Conocimientos y prácticas sobre sífilis materna y congénita en adolescentes embarazadas en un Hospital General de Paraguay: estudio cualitativo

Introducción: La sífilis en embarazadas, sigue siendo un gran problema de salud pública en todo el mundo, y en Paraguay, no es la excepción. La sífilis congénita puede provocar abortos, muertes fetales y neonatales, peso bajo al nacer, prematuridad y otras anomalías congénitas, el conocimiento general de la población en edad fértil es fundamental. Objetivo: Analizar los conocimientos y prácticas sobre sífilis materna y sífilis congénita en adolescentes embarazadas en un Hospital General de Paraguay. Metodología: Se realizó un estudio cualitativo, fenomenológico descriptivo. Para la recolección de datos se utilizó la entrevista, simple que fue grabada con previa autorización del participante, la conclusión y recomendación serán entregados a la institución y a las adolescentes embarazadas. Resultados: Participaron diez adolescentes, en su mayoría de 19 años de edad, cinco conocen que la sífilis se transmite a través de las relaciones sexuales, sin embargo, desconocen acerca de cómo se transmite la sífilis congénita. Cinco de las adolescentes menciona haber iniciado las relaciones sexuales a los 16 años. Dos adolescentes a los 15 años, dos a los 14 años y una a los 17 años, nueve de las adolescentes embarazadas mencionan acudir a sus controles prenatales de forma periódica. Dos aún no se han realizado el test de VDRL. Discusión: Se concluye en cuanto al conocimiento, que solo cinco de diez adolescentes conocen acerca de la sífilis, sin embargo, no conocen sobre la sífilis congénita. En cuanto a las prácticas preventivas, 10 acuden de forma periódica a sus controles prenatales.

Introduction: Syphilis in pregnant women continues to be a major public health problem throughout the world, and in Paraguay, it is no exception. Congenital syphilis can cause abortions, fetal and neonatal deaths, low birth weight, prematurity, and other congenital anomalies; general knowledge of the population of childbearing age is essential. Objective: To analyze the knowledge and practices about maternal syphilis and congenital syphilis in pregnant adolescents in a General Hospital in Paraguay. Methodology: A qualitative, descriptive phenomenological study was carried out. A simple interview was used to collect data, which was recorded with prior authorization from the participant. The conclusion and recommendation will be delivered to the institution and to the pregnant adolescents. Results: Ten adolescents participated, mostly 19 years of age, five know that syphilis is transmitted through sexual relations, however, they do not know how congenital syphilis is transmitted. Five of the adolescent's mention having started sexual relations at the age of 16. Two adolescents at 15 years old, two at 14 years old and one at 17 years old, nine of the pregnant adolescent's mention attending their prenatal check-ups periodically. Two have not yet been tested for VDRL. Discussion: It is concluded in terms of knowledge that only five out of ten adolescents know about syphilis; however, they do not know about congenital syphilis. Regarding preventive practices, 10 attend their prenatal check-ups periodically.

Parturientes adolescentes em Cruzeiro do Sul, Acre, Brasil: características socioeconômicas e obstétricas / Adolescent pregnancy in Cruzeiro do Sul, Acre, Brazil: socioeconomic characteristics, prenatal and obstetric care

Resumo O objetivo do estudo foi investigar as características socioeconômicas e obstétricas de parturientes adolescentes e suas complicações sobre a saúde materna e neonatal. Trata-se de uma análise de dados da linha de base da coorte de nascimentos MINA-Brasil conduzida no município de Cruzeiro do Sul, estado do Acre. Utilizou-se teste qui-quadrado para comparar características das puérperas adolescentes com as adultas e modelos múltiplos de regressão de Poisson com variância robusta para avaliar fatores associados. Entre as puérperas estudadas, 26,2% (IC95%: 24,0-28,4) eram adolescentes. Os fatores associados ao parto na adolescência foram ter nove anos ou menos de estudo (RPaj:1,36; IC95%: 1,14-1,61), pertencer aos menores quartis do índice de riqueza (1° quartil: RPaj:1,40; IC95%: 1,08-1,80) (2° quartil: RPaj:1,37; IC95%: 1,08-1,74), ser primigesta (RPaj:3,69; IC95%: 2,98-4,57), baixo IMC pré-gestacional (RPaj:1,28; IC95%: 1,04-1,57), infecção urinária na gravidez (RPaj:1,25; IC95%: 1,07-1,46) e menos de seis consultas de pré-natal (RPaj:1,42; IC95%: 1,21-1,66). Pobreza, baixa escolaridade, primigestação, baixo IMC pré-gestacional, infecção urinária na gestação e menor número de consultas de pré-natal foram associados ao parto na adolescência em município da região Norte do Brasil.

Abstract The present study aimed to investigate the socioeconomic and obstetric characteristics of adolescent mothers and the complications they cause to maternal and neonatal health. This baseline data analysis of the MINA-Brazil birth cohort was conducted in the municipality of Cruzeiro do Sul, state of Acre, Brazil. The chi-square test was used to compare characteristics of adolescent and adult postpartum women, and multiple Poisson regression models with robust variance were used to assess associated factors. Among the postpartum women, 26.2% (95%CI: 24.0-28.4) were adolescents. Factors associated with childbirth in adolescence included: nine years or less of schooling (adjPR:1.36; 95%CI: 1.14-1.61), belongs to the lowest quartiles of the wealth index (1st quartile: adjPR:1.40; 95%CI: 1.08-1.80) (2nd quartile: adjPR:1.37; 95%CI: 1.08-1.74), primigravidae (adjPR:3.69; 95%CI: 2.98-4.57), low pre-pregnancy BMI (adjPR:1.28; CI95%: 1.04-1.57), urinary tract infection during pregnancy (adjPR:1.25; CI95%: 1.07-1.46) and less than six prenatal consultations (adjPR:1.42; 95%CI: 1.21-1.66). Poverty, little schooling, primigravidae, low pre-pregnancy BMI, urinary tract infection during pregnancy and few prenatal consultations were associated with childbirth during adolescence in a municipality in the Northern region of Brazil.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy

El embarazo adolescente: un error o un deseo cumplido / Teenage pregnancies: a mistake or a fulfilled wish

Resumen Antecedentes: En México los embarazos adolescentes son 77 por cada 1,000. De los nacimientos anuales, el 17% son de madres adolescentes, con casi 350,000. Objetivo: Explicar por qué las adolescentes se embarazan a pesar del conocimiento de métodos anticonceptivos. Métodos: Con un estudio exploratorio y observacional, se evaluaron a 300 adolescentes embarazadas de 15 a 19 años, que no tenían antecedentes de consumo de sustancias adictivas y cuyos embarazos no fueron resultado de una violación.. Se aplicó el cuestionario de funcionamiento familiar y una entrevista de los antecedentes sociodemográficos. Resultados: El inicio de vida sexual fue a los 12 años para el 1.7%, de las participantes, a los 13 para el 7.3%, a los 14 para el 18.7%, a los 15 para el 36%, a los 16 para el 19.3% y las restantes (17%) tuvieron un inicio a los 19 años. El 100% manifestó que conocía métodos anticonceptivos, incluyendo la píldora del día siguiente. Conclusiones: El embarazo a temprana edad viene acompañado de mitos sociales e individuales sobre el conocimiento de la sexualidad humana, la anticoncepción y la vida amorosa. El embarazo representa para las jóvenes tener un objeto de amor y obtener un lugar en el mundo y dentro sus familias.

Abstract Background: In Mexico, teenage pregnancy is 77 for every 1,000. In terms of annual births, 17% are from teenage mothers, which are almost 350,000. Objective: To explain why teenage girls get pregnant in spite of knowing about contraceptives. Method: An observational and exploratory study by which 300 pregnant teenage girls between 15 and 19 years old were evaluated, with no history of substance abuse and whose pregnancies were not the result of rape. A questionnaire on family dynamics and an interview about their sociodemographic background were applied. Results: The first sexual intercourse for 1.7% of the participants was at 12 years old; for 7.3%, at 13; for 18.7%, at 14; for 36%, at 15; for 19.3%, at 16, and for the remaining 17%, near 19 years old. All of them (100%) stated they knew about contraceptives, including the morning-after pill. Conclusions: Pregnancies at an early age come with individual and social myths about the knowledge of human sexuality, contraception, and love life. For these young women, a pregnancy represents an object of love and obtaining a place in the world and within their families.

Poor nutritional status of fifteen-year-old or younger adolescent mothers enhances the risk of small-for-gestational-age newborns

Introduction: To analyze the factors (socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures) associated with the birth of small for gestational age newborns.Methods: A cross-sectional study was performed with 15 years old or younger postpartum adolescents divided into small-for-gestational-age newborn (SGA) and non-small-for-gestational age newborn groups (NSGA). Socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures (triceps skinfold (TS), and mid-arm circumference, (MAC)) were collected.Results: 8,153 women gave birth at the obstetric ward and 364 (4.46%) ≤ 15 years old adolescents were enrolled in the study. The proportion of SGA newborns was 34.61%. The SGA group attended fewer prenatal visits (p = 0.037), had a higher prevalence of nutritional status classified as "very low weight" (p < 0.001) and vaginal delivery (p = 0.023), compared to the NSGA group. The nutritional status and vaginal delivery remained significant even after adjustment for confounders. The prevalence risk for SGA birth was 30% higher in the group of mothers with nutritional status classified as "very low weight" (odds ratio 1.30, 95% confidence interval 1.13 to 1.50) (p < 0.001).Conclusions: 15.4% of adolescents ≤ 15 years of age had an arm circumference compatible with the "very low weight" condition, demonstrating the high prevalence of poor maternal nutritional status in this group. The birth of SGA among adolescents ≤ 15 years of age is independently associated with maternal nutritional status classified as "very low weight" by the mid-arm circumference measures (MAC).

Knowledge regarding child rearing among teenage pregnant women in a rural area of West Bengal: A cross-sectional survey

Background: Child rearing practices are very important determinants of overall growth and development of child. As mother is primary caregiver of child, her knowledge regarding child rearing is very important. Unfortunately, till today, in India, teenage marriage and teenage pregnancy are very common. These adolescent mothers are not only underprepared physically and psychologically for giving birth and rearing a child successfully, but also it is assumed that have no proper knowledge. However, there was no sufficient research study for assessing knowledge regarding child rearing among teenage pregnant women in West Bengal, especially in rural area. Aims and Objectives: Assessing the knowledge regarding child rearing practice and its relationship with the determinants among teenage pregnant women in rural area of West Bengal. Materials and Methods: A descriptive community-based cross-sectional epidemiological study was conducted in rural field practice area of Medical College, Kolkata among 99 adolescent pregnant women during time period of July–December 2021. Data were analyzed in SPSS software version 20. Results: Mean age of the respondents was 17.60 (±1.23) years. Among the participants 58% being school dropout and 46% were homemaker. Maximum number of participants was married and got pregnant within age group of 15–17. Only 59.6% had good knowledge about child rearing. Number of child and perceived social pressure was statistically significant with the CRK score. Conclusions: The government should give more emphasis to improving maternal education and preventing teenage marriage and teenage pregnancy as a long-term strategy for improving child health.

Cine y trayectorias del aborto adolescente en Argentina y España

Propósito/Contexto. La interrupción del embarazo es uno de los grandes capítulos de la Bioética y el cine permite estudiarlo a partir de historias singulares. En el contexto de la reciente ley argentina y el proyecto de modificación de la ley española, este trabajo tiene como propósito examinar y comparar las trayectorias de los abortos representados en las películas Invisible (de Argentina y lanzada en 2017) y La innocencia (de España y lanzada en 2020). Metodología/Enfoque. El enfoque es cualitativo y la metodología utilizada es el análisis de contenido de los filmes, el cual se centra en las trayectorias de los abortos representados y se articulan con los contextos legales argentino y español, vigentes al momento del estreno de los filmes. Resultados/Hallazgos. Los resultados reflejan la complejidad del acceso al aborto, donde lo ilegal aparece como primera opción y se observan las diversas limitaciones de la autonomía de las jóvenes. Discusión/Conclusiones/Contribuciones. La contribución principal del artículo es el cuestionamiento de los aspectos bioéticos ligados con el complejo proceso de toma de decisión del aborto de jóvenes adolescentes a través de historias singulares. Así también la confirmación de la riqueza del formato cinematográfico permite desplegar estos matices singulares para el análisis de situaciones complejas.

Purpose/Context. The interruption of pregnancy is one of the great chapters of bioethics, and cinema allows its study from a singular perspective. In the context of the recent Argentine law and the draft amendment of the Spanish law, this article aims to examine and compare the trajectories of abortions represented in the films Invisible (Argentina, 2017) and La innocència (Spain, 2020). Methodology/ Approach. We sustain a qualitative approach and the methodology used is the content analysis of films, focusing on the trajectories of the abortions represented there and articulating them with the Argentine and Spanish legal context in force at the time of the release of the films. Results/Findings. The results reflect the complexity of access to abortion, where illegality appears to be the first option, and the various limitations of young women's autonomy. Discussion/Conclusions/Contributions. The main contribution of the article is the questioning of bioethical aspects linked to the complexity of the decision-making process of abortion of young adolescents through the analysis of singular stories. In addition, the richness of the cinematographic format is confirmed, as it allows the deployment of these singular nuances for the analysis of complex situations.

Objetivo/Contexto. A interrupção da gravidez é um dos grandes capítulos da bioética, e o cinema permite estudá-la a partir de histórias singulares. No contexto da recente lei argentina e do projeto de emenda à lei espanhola, este trabalho tem como objetivo examinar e comparar as trajetórias do aborto retratadas nos filmes Invisível (Argentina, 2017) e La innocència (Espanha, 2020). Metodologia/Abordagem. A abordagem é qualitativa e a metodologia utilizada é a análise de conteúdo dos filmes, enfocando as trajetórias dos abortos representados e articulando-os com o contexto jurídico argentino e espanhol vigente na época do lançamento dos filmes. Resultados/Descobertas. Os resultados refletem a complexidade do acesso ao aborto, onde o ilegal aparece como primeira opção, e as diversas limitações da autonomia das jovens. Discussão/Conclusões/Contribuições. A principal contribuição do artigo é o questionamento dos aspectos bioéticos vinculados ao complexo no processo decisório do aborto de jovens adolescentes por meio de histórias singulares, bem como a confirmação da riqueza do formato cinematográfico permite exibir essas nuances únicas para a análise de situações complexas.

Validación de instrumentos para medir factores de riesgo que se presentan en las adolescentes gestantes que asisten en el recinto cien familias período enero-agosto 2019 / Validation of instruments to measure risk factors present in pregnant adolescents who attend the cien familias campus period january-august 2019

El embarazo en adolescente representa una situación en la que influyen muchos elementos importantes, como el estado físico, el mental y el social, ya que, en esta etapa, ninguno de estos elementos está desarrollados, sino que se encuentran en plena etapa de evolución y desarrollo, situación que acarrea graves consecuencias para la madre Objetivo: validar los instrumentos cuantitativo y cualitativo que nos permitirán determinar los factores de riesgo que se presentan en las adolescentes gestantes que asisten al centro de salud cien familias periodo enero ­ agosto 2019. Materiales y métodos: Investigación mixta: cuantitativa y cualitativa. De tipo de campo, de corte transversal de tipo evaluativo, de diseño no experimental. La población está constituida por 32 adolescentes embarazadas, con edades de 12 a 19 años. Resultados: El instrumento cualitativo arrojo un promedio de confiabilidad total de sus tres categorías de 90 lo que coloca en la categoría de muy confiable y en el instrumento cuantitativo se obtuvo un promedio de confiabilidad de 95,5 lo que señala que se encuentra ubicado dentro de la categoría de muy confiable. Conclusión: Los resultados evidencian que los instrumentos son aptos, confiables y válidos para medir la variable independiente, y su correlación con la variable dependiente, cumplimiento de la hipótesis general de esta investigación(AU)

Teenage pregnancy represents a situation in which many important elements influence, such as physical, mental and social status. since, at this stage, none of these elements are developed, but rather they are in the full stage of evolution and development, a situation that has serious consequences for the mother Objective: to validate the quantitative and qualitative instruments that will allow us to determine the risk factors that occur in pregnant adolescents who attend the health center one hundred families from January to August 2019. Materials and methods: Mixed research: quantitative and qualitative. Field type, cross-sectional, evaluative type, non-experimental design. The population is made up of 32 pregnant adolescents, aged 12 to 19 years. Results: The qualitative instrument showed an average of total reliability of its three categories of 90., which places it in the category of very reliable and in the quantitative instrument, an average reliability of 95.5 was obtained, which indicates that it is located in the very reliable category. Conclusion: The results show that the instruments are suitable, reliable and valid to measure the independent variable, and its correlation with the dependent variable, fulfilling the general hypothesis of this research(AU)

Maltrato en la gestante adolescente y su efecto en el peso del recién nacido en la altura geográfica peruana, Huancayo, Perú / Abuse in adolescent pregnant women and its effect on newborn weight in the Peruvian geographical altitude, Huancayo, Peru

INTRODUCCIÓN: La violencia en la gestante está asociada a muchos factores del recién nacido, pero esto casi no se ha reportado en la altura geográfica. OBJETIVO: Determinar si existe asociación entre el maltrato en la gestante adolescente y su efecto en el peso del recién nacido en la altura geográfica peruana. MÉTODO: Estudio de cohorte retrospectiva. Se tomó la información de 855 gestantes. La variable exposición fue que hubieran sufrido violencia, lo cual se asoció al peso y otros datos del recién nacido en la ciudad de Huancayo, Perú. RESULTADOS: Según el análisis multivariado, hubo más riesgo de que el niño tuviera un peso inadecuado cuando hubo violencia física (riesgo relativo ajustado [RRa]: 1,42; intervalo de confianza del 95% [IC95%]: 1,01-2,00; p = 0,045), cuando se tuvo un parto pretérmino según Capurro (RRa: 4,90; IC95%: 2,85-8,45; p < 0,001), cuando hubo complicaciones en el parto (RRa: 2,11; IC95%: 1,25-3,61; p = 0,006) y si el abuso inició en el primer trimestre (RRa: 14,74; IC95%: 4,70-46,27; p < 0,001), el segundo (RRa: 18,72; IC95%: 5,78-60,63; p < 0,001) o el tercero (RRa: 18,87; IC95%: 4,71-75,60; p < 0,001). CONCLUSIONES: Existe asociación entre sufrir violencia física durante la gestación y el bajo peso al nacer, y también se encontró asociación con otras variables.

INTRODUCTION: Violence in the pregnant woman is associated with many newborn factors, but this has hardly been reported in the geographical altitude. OBJECTIVE: To determine whether there is an association between adolescent pregnancy abuse and its effect on newborn birth weight in high altitude Peru. METHOD: Retrospective cohort study. Information was taken from 855 pregnant women. The exposure variable was whether they had suffered gender-based violence, the exposure variable was that they had suffered violence, which was associated with the weight and other data of the newborn in Huancayo city, Peru. RESULTS: In the multivariatee analysis it was found that there was a higher risk of the child having an inadequate weight when there was physical violence (adjusted relative risk [RRa]: 1.42; 95% confidence interval [95% CI]: 1.01-2.00; p = 0.045), when there was a preterm birth according to Capurro (RRa: 4.90; 95% CI: 2.85-8.45; p < 0.001), when there were complications in childbirth (RRa: 2.11; 95% CI: 1.25-3.61; p = 0.006) and if the abuse started in the first trimester (RRa: 14.74; 95% CI: 4.70-46.27; p < 0.001), second (RRa: 18.72; 95% CI: 5.78-60.63; p < 0.001) or third (RRa: 18.87; 95% CI: 4.71-75.60; p < 0.001). CONCLUSIONS: There is an association between suffering physical violence during gestation and low birth weight, and association was also found with other variables.

Understanding the Factors Leading to High Prevalence of Teenage Pregnancies in the Four Aspirational Districts of Assam, Namely Goalpara, Barpeta, Dhubri, and Darrang

Background: The prevalence of teenage pregnancy in Assam is higher than the national average as per both NHFS‑4 and NHFS‑5. Four districts in Assam, falling under the NITI‑Aayog Aspiration Districts Transformation program of 2018, namely, Goalpara, Barpeta, Darrang, and Dhubri, have a prevalence of teenage pregnancy at levels higher than the state’s average (12% as per NHFS‑5). Teenage pregnancy affects several health and nutritional indicators. Objectives: The objective of the study was to identify the factors associated with teenage pregnancies in the Aspirational Districts of Assam in both social and public health contexts. Methods: A comparative cross‑sectional study was carried out across these four districts, with sample size of teenage pregnant women as 388 and an equal number of controls. Results: The study presents several factors to be statistically significant, viz., lower level of education of the teenage mothers or their spouses and lesser access to adequate health‑related information by teenage mothers. Furthermore, less number of teenage mothers are aware of contraceptive availability and face objection from spouses to use contraception. A unique factor presented by the study is the higher elopement rate among teenage mothers. Conclusion: Many of the factors upheld by the study are rooted in social and cultural fabric of the communities and could be addressed by mobilizing local institutions like panchayat and religious bodies to act as deterrence to teenage marriages in the communities. Men should also be brought into the fold of discussions on this sensitive subject through information and awareness generation.

Adolescentes grávidas que experienciaram o nascimento prematuro: percepções acerca do cuidado pré-natal / Adolescentes embarazadas que experimentaron un nacimiento prematuro: percepciones acerca del cuidado prenatal / Pregnant adolescents who experienced premature birth: perceptions about prenatal care

Resumo Objetivo conhecer os significados atribuídos ao pré-natal por adolescentes que pariram prematuramente e seus alcances ao parto e nascimento. Método estudo qualitativo que adotou o Interacionismo Simbólico e a Análise de Conteúdo Temática como referenciais teóricos e metodológicos e a entrevista aberta como instrumento de coleta de dados. Onze adolescentes residentes em um município do interior paulista integraram o estudo ao longo do ano de 2018. Resultados as adolescentes apontaram relações limitadas com os profissionais com obstáculos ao desenvolvimento da autonomia para as questões da gestação, parto e nascimento, assim como para o estabelecimento do apoio social. Emergiram três categorias temáticas: 'Início do pré-natal: reflexões e projeções futuras'; 'Insuficiências na atenção pré-natal' e '(Des) acolhimento no parto e nascimento'. Conclusão conhecer os significados atribuídos ao pré-natal por adolescentes que pariram prematuramente favoreceu apontamentos ao atitudinal do profissional em relação à consideração da adolescente enquanto indivíduo que direciona o cuidado por meio de seu lugar de fala e no exercício dos seus direitos no sentido de promover uma experiência positiva e qualificar o pré-natal.

Resumen Objetivo conocer los significados atribuidos a la atención prenatal por las adolescentes que dieron a luz prematuramente y su alcance durante el parto y el nacimiento. Método estudio cualitativo que adoptó el Interaccionismo Simbólico y el Análisis de Contenido Temático como referenciales teóricos y metodológicos y la entrevista abierta como instrumento de recolección de datos. Once adolescentes residentes en una ciudad del interior de São Paulo participaron del estudio a lo largo de 2018. Resultados las adolescentes señalaron relaciones limitadas con profesionales con obstáculos al desarrollo de la autonomía para los temas de embarazo, parto y nacimiento, así como para el establecimiento de apoyo social. Surgieron tres categorías temáticas: 'Inicio de la atención prenatal: reflexiones y proyecciones de futuro'; 'Insuficiencias en la atención prenatal' y '(Des) acogida en el parto y el nacimiento'. Conclusión conocer los significados atribuidos a la atención prenatal por las adolescentes que dieron a luz prematuramente favoreció la actitud del profesional de considerar a la adolescente como un individuo que dirige el cuidado a través de su lugar de expresión y en el ejercicio de sus derechos para promover una experiencia positiva y calificar el prenatal.

Abstract Objective to know the meanings attributed to prenatal care by adolescents who gave birth prematurely and their reaches to labor and birth. Method qualitative study that adopted the Symbolic Interactionism and Thematic Content Analysis as theoretical and methodological references and the open interview as a data collection tool. Eleven adolescents living in a municipality in the interior of São Paulo integrated the study throughout the year 2018. Results the adolescents pointed out limited relationships with professionals with obstacles to the development of autonomy for the issues of pregnancy, delivery and birth, as well as for the establishment of social support. Three thematic categories emerged: 'Beginning of prenatal care: reflections and future projections'; 'Insufficiencies in prenatal care' and '(un) welcoming in labor and birth'. Conclusion knowing the meanings attributed to prenatal care by adolescents who gave birth prematurely, favored points to the attitudinal of the professional regarding the consideration of the adolescent as an individual who directs care through her place of speech and in the exercise of her rights in order to promote a positive experience and qualify prenatal care.

Socio-cultural factors influencing teenage pregnancy in the East Mamprusi Municipality, Ghana

Teenage pregnancy puts a heavy cost on the mother and newborn child, family and the wider society. Despite measures taken by the Ghana Health Service to tackle the issue of teenage pregnancy, the phenomenon remains a public health concern that is widespread throughout the country. The study investigated the socio-cultural factors influencing teenage pregnancy in the East Mamprusi Municipality using an exploratory descriptive design. The study was conducted in rural communities in the East Mamprusi Municipality, in the North East Region of Ghana. Eighteen (18) participants were purposively sampled. Data collection was done by face to face interviews using an interview guide. The study found that polygamous families, parents' desire for grandchildren, multiple sexual partners and poverty were reportedly influencing teenage pregnancy in the rural community. The bid to establish close family ties also accounted for early marriages. There is a culture of silence on matters of sexuality in the community. Teenage pregnancy is an observed phenomenon admitted by the participants and teenage girls are at risk of serious health complications. This phenomenon paints a gloomy picture of the girl child education in the municipality. (Afr J Reprod Health 2022; 26[5]: 120-130).

Características sociodemográficas que influyen en el embarazo en la adolescencia / Sociodemographic characteristics that influence pregnancy in adolescence

Introducción: el embarazo en la adolescencia constituye un alarmante problema de salud; describir las características que influyen en su aparición permite desarrollar actividades de promoción de salud encaminadas a mejorar dicha situación. Objetivo: describir las características sociodemográficas que influyen el embarazo en la adolescencia. Métodos: estudio observacional, descriptivo, de corte transversal en gestantes adolescentes pertenecientes al Policlínico Docente "7 de noviembre" del municipio Majibacoa durante el año 2020. El universo estuvo constituido por 34 gestantes adolescentes; se trabajó con la totalidad de estas. Se analizaron las variables: edad materna, características sociodemográficas, factores de riesgo familiares, factores de riesgo sociales y económicos y deserción escolar. Resultados: el 55,9% de las gestantes tenía entre 18 y 19 años. El 47% tenían nivel preuniversitario, el 52,9% eran estudiantes; el 67,6% se encontraban en unión y la mayoría tuvo su primera relación sexual después de los 14 años (58,8%). El 32,4% de las gestantes adolescentes eran hijas de madres con algún embarazo en la adolescencia. Se observó con mayor preponderancia el per cápita familiar bajo como factor de riesgo socioeconómico (43,8%). El 58,8% abandonaron sus estudios. Conclusiones: el inicio precoz de las relaciones sexuales, el antecedente de madres con embarazos en la adolescencia, el per cápita familiar bajo favorecen la aparición de una gestación en la adolescencia, donde la mayoría de las veces estas deciden abandonar sus estudios.

Introduction: teenage pregnancy constitutes an alarming health problem; Describing the characteristics that influence its appearance allows the development of health promotion activities aimed at improving this situation. Objective: to describe the sociodemographic characteristics that influence pregnancy in adolescence. Methods:observational, descriptive, cross-sectional study in pregnant teenagers belonging to the Teaching Polyclinic "7 de Noviembre" of the Majibacoa municipality during the year 2020. The universe consisted of 34 pregnant teenagers; all of these were worked on. The variables were analyzed: maternal age, sociodemographic characteristics, family risk factors, social and economic risk factors, and school dropout. Results: 55,9% of the pregnant women were between 18 and 19 years old. 47% had a pre-university level, 52,9% were students; 67,6% were in union and the majority had their first sexual intercourse after the age of 14 (58,8%). 32,4% of the adolescent pregnant women were the daughters of mothers with some pregnancy in adolescence. Low family per capita is exhibited with greater preponderance as a socio-economic risk factor (43,8%). 58,8% dropped out of their studies. Conclusions: the early initiation of sexual relations, the antecedent of mothers with teenage pregnancies, the low family per capita favor the appearance of a pregnancy in adolescence, where most of the time they decide to abandon their studies

Gravidez na adolescência: uma análise do perfil das adolescentes assistidas em hospital escola na cidade de maceió-al / Pregnancy in adolescence: An analysis of the profile ofadolescents assisted in a school hospital in the city of Maceió-AL / Embarazo em adolescencia: Um análisis del perfil de adolescentes assistidas em um hospital escolar de la ciudad de Maceió-AL

Introdução:Aadolescência é um período curto, porém é nela que ocorrem mudanças biológicas, físicas e psicológicas determinantes na busca da autoafirmação e que podem acarretar complicações no ciclo de vida. A gravidez vista nesta etapa é uma realidade no Brasil e, apesar de susceptível em qualquer classe social,os fatores econômico e social são determinantesnos índices estatísticos. Objetivo:Analisar o perfil das adolescentes que utilizam os serviços do ambulatório e enfermaria de obstetrícia do Hospital Veredas, identificar os fatores que levaram a uma maternidade precoce, as relações sociais, familiares e escolares das adolescentes, além das suas expectativas futuras na construção afetiva da relação mãe-filho e dos possíveis riscos gerados à saúde de ambos. Metodologia:Pesquisa analítica, individual, transversal e observacional, com dados coletados através de análise de prontuários para seleção da amostra e entrevistas com as gestantes do ambulatório e enfermaria de obstetrícia do Hospital Veredas, Maceió-Alagoas, entre janeirode 2020enovembro de 2020. Resultadose Discussão:Das adolescentes analisadas, 52,3% eram menores de idade, dadosignificativo que demonstraa natureza social destas gestações. Quando questionadas sobre sua percepção quanto a gestação, 57,5% declararamque se tratava de uma gravidez indesejada,informação que associadaa narrativa dessas mulheres, demonstra que a gravidez associada a ausência de uma rede de apoio, agrava sua rejeição, refletindo em um isolamento e dificuldade de aceitação. Pode-se constatar através de análise inferencial que uma tendência dasadolescentes etilistas evoluírem com gestações pré-termo (tempo de gestação < 37 semanas) e recém-nascidos prematuros. Conclusões:Através da análise dos dados e da bibliografia analisada, nota-se que a gravidez na adolescência é uma realidade no município de Maceió, e permanece um importante problema de saúde pública gerando impactos negativos nos aspectos sociais, econômicos e nos indicadores de saúde dessas jovens (AU).

Introduction:Adolescence is a short period, but it is when biological, physical and psycological changes happen and those are decisive in the search for self-affirmation and can cause complications in the life cycle. Teenage pregnancy is a reality in Brazil and, although susceptible in any social class, the economic and social factors are determinant in the statistical indexes. Objective:To analyze the profile of adolescents who use the services of the ambulatory and obstetric ward of Hospital Veredas, identifying thefactors that led to an early motherhood, the social, family and school relationships of the adolescents, in addition to their future expectations in the affective construction the mother-child relationship and the possible risks to their health. Methodology:Analytical, individual, cross-sectional and observational research, with data collected through analysis of medical records for sample selection and interviews with pregnant women from the outpatient clinic and obstetrics ward of Hospital Veredas, Maceió-Alagoas, between January2020toNovember 2020. Resultsand Discussion:Of the adolescents analyzed, 52.3% were minors, a significant figure that reflects the social nature of these pregnancies. When asked about their perception of pregnancy, 57.5% stated that it was an unwanted pregnancy, given that associated with the narrative of these women, demonstrates that pregnancy associated with the absence of a support network, aggravates their rejection, reflecting on a isolation and difficulty of acceptance. It can be seen through inferential analysis that a tendency for alcooholic teenagers to evolve with preterm pregnancies (gestation time <37 weeks) and premature newborns. Conclusions:Through the analysis of the data and the analyzed bibliography, it is noted that teenage pregnancy is a reality in the city of Maceió andremains an important public health,problem generating negative impacts on the social, economic and health indicators of these young women (AU).

Introducción: La adolescencia es un período corto, donde ocurren los cambios biológicos, físicos y psicológicos que son determinantes en la búsqueda de la autoafirmación y que pueden derivar en complicaciones en el ciclo vital. El embarazo visto en esta etapa es una realidad en Brasil y, aunque susceptible en cualquier clase social, los factores económicos y sociales son determinantes. Objetivo: Analizar el perfil de las adolescentes que utilizan los servicios del ambulatorioy obstétrico del Hospital Veredas, para identificar los factores que llevaron a una maternidad temprana, las relaciones sociales, familiares y escolares de las adolescentes, además de sus expectativas futuras en la construcción afectiva. Metodología: Investigación analítica, individual, transversal y observacional, con datos recolectados mediante análisis de historias clínicas para selección de muestras y entrevistas a gestantes del ambulatorio y sala de ginecología y obstetricia del Hospital Veredas, Maceió-Alagoas, entre el Enerode 2020al Noviembre 2020.Resultadosy Discussión:De las analizadas, el 52,3% fueron menores de edad, cifra significativa que refleja el carácter social de estos embarazos. Sobre su percepción del embarazo, el 57,5% afirmó que se trató de un embarazo no deseado, informaciónque,asociadaa la narrativa de estas mujeres, demuestra que el embarazo asociado a la ausencia de una red de apoyo, agrava su rechazo, reflejándose en una aislamiento y dificultad de aceptación. Se puede vera través del análisis inferencial que una tendencia de los adolescentes bebedores a evolucionar con los embarazos pretérmino (tiempo de gestación <37 semanas) y los recién nacidos prematuros.Conclusiones: A través del análisis de los datos y la bibliografía analizada, se constata que el embarazo adolescente es una realidad en la ciudad de Maceió, y sigue siendo un importante problema de salud pública generando impactos negativos en los indicadores sociales, económicos y de salud de estos jóvenes (AU).

Factors associated with neonatal death among adolescent mothers / Fatores associados ao óbito neonatal de mães adolescentes

Abstract Objectives: to analyze factors associated with neonatal death among adolescent mothers. Methods: randomized hospital-based cross-sectional study in a tertiary institution,, data from the Sistema de Informação sobre Nascidos Vivos (Sinasc), (Live Birth Information System), Sistema de Informação sobre Mortalidade (SIM) (Mortality Information System), and medical records. The study population was comprised of 1,341 adolescents aged 10-19 who had assisted childbirth at the institution between 2012 to 2016. The independent variables were sociodemographic characteristics, care, prenatal, childbirth, birth, and newborn's hospitalization, as well as the baby's characteristics. Logistic regression analysis was carried out to assess the association between neonatal death and explanatory variables. Results: the factors associated with death were from the countryside or other States (OR=2.68; CI95% =1.24-5.81), Apgar scores lower than 7 in the 1st (OR= 9.52; CI95% = 4.15-21.81) and the 5th (OR=4.17; CI95%=1.53-11.34) minutes of life; and birth weight less than 999g (OR=13.37; CI95% =3, 64-49.04) and between 1,500 to 2,499g (OR=3.43; CI95%=1.37-8.58). Conclusions: apgar and low birth weight were associated with the neonatal death among adolescent mothers, as well as the fact they come from the countryside and other States. These findings show, in addition to classic risks, potential difficulties for adolescents in having access to healthcare services in their hometown. To reduce the risks, there is a need for restructuring the maternal and child healthcare network and ensure a social protection network for these girls.

Resumo Objetivos: analisar fatores associados ao óbito neonatal de mães adolescentes. Métodos: estudo transversal de base hospitalar em instituição terciária, randomizado, com dados do Sistema de Informação sobre Nascidos Vivos (Sinasc), Sistema de Informação sobre Mortalidade (SIM) e de prontuários. A população do estudo compreendeu 1.341 adolescentes de 10 a 19 anos assistidos durante o parto na instituição entre 2012 a 2016. As variáveis independentes foram características sociodemográficas, assistenciais, relacionadas ao pré-natal, parto, nascimento e internamento do recém-nascido, além das características do bebê. Realizou-se análise de regressão logística para avaliar a associação entre óbito neonatal e variáveis explanatórias. Resultados: os fatores associados ao óbito foram municípios do interior e outros estados (OR=2,68; IC95%=1,24-5,81), índices de apgar menor que sete no 1º(OR=9,52; IC95%=4,15-21,81) e no 5º(OR=4,17; IC95%=1,53-11,34) minutos de vida e peso ao nascer menor que 999g (OR=13,37; IC95%= 3,64-49,04) e entre 1500 a 2499g (OR=3,43; IC95%= 1,37-8,58). Conclusões: o apgar e o baixo peso ao nascer se associaram ao óbito neonatal de mães adolescentes além da procedência de municípios do interior e outros estados. Estes achados mostram além de riscos clássicos, potenciais dificuldade das adolescentes em dispor de assistência nos seus lugares de residência. Para reduzir os riscos há necessidade de reorganizar a rede assistencial materno-infantil e garantir uma rede de proteção social a estas meninas.

Moratoria social y embarazo adolescente / Social Moratorium and Teenage Pregnancy

Resumen La infancia y la juventud se han considerado categorías emergentes del ciclo vital desde la modernidad. La adolescencia como etapa de transición entre la niñez y la adultez constituye un escenario de moratoria social que ha sido considerado como necesario para alcanzar la madurez. Este proceso ha sido definido como el camino de construcción de la identidad y la personalidad. Sin embargo, situaciones como la paternidad adolescente son hechos que ocurren con frecuencia y que tienen consecuencias en este proceso de identificación del adolescente.

Abstract Childhood and youth have been considered emerging life cycle categories since modernity. Adolescence as a transitional stage between childhood and adulthood is a social moratorium scenario, which has been considered necessary to reach maturity. This process has been defined as the path of building identity and personality. However, situations, such as adolescent parenthood are facts, which often occur, and have consequences in this process of identifying the adolescent.

Avaliar o desempenho do indicador proporção de gravidez na adolescência na atenção básica / Performance evaluation of the indicator proportion of teenage pregnancy in primary health care / Evaluar el desempeño de la proporción de embarazos adolescentes en la atención primaria de salud

Este estudo avalia a cobertura de atenção primária à saúde nos 295 municípios do estado de Santa Catarina e o alcance do indicador básico de saúde "proporção de gravidez na adolescência". Foi utilizado o método ecológico-transversal por meio da técnica de análise espacial, realizada no período de 2017 a 2018. Todos os testes levaram em consideração um α bidirecional de 0.05 e um intervalo de confiança (IC) de 95%. Como resultado, a proporção de gravidez não teve significância estatística com a cobertura populacional de equipes de Atenção Básica e a cobertura populacional de Saúde da Família. O estudo refutou a hipótese de que o indicador de cobertura de atenção básica impacta positivamente nos resultados do indicador "proporção de gravidez na adolescência" na faixa etária de 10 a 19 anos, de pactuação interfederativa 2017-2021.

This study evaluates the primary health care coverage in the 295 municipalities of Santa Catarina, Brazil, and the scope of the basic health indicator "proportion of teenage pregnancy". Using spatial analysis, this ecological cross-sectional study was carried out between 2017 and 2018. All tests considered a bidirectional α of 0.05 and a 95% confidence interval (CI). Results show that the proportion of pregnancies has no statistical significance with population coverage of primary healthcare teams and Family Health. It refuted the hypothesis that the primary care coverage indicator positively impacts the results of the indicator "proportion of teenage pregnancy" in the age group 10-19 years, established by the 2017-2021 inter-federative agreement.

Este estudio tuvo por objetivo evaluar la cobertura de la atención primaria de salud en los 295 municipios de Santa Catarina (Brasil) y el alcance del indicador básico de salud "proporción de embarazo en la adolescencia". Se utilizó el método transversal, ecológico, mediante la técnica de análisis espacial, realizado entre 2017 y 2018. Todas las pruebas tienen en cuenta un α bidireccional de 0,05 y un intervalo de confianza (IC) del 95%. Los resultados apuntan que la proporción de embarazos no tiene significación estadística con la cobertura poblacional de los equipos de atención primaria y la cobertura poblacional de salud familiar. El estudio refuta la hipótesis de que el indicador de cobertura de atención primaria impacta positivamente los resultados del indicador "proporción de embarazo en la adolescencia" en el grupo de edad de los 10 a los 19 años, del convenio interfederativo 2017-2021.

Produção de sentidos e sexualidade na juventude: um relato de experiência / Production of meanings and sexuality in youth: an account of experience

O presente artigo traz um relato de experiência de estágio em Psicologia Social, realizado com aproximadamente 80 jovens com idades entre 14 e 19 anos. O objetivo foi problematizar a responsabilidade, historicamente atribuída às mulheres, pelos cuidados relativos à prevenção de Infecções Sexualmente Transmissíveis (IST) e à gravidez não planejada. As atividades foram realizadas por meio de módulos temáticos. Desse modo, a presente produção versará sobre o encontro temático que abordou questões relacionadas à sexualidade na juventude. Como metodologia para a realização do encontro, abordamos os assuntos com o auxílio de recursos audiovisuais e de dinâmicas psicoeducativas, assim direcionando o encontro de acordo com as dúvidas e as inquietações dos/as próprios/as jovens. A maioria dos/as participantes afirmou que a sexualidade é tratada de maneira diferente para os homens e as mulheres. Foi possível perceber a culpabilização da mulher por uma gravidez não planejada. Além disso, muitos/as jovens percebem a gravidez na adolescência não como algo somente negativo, mas como possibilitador da reestruturação de vivências. A sexualidade na juventude se mostrou um elemento produtor de identidade marcado por questões de gênero. Entende-se aqui a importância de ampliar discussões sobre as temáticas, considerando os marcadores analíticos de gênero e geração, abrindo mão de moralidades conservadoras que perpetuam desigualdades entre homens e mulheres.

This article presents an experience on social psychology, conducted with approximately 80 young people, ranging from 14 to 19 years of age. The objective was to problematize the responsibility, historically attributed to women, for care related to the prevention of Sexually Transmitted Infections (STIs) and unplanned pregnancy. The activities were carried out through thematic modules. In this way, the present production will focus on the thematic meeting that addressed issues related to sexuality in youth. As a methodology for conducting the meeting, we approach the issues with the help of audiovisual resources and psychoeducational dynamics, thus, it is possible to direct the meeting according to the doubts and concerns of the young people themselves. Most of the participants stated that sexuality is treated differently for men and women. It was also possible to see the blame of the woman for an unplanned pregnancy. Moreover, many young people do not perceive pregnancy in adolescence not as something only negative, but as an enabler of the restructuring of experiences. Sexuality in youth has shown itself to be an element that produces gendered identity. It is understood here the importance of expanding discussions on the themes considering the analytical markers of gender and generation, thereby giving way to conservative morals that perpetuate inequalities between men and women.

Impacto do planejamento familiar na vida sexual e reprodutiva de adolescentes / Impact of family planning on the sexual and reproductive life of adolescents

Introdução: O programa de planejamento familiar é uma importante ferramenta na redução dos índices de gravidez na adolescência, que é considerada uma questão de saúde pública. Objetivos: Compilar as publicações científicas nacionais e internacionais acerca do impacto do planejamento familiar na prevenção da gravidez em adolescentes. Métodos: Foi realizada uma revisão de literatura nos bancos de dados da Biblioteca Virtual de Saúde (BVS), Google Scholar, SciELO e PubMed, no período de agosto a dezembro de 2020, a partir de estudos experimentais e observacionais. Resultados: Dos 20 artigos incluídos, foi realizado agrupamento dos dados que possibilitou a construção de três unidades temáticas: programa de planejamento familiar-potencialidades e fragilidades; fatores determinantes e condicionantes da gravidez na adolescência; educação sexual como ferramenta de prevenção da gravidez na adolescência. Conclusão: A eficácia dos programas de planejamento familiar, dependem de vários fatores: treinamento adequado dos profissionais envolvidos, fornecimento gratuito de insumos, metodologia de educação sexual aplicada, local da instalação da sede física do programa e o público-alvo atingido.

Introduction: The family planning program is an important tool in reducing teenage pregnancy rates, which is considered a public health issue. Objective: To compile national and international scientific publications on the impact of family planning on pregnancy prevention in adolescents. Method: A literature review was carried out in the databases of the Virtual Health Library (VHL), Google Schoolar, Scielo and PubMed, from August to December 2020, based on experimental and observational studies. Results: Of the 20 articles included, data were grouped, which enabled the construction of three thematic units: family planning program - strengths and weaknesses; determining and conditioning factors of teenage pregnancy; sex education as a tool to prevent teenage pregnancy. Conclusion: The effectiveness of family planning programs depends on several factors: adequate training of the professionals involved, free supply of inputs, applied sex education methodology, location of the program's physical headquarters and the target audience reached.