Who are the pregnant adolescents in the poorest state capital of Brazil?

OBJECTIVE: This study determines which adolescent girls are becoming pregnant. DESIGN: Cross-sectional study. SAMPLE: Pregnant or puerpera adolescents in Teresina, Brazil (278), aged 15-19 years. MEASUREMENTS: Comparisons were made between the older and younger age groups of the Teresina sample and between the socioeconomic and demographic characteristics of the Teresina sample and ever-pregnant adolescents from the 1996 Demographic and Health Survey (DHS) sample. Descriptive analyses and Pearson's chi-square tests were performed. RESULTS: Compared with the 1996 DHS sample, there has been a social improvement manifested by a higher proportion attending school and a lower proportion of adolescent workers in the 2006 Teresina sample. In the 2006 sample, 60.2% of those attending school were below their grade for age level. The principal reason for school abandonment 10 years ago was marriage (24.4%) and that among the 2006 Teresina sample was pregnancy (44.9%). Girls who were 15-17 years old in the 2006 sample experienced menarche and sexual debut earlier than those who were 18-19 years old in the same sample. CONCLUSIONS: Adolescent pregnancies are likely to have an unfavorable long-term impact on adolescent mothers' lifestyle, even with some improvement since 1996. Effective programs for adolescent pregnancy prevention are needed to reduce the possibility of continuance of these trends for another 10 or more years in the future.

Contraceptive method use by adolescents in Brazilian state capital.

OBJECTIVE: Adolescence is a period characterized by increased exploration and exposure to risk-taking behaviors, including unsafe sex. This study examines prior contraceptive method use by pregnant or recently pregnant adolescents in Teresina-Piauí, Brazil. DESIGN: Cross-sectional study. SETTING: Four hospital maternity units. PARTICIPANTS: Two-hundred and seventy-eight adolescents aged 15-19 admitted in four hospital maternity units for clinical treatment or for pregnancy resolution were interviewed. METHODS: The sample was stratified proportional to the number of adolescents who visit each hospital. Chi-square and Fisher exact test are used to analyze differences between contraceptive users and non-users. RESULTS: Half of interviewed adolescents used some form of contraception at first intercourse (53.2%) and 40.3% used contraception at intercourse leading to the current pregnancy. Male condom was the most common method at first intercourse (96.6% among users of a method) and at the time of pregnancy (58.9%). The main reasons for contraceptive nonuse were that the adolescent had not thought about contraception at the time of first sex (36.1%) and the adolescent wished for a baby at the time of pregnancy (26.5%). About 57% of girls who did not want the pregnancy reported that they did not use any contraceptive method right before the pregnancy. Among pregnant adolescents with an unwanted pregnancy, a greater percentage who had access to health services reported contraceptive use (48%) compared to only 16.7% of those with no access to health services. CONCLUSIONS: Contraceptive method use by adolescents was unsatisfactory as indicated by unwanted pregnancies among both users and nonusers of contraception. Prevention of unintended pregnancies requires greater information and access to contraceptives among all sexually active youth.