ABSTRACT
O objetivo do estudo foi estimar a magnitude da gravidez recorrente na adolescência verificar os fatores associados ao fenônemo e os principais resultados perinatais. Foram selecionadas 1.986 puérperas adolescentes no pós-parto em maternidades do Município do Rio de Janeiro. A análise estatística consistiu em utilizar testes qui-quadrado (χ²) para testar hipóteses de homogeneidade de proporções. Foram estimadas as associações entre as variáveis pela razão dos produtos cruzados - Odds Ratio (OR) e respectivos intervalos de confiança, utilizando-se procedimentos de regressão logística. Verificou-se que 31,4% já haviam experimentado a maternidade anteriormente e os principais fatores associados foram: idade materna entre 16 e 19 anos e paterna superior a 19 anos, a idade de menarca anterior aos 12 anos, a cor da pele da puérpera preta ou parda, a escolaridade inferior à 5ª série do ensino fundamental e a presença do companheiro durante a gestação. O óbito perinatal foi significativamente maior entre grupo de adolescentes com gestações sucessivas. Os resultados obtidos revelam que as adolescentes com gravidez recorrente apresentam piores condições sociodemográficas do que aquelas na primeira gravidez. Os achados indicam a importância das políticas sociais para as mulheres com gravidez recorrente na adolescência.
The aim of the study was to evaluate the prevalence of repeated pregnancy among adolescents and identify associated factors and perinatal outcomes. A sample of 1,986 post-partum adolescents was selected from public hospitals in the city of Rio de Janeiro, Brazil. To verify the hypothesis of homogeneity of proportions, chi-square tests (χ²) were used. Odds ratios and correspondent confidence intervals were estimated. Logistic regression procedures were used. A repeated pregnancy prevalence of 31.4% was identified and the principal associated factors were: maternal age 15-19 years; paternal age >19 years; early menarche; black or brown maternal skin color; schooling < 5 years; living with partner during pregnancy. Perinatal death was significantly higher in the adolescent mothers group with repeated pregnancy. The results showed that the most disadvantaged socioeconomic conditions were found among adolescent mothers with repeated pregnancy in comparison to mothers on their first pregnancy. The findings sustain the relevance of social policies for adolescent mothers with repeated pregnancy.
Subject(s)
Adolescent , Child , Female , Humans , Infant, Newborn , Male , Pregnancy Outcome , Pregnancy/statistics & numerical data , Brazil , Parity , Risk Factors , Urban HealthABSTRACT
Objective To explore the complications and the treatments of repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia. Methods We performed a retrospective study in 6832 cases underwent first cesarean delivery,within which 201 cases were accompanied by the placenta praevia;and 337 cases underwent repeated cesarean deliver, within which 26 cases were accompanied by the placenta praevia. All subjects accepted cesarean delivery from January2006 toApril 2010 in our hospital. Results The occurrence rate of placenta previa was significantly higher in the repeated cesarean delivery than first-ever cesarean delivery (7. 72% vs 2. 94%, x2 = 22. 33, P ＜ 0. 01 ) , especially the occurrence of complete placenta previa (42. 30% vs 0. 00%, x2 = 80. 43, P ＜ 0. 01 ). The rates of uterus rupture, placenta accreta, postpartum hemorrhage and hysterectomy (r = 26. 92% ,23.08% ,26. 92% and 7. 69%, respectively) in repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia were significantly higher than those of the cases ( r = 2. 57% ,0. 32%, 1.29% and 0. 00%, respectively ) had repeated cesarean delivery in scar uterus pregnancy but no placenta previa ( x2 = 27.97,50. 41,42. 16,12. 79, respectively, Ps ＜ 0. 01 ). Conclusion The incidence of placenta previa increased in scar uterus pregnancy, especially the complete placental previa.Scar uterus pregnancy accompanied by the placenta praevia are more likely to occur uterus rupture,placenta accreta,postpartum hemorrhage and had hysterectomy. Obstetricians should give more effort to reduce the cesarean section rate,improve the quality of medical care.
ABSTRACT
A gravidez na adolescência pode ser entendida como um período de crises que traz riscos e conseqüências negativas para a adolescente, podendo ser potencializados pela repetição. Mostra-se relevante conhecer a realidade biopsicossocial dessas adolescentes e analisar os fatores envolvidos nessa repetição. Aplicou-se, então, um questionário semi-estruturado, numa Maternidade Escola em Natal/RN, a 50 puérperas com idade entre 12 e 18 anos de idade (média 17 anos), das quais 82 por cento não freqüentam a escola, 62 por cento vivem em união estável e 68 por cento têm renda familiar até três salários mínimos. Iniciaram a vida sexual aos 13 anos e o intervalo entre a gravidez anterior e a atual foi de 1 a 12 meses para 52 por cento das entrevistadas. Assim, o início precoce da vida sexual, a convivência com o companheiro e o abandono escolar podem tornar as adolescentes vulneráveis à gravidez e sua repetição e acentuar os riscos psicossociais.
Adolescent pregnancy can be understood as a period of crisis that brings risks and negatives consequences for a teenager that can be potentiated by repetition. It is important to know the biopsychosocial reality of these teenagers and analyze the factors involved in this repetition. A semistructured questionnaire was administered to 50 mothers aged between 12 and 18 years of age (mean 17 years old) in a Maternity School from Natal/RN. Results showed that 82 percent of them were not attending school, 62 percent were in a stable marriage and the family income of 68 percent did not exceed three minimum wages. The sexual initiation occurred at 13 years old and the distance between the first and current pregnancy were 1 to 12 months for 52 percent of interviewed. Therefore, early initiation in a sexual life, living with a partner and abandoning school can make teenagers vulnerable to repeated pregnancy and strengthen psychosocial risks.
Subject(s)
Adolescent , Pregnancy in Adolescence/psychologyABSTRACT
A fim de traçar o perfil biopsicossocial de adolescentes com repetição de gravidez e seus fatores associados, investigou-se questões socio-demográficas, variáveis biológicas e psicológicas de 50 adolescentes multigestas.Os dados analisados através de estatística descritiva apontam que a maioria das adolescentes não frequentava a escola e vivia em união estável, que 54% não fez uso de métodos contraceptivos na primeira relação sexual e 88% nunca participou dos programas de Planejamento Familiar. Assim, políticas públicas de educação sexual e reprodutiva devem identificar comportamentos sexuais de risco, atuar na construção de valores familiares e no planejamento das gestações.
A fin de trazar el perfil biopsicosocial de adolescentes con repetición de embarazo y los factores asociados, se investigaron las variables sociodemográficas, biológicas y psicológicas de 50 adolescentes que se encontraban en su segunda gestación. Los datos analizados a través de estadística descriptiva muestran que la mayoría de las adolescentes no frecuentaba la escuela y vivía en unión estable, el 54% no usó métodos contraceptivos en la primera relación sexual y el 88% nunca participó de programas de planeación familiar. Se concluye que las políticas públicas de educación sexual y reproductiva deben identificar comportamientos sexuales de riesgo, actuar en la construcción de valores de la familia y en el embarazo planeado.
This study was intended to outline the biopsychosocial profile of teenagers with repeated pregnancy and to determine the associated factors. It was inquired for sociodemographic, biologic and psychologic variables of 50 teenagers during their second pregnancy. Data analized using descriptive statistics show that most teenagers in the study didnt go to school regularly and lived in a stable union; 54% of them didnt use contraceptive methods in their first sexual intercourse, while 88% had never participated in family planning programs. It is concluded that the public policies of sexual and reproductive education should identify sexual risk behaviors and act in the construction of family values and in the planned pregnancy.