Unplanned teenage pregnancy and adolescent sexual behavior
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v33.i4.34866Keywords:
adolescence, pregnancy, sexual behaviorAbstract
The teenage years are a pivotal period of physical and psychological change. These formative years play a critical role in shaping an individual’s transition to adulthood. Early childbearing or pregnancy, especially if unplanned, can significantly disrupt a young woman’s development, adversely affecting her health, education, and future income potential. Pregnant teenagers are often pressured to drop out of school, with implications in their educational opportunities and career prospects. Understanding the long-term consequences of teenage pregnancy is essential to developing effective interventions and addressing its underlying causes. This narrative review examines the incidence, risk factors, impact, and preventive measures associated with teenage pregnancy.
Worldwide, the incidence of pregnancy before the age of 18 is approximately 15%. Teenage pregnancy is closely related to adolescent sexual behavior. While condom use has slightly declined, awareness of the associated risks – such as sexually transmitted infections (STIs) and unplanned pregnancy – remains a major concern. Several interrelated risk factors contribute to this problem, including age, education level, economic status, mental health, and family environment. Moreover, teenage pregnancy is associated with adverse obstetric outcomes, including preterm birth and low birth weight, as well as higher rates of psychiatric disorders and socioeconomic challenges. The implementation of evidence-based prevention strategies, such as family and community involvement, is crucial. In Portugal, laws support sex education, access to contraception, and voluntary termination of pregnancy. Although the birth rate among Portuguese teenagers has declined significantly since the 1970s, it remains a major public health concern. Addressing the social, physical, and mental health risks associated with adolescent pregnancy requires a comprehensive approach that includes sexual education, accessible health services, mental health support, and promotion of contraceptive use among both girls and boys.
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References
World Health Organization. Adolescent pregnancy. January, 2020. (Assessed May, 8 2023). Available at: https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy.
Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG : an international journal of obstetrics and gynaecology 2014; 121 Suppl 1, 40–48. https://doi.org/10.1111/1471-0528.12630.
Bennett SE, Assefi NP. School-based teenage pregnancy prevention programs: a systematic review of randomized controlled trials. The Journal of adolescent health: official publication of the Society for Adolescent Medicine 2005; 36(1), 72–81. https://doi.org/10.1016/j.jadohealth.2003.11.097.
United Nations Children’s Fund (UNICEF). Early childbearing. May, 2021. (Assessed May, 8 2023). Available at: https://data.unicef.org/topic/child-health/adolescent-health/.
Pordata. Taxa de fecundidade por grupo etário. June, 15, 2021. (Assessed June, 1 2023) Available at: https://www.pordata.pt/pt/estatisticas/populacao/nascimentos-e-fecundidade/taxa-de-fecundidade-por-grupo-etario-0.
Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. The Lancet. Global health 2020; 8(9), e1152–e1161. https://doi.org/10.1016/S2214-109X(20)30315-6.
Canavarro MC, Pedrosa A. Gravidez e parentalidade na adolescência: perspetivas teóricas. Saúde Reprodutiva - Sexualidade e Sociedade 2012, 2, 34–55.
Matos MG, Equipa do Projecto Aventura Social e Saúde. A saúde dos adolescentes portugueses (Quatro anos depois). Lisboa: Edições Faculdade de Motricidade Humana/Universidade Técnica de Lisboa; PEPT & Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa 2003.
Matos MG, Equipa Aventura Social. A Saúde dos Adolescentes após a Recessão – Dados nacionais 2018. Lisboa: Projeto Aventura Social & Faculdade de Motricidade Humana/Universidade de Lisboa 2018.
Matos MG, Simões C, Camacho I, Reis M, Equipa Aventura Social. A Saúde dos Adolescentes em Tempo de Recessão – Dados nacionais do estudo HBSC de 2014 – Relatório do estudo HBSC 2014. Lisboa: Centro de Malária e Outras Doenças Tropicais/Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa & Faculdade de Motricidade Humana/Universidade de Lisboa 2015.
Matos MG, Simões C, Tomé G, Camacho I, Ferreira M, Ramiro L, et al. Aventura Social & Saúde, A Saúde dos adolescentes portugueses – Relatório Final do Estudo HBSC 2010. Lisboa: Centro Malária e Outras Doenças Tropicais/IHMT/UNL; FMH/Universidade Técnica de Lisboa 2012.
Chung HW, Kim EM, Lee, J-E. Comprehensive understanding of risk and protective factors related to adolescent pregnancy in low- and middle-income countries: A systematic review. Journal of Adolescence 2018; 69: 180–188. https://doi.org/10.1016/j.adolescence.2018.10.007.
Amoran, OE. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria. International Journal for Equity in Health 2012; 11, 37. https://doi.org/10.1186/1475-9276-11-37.
Maravilla JC, Betts KS, Couto E Cruz C, Alati, R. Factors influencing repeated teenage pregnancy: A review and meta-analysis. American Journal of Obstetrics and Gynecology 2017; 217(5): 527-545.e31. https://doi.org/10.1016/j.ajog.2017.04.021.
Cook SMC, Cameron ST. Social issues of teenage pregnancy. Obstetrics, Gynaecology and Reproductive Medicine 2017, 27(11): 327–332. https://doi.org/10.1016/j.ogrm.2017.08.005.
Faler CS, Câmara SG, Aerts DRG de C, Alves GG, Béria JU. Family psychosocial characteristics, tobacco, alcohol, and other drug use, and teenage pregnancy. Cadernos De Saúde Publica 2013; 29(8): 1654–1663. https://doi.org/10.1590/0102-311x00107812.
Fasula AM, Chia V, Murray CC, Brittain A, Tevendale H, Koumans EH. Socioecological risk factors associated with teen pregnancy or birth for young men: A scoping review. Journal of Adolescence 2019; 74: 130–145. https://doi.org/10.1016/j.adolescence.2019.06.005.
East PL, Slonim A, Horn EJ, Trinh C, Reyes BT. How an adolescent’s childbearing affects siblings’ pregnancy risk: A qualitative study of Mexican American youths. Perspectives on Sexual and Reproductive Health 2009; 41(4): 210–217. https://doi.org/10.1363/4121009.
Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. European Journal of Public Health 2006; 16(2): 157–161. https://doi.org/10.1093/eurpub/cki158.
Diedrich JT, Klein DA, Peipert JF. Long-acting reversible contraception in adolescents: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology 2017; 216(4): 364.e1-364.e12. https://doi.org/10.1016/j.ajog.2016.12.024.
Brosens I, Muter J, Gargett CE, Puttemans P, Benagiano G, Brosens JJ. The impact of uterine immaturity on obstetrical syndromes during adolescence. American Journal of Obstetrics and Gynecology 2017, 217(5): 546–555. https://doi.org/10.1016/j.ajog.2017.05.059.
Chen X-K., Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: A large population based retrospective cohort study. International Journal of Epidemiology 2007; 36(2): 368–373. https://doi.org/10.1093/ije/dyl284.
Malabarey OT, Balayla J, Klam SL, Shrim A, Abenhaim HA. Pregnancies in young adolescent mothers: A population-based study on 37 million births. Journal of Pediatric and Adolescent Gynecology 2012; 25(2): 98–102. https://doi.org/10.1016/j.jpag.2011.09.004.
Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang C-C, Gomez-Lobo V. Adverse Maternal and Neonatal Outcomes in Adolescent Pregnancy. Journal of Pediatric and Adolescent Gynecology 2016; 29(2): 130–136. https://doi.org/10.1016/j.jpag.2015.08.006.
Kirbas A, Gulerman HC, Daglar K. Pregnancy in Adolescence: Is It an Obstetrical Risk? Journal of Pediatric and Adolescent Gynecology 2016; 29(4): 367–371. https://doi.org/10.1016/j.jpag.2015.12.010.
Marvin-Dowle K., Kilner K., Burley VJ, Soltani H. Impact of adolescent age on maternal and neonatal outcomes in the Born in Bradford cohort. BMJ Open 2018; 8(3): e016258. https://doi.org/10.1136/bmjopen-2017-016258.
Loto OM, Ezechi OC, Kalu BKE, Loto A, Ezechi L, Ogunniyi SO. Poor obstetric performance of teenagers: Is it age- or quality of care-related? Journal of Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology 2004; 24(4): 395–398. https://doi.org/10.1080/01443610410001685529.
Haldre K, Rahu K, Karro H, Rahu M. Is a poor pregnancy outcome related to young maternal age? A study of teenagers in Estonia during the period of major socio-economic changes (from 1992 to 2002). European Journal of Obstetrics, Gynecology, and Reproductive Biology 2007; 131(1): 45–51. https://doi.org/10.1016/j.ejogrb.2006.05.002.
Stevens-Simon C, Beach RK, McGregor JA. Does incomplete growth and development predispose teenagers to preterm delivery? A template for research. Journal of Perinatology: Official Journal of the California Perinatal Association 2002; 22(4): 315–323. https://doi.org/10.1038/sj.jp.7210694.
Santos MMA de S, Baião MR, de Barros DC, Pinto A de A, Pedrosa PLM, Saunders C. Pre-pregnancy nutritional status, maternal weight gain, prenatal care, and adverse perinatal outcomes among adolescent mothers. Brazilian Journal of Epidemiology 2012; 15(1): 143–154. https://doi.org/10.1590/s1415-790x2012000100013.
Kingston D, Heaman M, Fell D, Chalmers B, Maternity Experiences Study Group of the Canadian Perinatal Surveillance System, Public Health Agency of Canada. Comparison of adolescent, young adult, and adult women’s maternity experiences and practices. Pediatrics 2012; 129(5): e1228-1237. https://doi.org/10.1542/peds.2011-1447.
Santos GHND, Martins M da G, Sousa M da S, Batalha S de JC. Impact of maternal age on perinatal outcomes and mode of delivery. Revista Brasileira De Ginecologia E Obstetrícia: Revista Da Federação Brasileira Das Sociedades De Ginecologia E Obstetrícia 2009; 31(7): 326–334.
Barnet B, Liu J, Devoe M. Double jeopardy: Depressive symptoms and rapid subsequent pregnancy in adolescent mothers. Archives of Pediatrics & Adolescent Medicine 2008; 162(3): 246–252. https://doi.org/10.1001/archpediatrics.2007.60.
Moffitt TE, E-Risk Study Team. Teen-aged mothers in contemporary Britain. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2002; 43(6): 727–742. https://doi.org/10.1111/1469-7610.00082.
Wall-Wieler E, Roos LL, Nickel NC Teenage pregnancy: The impact of maternal adolescent childbearing and older sister’s teenage pregnancy on a younger sister. BMC Pregnancy and Childbirth 2016; 16(1): 120. https://doi.org/10.1186/s12884-016-0911-2.
Hornberger LL, COMMITTEE ON ADOLESCENCE. Diagnosis of Pregnancy and Providing Options Counseling for the Adolescent Patient. Pediatrics 2017; 140(3): e20172273. https://doi.org/10.1542/peds.2017-2273.
Figueiredo B. Maternidade na adolescência: Do risco à prevenção. Revista Portuguesa de Psicossomática 2001 (Assessed June, 1 2023). Available at: https://www.redalyc.org/articulo.oa?id=28730211.
Solomon-Fears C. Teenage Pregnancy Prevention: Statistics and Programs. 2015. (Assessed June, 15 2023). Available at: https://www.everycrsreport.com/files/20150226_RS20301_f18f59d89e39e7e9b41d90e82c49a3b39ca8c12c.pdf.
Decreto Lei nº259/2000 de 17 de Outubro do Ministério da Educação, Diário da República n.º 240/2000, Série I-A de 2000-10-17, páginas 5784 – 5786, 2000. (Assessed June, 15 2023). Available at: https://data.dre.pt/eli/dec-lei/259/2000/10/17/p/dre/pt/html.
Divisão de Saúde Sexual Reprodutiva Infantil e Juvenil. Relatório dos Registos das Interrupções da Gravidez |2018. 2018. (Assessed June, 15 2023). Available at: https://www.spdc.pt/images/RelatrioIVG2018_Imprensa.pdf.
Vargas G, Borus J, Charlton BM. Teenage pregnancy prevention: the role of young men. Current opinion in pediatrics 2017; 29(4), 393–398. https://doi.org/10.1097/MOP.0000000000000510
Connor S, Edvardsson K, Spelten E. Male adolescents’ role in pregnancy prevention and unintended pregnancy in rural Victoria: health care Professional’s and educators’ perspectives. BMC pregnancy and childbirth 2018; 18(1), 245. https://doi.org/10.1186/s12884-018-1886-y.
Sociedade Portuguesa da Contraceção, Sociedade Portuguesa de Ginecologia, Sociedade Portuguesa de Medicina da Reprodução. Consenso sobre Contraceção 2020. 2020 (Assessed June, 15 2023). Available at: https://www.spdc.pt/images/CONSENSOS_FINAL.pdf.
American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice. Long-acting reversible contraception: implants and intrauterine devices. Obstetrics & Gynecology 2011; 118, 184–96. (Assessed June 15, 2023). Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devices.
Peipert JF, Zhao Q, Allsworth JE, Petrosky E, Madden T, Eisenberg D, et al. Continuation and satisfaction of reversible contraception. Obstetrics and gynecology 2011; 117(5), 1105–1113. https://doi: 10.1097/AOG.0b013e31821188ad.
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