Childbearing in adolescence: intergenerational dejà-vu? Evidence from a Brazilian birth cohort

Abstract

BackgroundPregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life.MethodsThe study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model.ResultsThe rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence – RR = 1.35 (95% CI 1.04-1.74).ConclusionAdolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime.

Outcome of Adolescent Pregnancy: A Retrospective Cohort Study

“…It is highly possible that mothers of pregnant adolescents were also pregnant adolescents (15). In the present study, one out of three mothers of pregnant adolescents also had adolescent pregnancies.…”

“…In these countries, complications during pregnancy and childbirth are considered as the most important causes of death among girls aged [15][16][17][18][19] years. Maternal complications, maternal anaemia, premature birth and low birthweight are associated with prenatal mortality and increased rate of infant death (3)(4)(5).…”

Specific features of teenage pregnancy and delivery in relation to age

“…Показано, что адекватное медицин-ское наблюдение в I триместре беременности получают в среднем только 47% подростков, в то время как среди женщин в возрасте от 20 лет данный показатель составля-ет около 78%. Дородовое наблюдение в более поздние сроки беременности получают 11,6% подростков, а 5% во-обще не обращаются в медицинские учреждения на про-тяжении всей беременности [16,17]. Результаты нашего исследования также подтверждают данные о поздней по-становке несовершеннолетних беременных на учет в жен-ских консультациях, причем, чем младше возрастная группа, тем позже срок первой явки (22,4±7,5 нед для воз-растной группы 13-15 лет и 15,8±6,9 нед для возрастной группы 16-17 лет).…”

“…Младенцы, рожденные до полных 37 нед беременности и особенно родившиеся глубоко недоно-шенными (до полных 32 нед беременности), находятся в группе риска смерти и инвалидности. Преждевременные роды среди подростков составляют около 21%, что в 3 раза выше, чем среди матерей в возрасте 20-39 лет (от 9,2 до 10,7%) [1,16]. По нашим данным, преждевременно роды произошли у 8,2% беременных 1-й группы (причем в этой группе все преждевременные роды наблюдались после 32 нед) и у 4,1% беременных 2-й группы (от 28 до 36 нед), что подтверждает имеющиеся данные литературы.…”

The public health and economic consequences of unintended pregnancies in South Africa

“…10 The problem of unintended pregnancies can be additive as children born from an unintended pregnancy are also likely to perpetuate unintended pregnancies when they are adults. 11,12 Many countries with abortion restrictions pose considerable personal harm and economic consequences to those that pursue illegal and unsafe abortions. Previous estimates suggest an average cost of treating post abortion complications range from $86 -$111 (2006).…”