develop. The study concludes that there is need for awareness raising as well as legislation which will compel schools not to expel such pupils but that they are given time to deliver their babies and be allowed to re-join the school. It is thought that institutionalising and publicising the EDSEC policy should lead to more and better reporting, more re-entry, and fewer abortions. There is necessity for awareness development among stakeholders, rigorous and vigorous campaigns and preparedness to tackle strong resistance which has been shown through the practices reported in this study to be hypocritical. Key words: counselling, policy, practice, pregnancy, re-entry, Swaziland.

Comparing glycine and serine kinetics in adolescent girls and adult women during early and late pregnancy

During pregnancy, glycine (Gly) and serine (Ser) becomes more important because they are the primary suppliers of methyl groups for synthesis of fetal DNA and Gly is also required for collagen synthesis. The objective of this study was to measure and compare Gly and Ser kinetics of pregnant adolescent girls and adult women in the first (13.0±0.4 wk of gestation) and third trimesters (28.8±0.4 wk of gestation). Measurements were made in the fasted state by continuous intravenous infusions of 2H2‐Gly and 15N‐Ser in 11 adolescent girls (17.4±0.1 y of age) and in 10 adult women (25.8±0.5 y of age) for 6 h. Adult women Adolescent girls Flux 1st trimester 3rd trimester 1st trimester 3rd trimester μmol/kg/h Gly 156±14 136±9 165±11 142±7* Ser 129±15 119±13 133±11 111±6 Gly→Ser 4.2±0.6 4.2±0.5 4.3±0.5 4.8±0.4 Ser→Gly 62±9 57±7 70±7 54±3* Different vs. trimester 1 value, P&lt;0.05, paired t‐test. Adolescent girls had significantly slower glycine flux and made less glycine from serine in the 3rd trimester (P &lt; 0.05). Baby's birth length was significantly shorter in adolescent girl (P = 0.04), and baby's birth weight was 7% less compared with mean values of adult women. These findings suggest that pregnant adolescents could not maintain Gly production in late pregnancy compared to early pregnancy, which makes their fetus more vulnerable to impaired cartilage synthesis, hence linear growth. Supported by USDA Grant # 58–6250‐6001

Comparing the in vivo glycine fluxes of adolescent girls and adult women during early and late pregnancy

During pregnancy, growth of the foetus depends on an adequate glycine supply because it is needed for synthesis of fetal DNA, collagen and serine. Since pregnant adolescent girls give birth to lower birth weight babies, it is possible that they do not produce sufficient glycine to meet overall demands as their adult counterparts, especially after an overnight fast. The objective of the study was to measure and compare the flux of glycine among adolescents and adult women in the first and third trimesters of pregnancy. Glycine flux was measured by continuous intravenous infusion of (2)H(2)-glycine in eight overnight fasted adolescents and in eight adult women in the first and third trimesters of pregnancy. There was a significant interaction between subject's age and time of pregnancy (P = 0.02), as weight-specific glycine flux decreased by 39 % from trimesters 1 to 3 in the adolescents but increased by approximately 5 % in the adults. Whole body glycine flux also decreased significantly in the adolescent group (P < 0.05) from trimesters 1 to 3, and this was associated with a significant reduction in plasma glycine concentration. In trimester 3, there was a positive correlation between glycine flux and the subject's age indicating that younger subjects had slower fluxes. These findings suggest that after a brief period of food deprivation, the pregnant adolescent cannot maintain glycine production as her adult counterpart in late pregnancy. It is possible that this inability to maintain endogenous glycine production makes her foetus more vulnerable to impaired growth if food deprivation becomes more frequent or is prolonged.

Comparing the glucose kinetics of adolescent girls and adult women during pregnancy

Fetal energy demands are met mostly from oxidation of maternally supplied glucose. In pregnant adults this increased glucose requirement is met by an increase in gluconeogenesis. It is not known, however, whether, like their adult counterparts, pregnant adolescent girls can increase gluconeogenesis-hence, glucose production. Our objective was to measure glucose kinetics in 8 pregnant adolescents and 8 adult women. We measured glucose kinetics after an overnight fast by using a primed-constant 6-h U-(13)C-glucose infusion at the end of trimester 1 and early trimester 3. From trimester 1 to trimester 3, whole-body glucose production increased significantly in both groups (P < 0.01). However, whereas the weight-specific rate in adults increased by 18.2%, it increased by only 14.3% in adolescents. In adults, the increase in whole-body glucose production was largely due to a significant increase (P < 0.01) in the rate of gluconeogenesis, but in adolescents there was no change in whole-body gluconeogenesis, and weight-specific gluconeogenesis actually decreased by 11.7%. In both groups, the rate of whole-body glycogenolysis increased significantly (P < 0.05) in trimester 3, and in adolescents, it increased by 95%. These findings suggest that, in the fasted state in late pregnancy, pregnant adolescents cannot increase weight-specific glucose production by the same magnitude as their adult counterparts. Furthermore, whereas adult women increase glucose production primarily through gluconeogenesis, adolescents do so through glycogenolysis.

Possible New Developments in Community Control of Iron-Deficiency Anemia

Two findings that may revolutionize the implementation of oral iron supplementation programs worldwide have recently come to light. The first is that weekly administration of oral iron to anemic Chinese preschool children improved iron status as much as daily dosing, producing only negligible side effects. The relevance of this finding is being examined in studies of pregnant women, adolescent girls, and preschoolers in eight countries in the WHO (World Health Organization)–UNU (United Nations University)–UNICEF study of weekly iron supplements. Hopefully, this phenomenon will vastly increase the coverage, feasibility, and effectiveness of supplementation programs, particularly in the developing world. The second finding, that daily oral iron given to iron-sufficient Indonesian toddlers appeared to decrease weight gain compared with a placebo group, had not been apparent in three other small studies. If verified, screening for anemia could be required for all young children in predominantly anemic populations before iron supplements are given. However, it may not be an issue if weekly dosing is adopted.

Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India

Vitamin D deficiency is common in urban Indians despite living in the tropics and its public health consequences are enormous. However, 70% of India is rural, and data from rural subjects, who are expected to have good sun exposure, are scant. To determine the population prevalence of vitamin D deficiency in rural pregnant women and adolescent girls, compare serum 25-hydroxyvitamin D (25OHD) status in adolescent boys from the same families, and determine seasonal differences in serum 25OHD. A cross-sectional study conducted over 18 months. A random selection of 121 adolescent girls from a survey of a population of 8270 in a rural low socioeconomic community; 139 pregnant women in the second trimester; and a subset of 28 adolescent girls compared with 34 brothers. Serum 25OHD, serum alkaline phosphatase (AP), sun exposure, and dietary calcium intake. The age-adjusted community prevalence of vitamin D deficiency (25OHD < 50 nmol/l) in adolescent girls was 88.6%. Seventy-four per cent of pregnant women had vitamin D deficiency. Mean +/- SD 25OHD in girls and women in summer was 55.5 +/- 19.8 nmol/l compared to 27.3 +/- 12.3 nmol/l in winter (P < 0.001). Winter serum 25OHD in boys (67.5 +/- 29.0 nmol/l) was higher than that in their sisters (31.3 +/- 13.5 nmol/l, P < 0.001). We report a high prevalence of vitamin D deficiency among pregnant women and adolescent girls from a rural Indian community. Boys are relatively protected. Seasonal variation in serum 25OHD is significant at latitude 26 degrees N.

Occupational therapy and pharmacodependence: categorization and update of national publications

This research aims to update and systemize publications on chemical dependence and occupational therapy. This is a historical, conceptual andepidemiological study of pharmacodependence, as well as of its therapeutic approaches. The aim of this update is to organize and to describe thematiccategories derived from national articles published about this problematic and to correlate data found with theoretical and procedural proposals found inthe literature of occupational therapy in this clinic. Articles selection was done by means of surveys in scientific databases, and the categories were createdaccording to the frequency of the themes “risk behavior” and “bio-psychosocial damages and losses”. We found eight articles, one of them approachingthe use of drugs by pregnant adolescent girls; four discussed drug use among students, both of the elementary and secondary levels and the universitylevel; one approached the relationship between use of psychoactive substances and psychiatric disturbances; and two were about users of injectabledrugs and its close relationship with HIV. The study demonstrates that occupational therapy intervention, described in specialized literature regardingthis population, is based mainly on the application and development of strategies that facilitate opportunities of exchanges and broaden possibilities,and action is their work tool. We conclude that despite all damages and losses psychoactive substances use can cause to the life of the subject, still it isa frequent practice that is followed by risk behaviors.

Prevalence of Anemia among Pregnant Women and Adolescent Girls in 16 Districts of India

Nutritional anemia is one of India's major public health problems. The prevalence of anemia ranges from 33% to 89% among pregnant women and is more than 60% among adolescent girls. Under the anemia prevention and control program of the Government of India, iron and folic acid tablets are distributed to pregnant women, but no such program exists for adolescent girls. To assess the status of anemia among pregnant women and adolescent girls from 16 districts of 11 states of India. A two-stage random sampling method was used to select 30 clusters on the basis of probability proportional to size. Anemia was diagnosed by estimating the hemoglobin concentration in the blood with the use of the indirect cyanmethemoglobin method. The survey data showed that 84.9% of pregnant women (n = 6,923) were anemic (hemoglobin < 110 g/L); 13.1% had severe anemia (hemoglobin < 70 g/L), and 60.1% had moderate anemia (hemoglobin > or = 70 to 100 g/L). Among adolescent girls (n = 4,337)from 16 districts, the overall prevalence of anemia (defined as hemoglobin < 120 g/L) was 90.1%, with 7.1% having severe anemia (hemoglobin < 70 g/L). Any intervention strategy for this population must address not only the problem of iron deficiency, but also deficiencies of other micronutrients, such as B12 and folic acid and other possible causal factors.

78: Concepts of the advantages and disadvantages of teenage childbearing among pregnant adolescents: A qualitative analysis

To explore what pregnant adolescents see as the pros and cons of having a baby during their teen years instead of waiting until they are older. Pregnant teens (12 to 19 years of age) were approached before their first prenatal appointments to participate in an interview exploring pregnancy intentions and background behaviors (February 2002 to August 2004). Qualitative and quantitative data from participants who provided written responses to two open-ended questions were used in the current study. The sample consisted of 246 pregnant teenagers (average age= 16.84, SD= 1.54; 47%, Hispanic, 20% Non-Hispanic White; 18% Non-Hispanic Black; 15% Other). Coded themes associated with perceived advantages of teen childbearing included enhancement of family and other relationships (someone to love, close in age to child, family/partner support), benefits for teen’s life and positive changes (becoming more responsible, having purpose in life, growing up with their child). In contrast, themes associated with perceived disadvantages of teen childbearing included feeling unprepared for parenting (too young, lack of stability/resources), requirements to change and/or abandon life goals (putting their life on hold, missing out on being a teen, taking on more responsibilities), and other’s judgment/view of teen mother. Age, ethnic/racial, and pregnancy intentions differences in identified themes emerged. Understanding how pregnant adolescent girls at different ages, from different backgrounds and with different pregnancy intentions view the potentially good and bad effects of having children during their teens years provides a window into their expectations for the future and may inform interventions for pregnant/parenting teens regarding the realities of teenage parenting.

Nutritional status and birth outcomes of adolescent pregnant girls in Morogoro, Coast, and Dar es Salaam regions, Tanzania

Objective Studies that link adolescence pregnancies, nutritional status, and birth outcomes in Tanzania are scarce. We examined the nutritional status and birthoutcomes of pregnant adolescent girls from rural and urban areas of three regions in Tanzania. Methods The study was carried out in the regions of Dar es Salaam (Chamazi and Gezaulole dispensaries and Round Table Maternity Home), Coast (Tumbi Regional Hospital and Mlandizi Health Center), and Morogoro (Regional Hospital, Uhuru Clinic, and Mlali Health Center). One hundred eighty pregnant adolescent girls ages 15 to 19 y were recruited and interviewed, and their nutritional status measurements were taken at the seven health facilities. Information concerning date of birth, marital status, educational status, sex education, and income status was collected with a structured questionnaire. Height, weight, and mid-upper arm circumference were measured according to standard techniques. Hemoglobin concentration was measured with a hemoglobinometer and the HemoCue technique. Nutritional status was assessed by body mass index, and hemoglobin concentration was determined by cutoff points of the World Health Organization. Suitable statistical analysis was done with SPSS 9.0. Weekly weight gain during pregnancy was measured in 123 subjects who kept their appointments and reported back after 2 wk. Fifty-seven subjects did not keep their appointments and were lost to follow-up. Records of infants' birth weights and mode of delivery were obtained from 50 subjects whodelivered at the study sites. Results The height ofabout 54% of the subjects was shorter than 151 cm, suggestive ofshort maternal height. Severe wasting was observed in 27% ofsubjects. Mean weekly weight gain during pregnancy was 317 ±110 g (−500 to 500 g). No significantdifferences were observed between rural and urban settings. Mean infantbirth weight was 2600 ± 480 g. About 48% ofinfants had low birth weight (<2500 g) and only 14% ofinfants had birth weight greater than 3000 g. About14% of infants were born by cesarean section. Nearly 86%of the pregnant adolescent girls were anemic. A hemoglobinconcentration below 7 g/dL was observed in 5% of subjects. Mostsubjects (55%) had hemoglobin concentrations from 7 to lowerthan 10 g/dL. There was a weak correlation between infant birth weightand weekly weight gain of the girls during pregnancy( r = 0.36, P≤ 0.01). However, a strong correlation was observed betweenbirth weight and hemoglobin level of adolescent girls during pregnancy( r = 0.67, P= 0.01). Short stature was observed to contribute towardcesarean delivery ( P = 0.05) becausemore cesarean deliveries were performed in short girls (<151 cmtall). Conclusions The nutritional status ofpregnant adolescent girls in the study areas was poor and resulted inpoor pregnancy outcome. Girls should be educated about reproductivehealth at the primary level ofeducation.

Postpartum Depression and Social Support in Adolescents

The purpose of the study was to determine the effectiveness of a social support intervention delivered to pregnant adolescent girls between 32 and 36 weeks of gestation in preventing symptoms of depression at 6 weeks postpartum. The study used a repeated measures design. Data were collected at a teenage parenting program, an educational option of the public school system. Participants (n = 128) were pregnant and postpartum adolescents. Symptoms of depression at 6 weeks postpartum. Participants completed the Postpartum Support Questionnaire, Rosenberg's Self-Esteem instrument, and the Center for Epidemiological Studies of Depression instrument at baseline, then were randomly assigned to one of three intervention groups (pamphlet, video, or pamphlet plus video) or the control group. The content of the intervention was based on a synthesis of the literature describing social support needed and desired by postpartum adolescents. No significant differences were found in Center for Epidemiological Studies of Depression instrument scores among the groups at 6 weeks postpartum. Using path analysis, the authors found that predictors of symptoms of depression at 6 weeks postpartum were (a) receiving more support from friends, family, and others and (b) having low self-esteem. These findings differ from earlier studies, and both research and clinical implications are discussed.