Adolescent Pregnancy Research Articles

A Structural Equation Modeling Analysis of Attitudes and Behaviors on Early Fertility Among Young Women in Selected Regions in Nicaragua

Nicaragua has one of the highest adolescent fertility rates in Latin America and in the Caribbean. However, studies on adolescent pregnancies are limited. This study investigates the mechanism of early fertility among women aged 15 to 24 in northern central and eastern regions (NC-E) and the Pacific region (PAC), using data from the Nicaraguan Demographic and Health Survey 2011/12 ( N = 2,600). Structural equation modeling analysis was conducted in NC-E and PAC to examine the associations between exogenous variables (ethnicity and residence), mediators (education, sexuality education, knowledge and attitudes on pregnancy prevention, and sexual behaviors), and outcome (early fertility). The results showed educational attainment and sexual behaviors were crucial mediators of early fertility in NC-E and PAC, whereas sexuality education was only in NC-E. Residence was an exogenous variable in both groups, whereas ethnicity was not. Although educational attainment and sexuality education would improve knowledge, they did not contribute to reducing risky sexual behaviors. Further discussions on ethnic differences and variables measuring the actual decision-making related to risky sexual behaviors are suggested.

120. Sociodemographic and Psychosocial Factors Associated with Adolescent Pregnancy

120. Sociodemographic and Psychosocial Factors Associated with Adolescent Pregnancy

1. Adverse Obstetrical Outcomes are Increased in Adolescent Pregnancy

1. Adverse Obstetrical Outcomes are Increased in Adolescent Pregnancy

15. Adverse Obstetrical Outcomes are Increased in Adolescent Pregnancy

15. Adverse Obstetrical Outcomes are Increased in Adolescent Pregnancy

Factors associated with recurrent adolescent pregnancy in a public hospital

Objetivo: Establecer los factores asociados al embarazo reincidente en adolescentes atendidas en un hospital público del Perú, 2021-2022. Materiales y Métodos: Estudio de enfoque cuantitativo, observacional, analítico transversal. Se obtuvo información de las historias clínicas de todas las gestantes adolescentes (N=252) atendidas en un hospital público de atención médica general. Se evaluaron factores sociodemográficos, familiares y gineco-obstétricos de las adolescentes. El estudio fue aprobado por el comité de ética hospitalario y la asociación se determinó mediante la prueba de Regresión de Poisson. Resultados: El 16.67% de las gestantes presentó embarazo recurrente durante el 2021 y 2022, siendo 20.67% y 10.78%, respectivamente. Se identificó que estar casada (p<0.001; RPa:0.06), residir solo con una hermana (p<0.001; RPa:0.032) y tener una edad más avanzada en primer embarazo (p<0.001; RPa:0.41) fueron factores que reducen la probabilidad del embarazo recurrente, por otro lado, presentar al menos un antecedente de un aborto (p<0.001; RPa:4.49) incrementa la probabilidad de un embarazo recurrente. Conclusión: Se identificaron factores sociodemográficos, familiares y gineco- obstétricos que se asocian con la reincidencia del embarazo en las adolescentes atendidas en un hospital público del Perú.

The epidemiology of gestational diabetes, gestation hypertension, and anemia in North Palestine from 2018 to 2020: A retrospective study.

In Palestine, women face a challenging environment and a demanding lifestyle, which puts them at a higher risk of experiencing complications during pregnancy. This study aimed to examine the risk factors linked with abnormal hemoglobin (Hb) levels, gestational diabetes (GD), and gestational hypertension (GH) among pregnant women. The results was compared between women residing in cities or villages areas and those in refugee camps. Medical records (N = 7889) for pregnant women at primary healthcare centers in the North West Bank were reviewed for sociodemographic and medical data along with the reported fasting blood sugar, hemoglobin, and blood pressure in the first and second trimesters from July 2018 to July 2020. However, only 6640 were included in the analysis as 1249 were excluded for having multiple pregnancy or lost to follow up. Complications and risk factors were defined according to the available global guidelines. Then, descriptive analysis was used to show the percentages of different risk factors and complications among them. The correlation between the several characteristics and variables with these complications was assessed by calculating the odds ratios (OR) using logistic regression. P-values of <0.05 were considered significant. The prevalence of adolescent pregnancy was the highest among women living in rural areas (9.8%) and grand multigravidity among refugee women (22%). The overall prevalence of anemia was higher in the second-trimester (16.2%) than in the first-trimester (11.2%), with anemic women in the first-trimester being more likely to be anemic in the second-trimester (OR = 8.223, P-value<0.001). Although anemia was less common in the first-trimester among refugees than among women living in urban areas (OR = 0.768, P-value = 0.006), it was more prevalent in the second-trimester (OR = 1.352, P-value<0.001). Moreover, refugee women were at lower risk than women living in urban areas of having GD (OR = 0.687, P-value<0.001) and diabetes mellitus (OR = 0.472, P-value<0.001) in the second-trimester. GH was associated with GD (OR = 1.401, P-value = 0.003) and DM (OR = 1.966, P-value<0.001). The findings of this study provide evidence-based data on the considerable prevalence of pregnancy complications, anemia, GD, and GH among Palestinian pregnant women living in the north of the West Bank. Multi gravida, gestational age, Hb levels, and the type of settings were strong predictors of pregnancy complications. Therefore, a national plan is needed to ensure adequate maternal care for all, especially disadvantaged women, those in rural areas and refugee camps.

Muscle strength during pregnancy and postpartum in adolescents and adults.

Adolescent childbirth is associated with worse physical function over the long-term. Differential loss of muscle strength during pregnancy and postpartum for adolescents compared to adults may be one explanation for this, but research examining these differences is lacking. The objective of this study as to assess hand grip strength and hip adduction muscle strength in adolescents and adults during pregnancy and postpartum. A prospective cohort study was carried out with adolescent (13 to 18 years) and adult (23 to 28 years) primigravid women. Assessments were performed at three timepoints: before the 16th gestational week, during the third trimester, and between the fourth and sixth week postpartum. Hand grip strength (continuous and muscle weakness if ≤ 20.67 kgf) and hip adductor measures (continuous and muscle weakness if ≤ 13.8 kgf) were assessed using dynamometry. Generalized estimating equations modelled longitudinal relationships between muscle weakness and age group. More adolescents had hip adductor weakness than adults in the third trimester of pregnancy (62.5% vs. 31.8%, p < 0.005), which was corroborated by the longitudinal analyses. For all women, there were higher odds of hip adductor weakness in the third trimester (OR = 4.35; p< 0.001) and postpartum (OR = 9.45; p < 0.001) compared to the 16th gestational week. No significant difference in HGS was observed between age groups or across the different timepoints. The higher proportion of hip adductor weakness among adolescents may indicate a need for resistance training during and after pregnancy and physical therapy if weakness or injury is noted.

Acceptance Test and Iron Content Test Churros Formulation of RALE Flour (Red Beans and Soybeans) as an Alternative Snack to Prevent Anemia for Teenage Girls

Conditions in which the amount of hemoglobin in the blood is below normal limits is called anemia. Iron deficiency is one of the causes of anemia which is still common in pregnant women and adolescents. The aim of this study was to determine the acceptability and levels of iron in churros formulated by RALE (red bean and soybean flour) as a snack to prevent anemia for girls. The research method is an experiment on 3 formulations of adding many flours: red bean: soybean with the formulations CP 1 (85:5:10), CP 2 (75:10:15), and CK 3 (100:0:0), using organoleptic tests in the form of likes and dislikes for color, taste, aroma, texture which were presented to 25 panelists. Test for iron content using ICP-OES method for the best organoleptic formulation and test results (CK 3). The results showed the CP 1 formulation were the most preferred with an average score of 4.32 which was included in the like category. The conclusion of this study showed organoleptic properties, the formulation favored by the panelists was the CP 1 formulation with a ratio of flour: red bean flour: soybean flour of 85:5:10, having an iron content of 3.86 mg/100 grams churros.

Mechanisms behind gender transformative approaches targeting adolescent pregnancy in low- and middle-income countries: a realist synthesis protocol

IntroductionAdolescent pregnancy is defined as pregnancy at the age of 19 or below. Pregnancy and childbirth complications are the most significant cause of death among 15–19-year-old girls. Several studies have indicated that inequitable gender norms can increase the vulnerability of adolescent girls, including violence exposure, early marriage, and adolescent pregnancy. To address these disparities, gender transformative approaches aim to challenge and transform restrictive gender norms, roles, and relations through targeted interventions, promoting progressive changes. This realist review aims to synthesise existing evidence from a broad range of data sources to understand how, why, for whom, and in what contexts gender transformative approaches succeed in reducing adolescent pregnancy in low- and middle-income countries.Method and analysisWe employ a five-step realist synthesis approach: (1) clarify the scope of review and assessment of published literature, (2) development of initial programme theories, (3) systematic search for evidence, (4) development of refined programme theories, and (5) expert feedback and dissemination of results. This protocol presents the results of the first three steps and provides details of the next steps.We extracted data from 18 studies and outlined eight initial programme theories on how gender transformative approaches targeting adolescent pregnancy work in the first three steps. These steps were guided by experts in the field of sexual and reproductive health, implementation science, and realist methodology. As a next step, we will systematically search evidence from electronic databases and grey literature to identify additional studies eligible to refine the initial programme theories. Finally, we will propose refined programme theories that explain how gender transformative approaches work, why, for whom, and under which circumstances.Ethics and disseminationEthics approval is not required because the included studies are published articles and other policy and intervention reports. Key results will be shared with the broader audience via academic papers in open-access journals, conferences, and policy recommendations. The protocol for this realist review is registered in PROSPERO (CRD42023398293).

Nutritional knowledge, nutritional status and associated factors among pregnant adolescents in the West Arsi Zone, central Ethiopia

When pregnancy occur among teenagers; there is a competition for nutrients between the still-growing adolescent mother and her fetus. Pregnant adolescents’ nutrition issues are not addressed well and changes are too slow in Ethiopia. This study aimed to study, nutrition knowledge, nutritional status and associated factors among pregnant adolescents in West Arsi , central Ethiopia. We conducted a cross-sectional study of 426 pregnant adolescents between January 1 and January 25, 2023. Data were collected using kobo collect and analyzed using SPSS version 25. We performed linear regression to identify independent predictors of nutritional status and multivariable logistic regression analyses to identify nutritional knowledge. Odds ratios (ORs) with 95% confidence intervals were estimated to show the strength of the association. Magnitude of good nutrition knowledge was 23.7%, 95% CI (21.4–25.3%), and the odds of having good nutrition knowledge was 7.5 times higher among participants whose education level was above college compared with illiterate participants [(AOR = 7.5, 95% CI = (5.27–9.38)],the odds of having good nutrition knowledge was 8 times higher among adolescent who had ANC visits, [(AOR = 8, 95% CI = (3.63–13.85)], and the odds of having good nutrition knowledge was 5 times higher among adolescents who received nutrition education [(AOR = 5, 95% CI = (3.67- 13.53)]. Receiving nutrition education (β = 0.25, P = 0.002) and good nutrition knowledge (β = 0.08, P < 0.001) were positively associated with nutritional status; however, food insecurity (β = − 0.93, P < 0.001) was negatively associated with nutritional status. The nutrition knowledge of pregnant adolescents was suboptimal; educational status, ANC visits and nutrition education were associated with good nutrition knowledge, whereas food insecurity, low nutrition knowledge, and not receiving nutrition education were predictors of poor nutritional status. Nutritional education interventions, increasing utilization of ANC, and interventions for improving food security are strongly recommended.

Impact of Pre-Gestational BMI and Gestational Weight Gain on Fetal Development Outcomes in Adolescent Pregnant Women.

Background. Gestational weight gain (GWG) constitutes an essential aspect of the gestational process. Due to factors such as pregestational body mass index (BMI), nutritional intake, level of physical activity, and psychological aspects, the recommended GWG may not be achieved, leading to adverse neonatal outcomes. Adolescents, due to their physiological and mental developmental stage, are at a higher risk of inappropriate GWG. Our aim is to highlight the importance of GWG in our population and to determine the correlation with perinatal outcomes. Methods. Pregnant adolescents who attended a tertiary care institution for prenatal care were included; maternal data such as preBMI and GWG were used to determine maternal and neonatal outcomes using the chi-square test and OR determination. Results. A total of 202 adolescent pregnant patients were included, comprising those with inadequate GWG (n = 70), adequate GWG (n = 85), and excessive GWG (n = 47). A statistically significant association was found between low BMI and inadequate GWG. Patients with inadequate GWG demonstrated a correlation with IUGR and low birth weight, while patients with excessive GWG gave birth to macrosomic neonates. Conclusion. We concluded that previous habits play a significant role in determining weight gain throughout pregnancy. GWG has a direct impact on neonatal growth and development.

Awareness and Use of Family Planning Methods among Married Women in A Community

Family planning/contraception reduces the need for abortion, especially unsafe abortion, reduces infant mortality, helps prevent HIV/AIDs, reduces adolescent pregnancies and helps to slow down increasing population growth. Over 60% of unintended pregnancies end in abortion, safe or unsafe, legal or illegal. An estimated 45% of all abortions remain unsafe and hospitalizes about 7 million women a year in developing countries. A descriptive cross-sectional research was carried out in ward no.14, Kathmandu Metropolitan city. The objective of this study was to find out awareness and use of Family planning method among married women in a community. Non probability, purposive sampling method was used. Sample size was 68 married women. The respondents mean age was 33.1 years and standard deviation was 6.5 years. All of the respondents (100%) were familiar with condom, pills, depo-provera, female sterilization whereas 95.6% heard about implants. Almost all of the respondents (98.5%) stated implants prevents pregnancy for 5 years and half of them (47.1%) were aware implants doesn't interfere with breast feeding. major source of information regarding family planning methods was from health professionals (80.8%) Whereas husband (13.2) level of awareness regarding family planning methods where 1.5% of the respondents had inadequate awareness, 54.3% had moderately adequate awareness and 44.1% of the respondents had adequate awareness. there is no significant association with age (0.479), duration of marriage (0.325), occupation (0.146) of the mother with level of awareness regarding family planning methods.

Does extending school time reduce the juvenile pregnancy rate? A longitudinal analysis of Ceará State (Brazil)

PurposeAdolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can potentially diminish rates of adolescent pregnancy, given that educational attainment stands as the foremost risk factor influencing sexual initiation, the use of contraceptive methods during initial sexual encounters and fertility. The aim of this paper is to analyze the impact of the implementation of the public educational policy introducing full-time schools (FTS) for high schools in the state of Ceará, Brazil, on early pregnancy rates.Design/methodology/approachUsing the difference-in-differences method with multiple time periods, we measured the average effect of this staggered treatment on the treated municipalities.FindingsThe main result indicates a reduction of 0.849 percentage points in the teenage pregnancy rate. Concerning dynamic effects, the establishment of FTS in treated municipalities results in a 1.183–1.953 percentage point decrease in teenage pregnancy rates, depending on the timing of exposure. We explored heterogeneous effects within socioeconomically vulnerable municipalities, yet discerned no impact on this group. Rigorous tests confirm the robustness of the results.Originality/valueThis paper aims to contribute to: (1) the consolidation of research on the subject, given the absence of such research in Brazil to the best of our knowledge; (2) the advancement and analysis of evidence-based public policy and (3) the utilization of novel longitudinal data and methodology to evaluate adolescent pregnancy rates.

Comparative analysis of adolescent pregnancy causes in Tanzania: A comprehensive review of literature

Teenage pregnancy remains a global challenge with profound implications, necessitating a thorough exploration of its causes and contributing factors. This study provides a comprehensive review of research studies conducted in Tanzania from 2019 to 2023, contributing to the ongoing discourse on the complex interplay of socio-cultural, economic, and educational factors shaping the experiences of Tanzanian adolescents. Twelve studies, comprising seven journals and five master theses, were purposefully selected to identify commonalities and disparities in their findings. The study systematically examines the identified studies, shedding light on the prevailing factors associated with teenage pregnancies in Tanzania. Several themes emerged from the reviewed literature, with all studies unequivocally pinpointing poor knowledge on sexual and reproductive health as a common factor contributing to teenage pregnancies. Moreover, a substantial majority, 75%, highlighted the significance of low economic status in this context, emphasizing the intersectionality of socio-economic factors. Furthermore, this comparative analysis delves into the nuanced findings of the selected studies, revealing that 50% of the reviewed research identified peer influence as a significant contributor to teenage pregnancies. These findings not only underscore the multifaceted nature of the issue but also highlight the need for targeted interventions addressing both individual knowledge gaps and broader socio-economic challenges.

Comparing pregnancy and pregnancy outcome rates between adolescents with and without pre-existing mental disorders.

There are limited population-based data on the role of mental disorders in adolescent pregnancy, despite the presence of mental disorders that may affect adolescents' desires and decisions to become pregnant. This study aimed to examine the relationship between specific types of mental disorders and pregnancy rates and outcome types among adolescents aged 13-19 years, using single-year age groups. We conducted a retrospective cohort study using data from the Merative™ MarketScan Research Databases. The study population consisted of females aged 13-19 years with continuous insurance enrollment for three consecutive calendar years between 2005 and 2015. Pregnancy incidence rates were calculated both overall and within the different categories of mental disorders. The presence of mental disorders, identified through diagnosis codes, was classified into 15 categories. Pregnancy and pregnancy outcome types were determined using diagnosis and procedure codes indicating the pregnancy status or outcome. To address potential over- or underestimations of mental disorder-specific pregnancy rates resulting from variations in age distribution across different mental disorder types, we applied age standardization using 2010 U.S. Census data. Finally, multivariable logistic regression models were used to examine the relationships between 15 specific types of mental disorders and pregnancy incidence rates, stratified by age. The age-standardized pregnancy rate among adolescents diagnosed with at least one mental disorder was 15.4 per 1,000 person-years, compared to 8.5 per 1,000 person-years among adolescents without a mental disorder diagnosis. Compared to pregnant adolescents without a mental disorder diagnosis, those with a mental disorder diagnosis had a slightly but significantly higher abortion rate (26.7% vs 23.8%, P-value < 0.001). Multivariable logistic regression models showed that substance use-related disorders had the highest odds ratios (ORs) for pregnancy incidence, ranging from 2.4 [95% confidence interval (CI): 2.1-2.7] to 4.5 [95% CI:2.1-9.5] across different age groups. Overall, bipolar disorders (OR range: 1.6 [95% CI:1.4-1.9]- 1.8 [95% CI: 1.7-2.0]), depressive disorders (OR range: 1.4 [95% CI: 1.3-1.5]- 2.7 [95% CI: 2.3-3.1]), alcohol-related disorders (OR range: 1.2 [95% CI: 1.1-1.4]- 14.5 [95% CI: 1.2-178.6]), and attention-deficit/conduct/disruptive behavior disorders (OR range: 1.1 [95% CI: 1.0-1.1]- 1.8 [95% CI: 1.1-3.0]) were also significantly associated with adolescent pregnancy, compared to adolescents without diagnosed mental disorders of the same age. This study emphasizes the elevated rates of pregnancy and pregnancy ending in abortion among adolescents diagnosed with mental disorders, and identifies the particular mental disorders associated with higher pregnancy rates.

Assessing Biomedical and Psychosocial Factors in a Cross-Sectional Study of School Dropouts Among Pregnant Adolescents and Young Mothers in Quito, Ecuador.

Over nearly three decades, Ecuador experienced a significant rise in adolescent motherhood. By focusing on social, health, and psychological aspects, the research aims to reveal the complex factors influencing the decision to discontinue education. The emphasis on providing a platform for direct expression of personal experiences not only adds qualitative depth to the study but also ensures that the voices of those involved are heard authentically. Employing a nonexperimental, descriptive, cross-sectional approach with qualitative and quantitative methods, the research delves into the interplay of biological, psychological, and social factors. Descriptive statistics, presented through tables and graphs, were used for variable analysis, complemented by inferential statistics to validate hypotheses. Focus group sessions, processed with ATLAS.ti(ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) underwent a thorough review in workshops with Servicio de Atención Integral para Adolescentes(SAIA) experts. Adolescent participants were randomly recruited through the hospital's system. The findings unveiled a significant dropout rate among adolescents, where pregnancy was just one factor influencing their decision. Those discontinuing education often embraced a life project centered on motherhood and domestic roles, facing domestic violence and mental health disorders. In contrast, those persisting with education were driven by professional development, facing challenges but benefiting from family support. Despite unwanted pregnancies and low contraceptive use, many found personal growth and identity affirmation in motherhood. Our research highlights key insights into factors like pregnancy desire, contraception, reactions, and challenges. Urgent action is needed to address systemic problems and provide holistic support, acknowledging the resilience and validity of choices made by adolescent mothers in balancing motherhood with education and career goals.

Efforts to Deal with the Impact of Adolescent Pregnancy through a Holistic Approach: A Literature Review

Teenage pregnancy, occurring at the age of 15-19 years, is a global public health problem with negative impacts for both mother and baby. The purpose of the study is to analyze the efforts that have been made in various countries in dealing with the impact of adolescent pregnancy to obtain strategies and recommendations that have the potential to create positive changes in handling the problem of adolescent pregnancy globally. This research method uses a literature review. The literature search process carried out in this literature review uses the database Scopus with a range of publication years 2019-2023. The search was conducted using several keywords "Teenage pregnancy" AND "impact". The findings of 10 journals show that teenage pregnancy has significant health and social impacts, including the risk of obstetric complications, high rates of maternal and infant mortality, and long-term consequences for mother and child. Factors such as low access to education, lack of knowledge about reproductive health, peer influence, and family problems trigger teenage pregnancy. The importance of a holistic approach involving collaboration between government, religious leaders, families, and educational institutions to prevent teenage pregnancy, increase knowledge of sexual education, and form positive, preventive attitudes needs to be done to reduce the risks and adverse effects associated with teenage pregnancy.

Adolescent Childbearing and Associated Factors in Vietnam

This research examines the factors influencing adolescent girl childbirth in Vietnam by employing data from the 2019 Vietnam Population and Housing Census and socio-ecological theory. The research underscores the substantial impact of environmental systems on adolescent childbirth, encompassing age, marital status, educational level, living area, and ethnicity. Higher adolescent birth rates are observed among older adolescents, ethnic minorities, and those with lower levels of education; this highlights the significance of cultural norms, restricted healthcare access, and poverty in influencing these results. The study emphasizes the importance of education, access to healthcare, and community support in mitigating the occurrence of pregnancies among adolescents. It further advocates for focused interventions that enhance the development of human capital, with a specific focus on rural regions and ethnic minority populations. To lessen the hazards associated with adolescent pregnancy, the study recommends policies that reduce child marriage and early motherhood and enhance education and knowledge on sexual and reproductive health.

Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial

When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants’ homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.

What's Behind the Dramatic Pre-2020 Declines in Hispanic/Latina Adolescent Childbearing? Decomposing Change by Age, Origin, and Nativity

PurposeTo assess whether the large declines in adolescent childbearing among Hispanic adolescents over the period 2000-2019 have been driven by co-occurring changes in the composition of the Hispanic population and, if so, whether they have done so differentially by Hispanic subgroup. MethodsWe use birth counts from the United States vital statistics system and population denominators from the United States decennial census long form 5-percent Public Use Microdata and the American Community Survey to conduct a decomposition analysis apportioning observed declines in Hispanic adolescent childbearing to: (1) compositional shifts in nativity, age, and region-of-origin and (2) subgroup changes in childbearing rates. ResultsThe Hispanic adolescent fertility rate fell by over 71% from 2000 to 2019, with Mexican-Origin, United States-born, and younger adolescents exhibiting the steepest declines (79%, 70%, and 80% declines, respectively). Results from the decomposition analysis show that almost 90% of the decline is due to within-group rate change, with some variability by subgroup and by decade. Only 10% of the decline was due to compositional changes, with shifts in nativity driving much of the effect. DiscussionDeclines in Hispanic adolescent childbearing over the last decades have occurred in spite of substantial shifts in the composition of the Hispanic population, not because of them. These findings set the stage for a more detailed examination of the drivers of change in sexual activity, contraceptive use, and abortion, all of which are proximate determinants of adolescent pregnancy and childbearing. Additionally, a focus on more distal factors is needed, including the role that changing political, societal, and economic conditions in the United States have for early fertility patterns.