Objectives: The aims of the study were to describe the sociodemographic, sexual, reproductive and relational characteristics of adolescents having an abortion in Portugal and to explore the differences between three adolescent age groups. Methods: We recruited a nationally representative sample of 224 adolescents (<16 years, n = 18; 16-17 years, n = 103; 18-19 years, n = 103) who had an abortion. Data were collected from 16 health care services that provide abortion. Results: The adolescents were predominantly single, were from non-nuclear families, had low-socioeconomic status and were students. Mean age at first sexual intercourse was 15 years and mean gynaecological age was 5 years. Most had had multiple sexual partners, and for most it was their first pregnancy. At conception, the majority were involved in a long-term romantic relationship, were using contraception but did not identify the contraceptive failure that led to the pregnancy.Significant age group differences were found. Compared with the younger age groups, the 18-19 years age group was more frequently married or living with a partner, had finished school, had attained a higher educational level (as had their partner), intended to go to university, and had a greater number of sexual partners. Compared with the other groups, those under 16 years of age reported earlier age at menarche and at first sexual intercourse, and had a lower gynaecological age. Conclusions: Our study characterises the life contexts of Portuguese adolescents who had an abortion. It highlights the need to recognise the heterogeneity of this group according to age.The findings have important implications for the development of age-appropriate guidelines to prevent unplanned pregnancy.

Foi nosso objetivo explorar o contributo simultâneo de fatores individuais, sociais e ambientais e das possíveis interações entre eles para a decisão de prosseguir uma gravidez adolescente à luz do atual quadro legislativo que despenaliza a interrupção da gravidez por opção da mulher, em Portugal. A amostra foi constituída por 276 adolescentes que engravidaram de forma não planeada e contactaram com os serviços de saúde dentro do prazo legal que lhes permitiria optar pela interrupção: 133 adolescentes que prosseguiram a gravidez e 143 que a interromperam. Os dados foram recolhidos entre 2008 e 2013 em 53 serviços de saúde de todas as regiões. Não ter ponderado as duas alternativas possíveis (prosseguimento/interrupção), pertencer a famílias de baixo nível socioeconómico e com história de maternidade adolescente, ter abandonado a escola e residir em áreas com maior densidade populacional e onde a população feminina é menos escolarizada foram fatores explicativos do prosseguimento da gravidez. A menor idade da adolescente associou-se com o prosseguimento apenas quando não foram ponderadas ambas as alternativas. O efeito da religiosidade local variou de acordo com o envolvimento religioso da adolescente. Estes resultados têm importantes implicações para a prática clínica e investigação na área da decisão reprodutiva na adolescência. Palavras-chave:Gravidez na adolescência, Decisão reprodutiva, Maternidade, Interrupção voluntária da gravidez. IntroduçãoCerca de 4% dos nascimentos portugueses ocorrem em mulheres com menos de 20 anos (PORDATA, 2013b). Este fenómeno é mais frequente em Portugal do que na maioria dos países da União Europeia (United Nations Population Found [UNPF], 2013), o que constitui uma preocupação premente à luz das mudanças sociais que marcaram as últimas décadas. Espera-se atualmente que o papel da mulher na sociedade vá além das tradicionais funções de esposa e de 19

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Introduction:The current study aimed to describe the relational and reproductive trajectories leading to adolescent pregnancy in Portugal, and to explore whether there were differences in this process according to adolescents' place of residence. Material and Methods: Data were collected between 2008 and 2013 in 42 public health services using a self-report questionnaire developed by the researchers. The sample consisted of a nationally representative group of pregnant adolescents (n = 459). Results: Regardless of having had one (59.91%) or multiple sexual partners (40.09%), the majority of adolescents became pregnant in a romantic relationship, using contraception at the time of the conception and knowing the contraceptive failure which led to pregnancy (39.22%). In some regions other trajectories were highly prevalent, reflecting options such as planning the pregnancy (Alentejo Region/ Azores Islands), not using contraception (Centro Region/Madeira Islands) or using it incorrectly, without identifying the contraceptive failure (Madeira Islands). On average, romantic relationships were longer than 19 months and adolescents' partners were older than themselves (> 4 years) and no longer in school (75.16%); these results were particularly significant when the pregnancy was planned. Discussion: The knowledge gained in this study shows that prevention efforts must be targeted according to the adolescents' needs in each region and should include high-risk male groups. Conclusion: Our results may enable more efficient health policies to prevent adolescent pregnancy in different country regions and support educators and health care providers on sexual education and family planning efforts.

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