Poor maternal mental health and trauma as risk factors for a short interpregnancy interval among adolescent mothers

Patchen, Loral; Caruso, D. M.; Lanzi, Robin Gaines

doi:10.1111/j.1365-2850.2008.01353.x

Cited by 15 publications

(8 citation statements)

References 5 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Policy documents from the UK were also used to explore elements of the theory areas under investigation, applying the criteria of relevance and rigor. Identified quantitative studies that were not synthesised in any 'pooled' analysis Twenty-one additional quantitative studies [112][113][114][115][123][124][125][126][127][128][143][144][145][146][147][148][149][150][151][152][153] were identified as included studies, but were not synthesised in any 'pooled' analysis as they did not report on or contain data relevant to the outcomes under investigation. We extracted data on other risk factors but had insufficient data to perform metaregression with any statistical integrity.…”

Section: Realist Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Whitaker¹,

Hendry

Aslam

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundThe UK has one of the highest rates of teenage pregnancies in Western Europe. One-fifth of these are repeat pregnancies. Unintended conceptions can cause substantial emotional, psychological and educational harm to teenagers, often with enduring implications for life chances. Babies of teenage mothers have increased mortality and are at a significantly increased risk of poverty, educational underachievement and unemployment later in life, with associated costs to society. It is important to identify effective, cost-effective and acceptable interventions.ObjectivesTo identify who is at the greatest risk of repeat unintended pregnancies; which interventions are effective and cost-effective; and what the barriers to and facilitators of the uptake of these interventions are.Data sourcesWe conducted a multistreamed, mixed-methods systematic review informed by service user and provider consultation to examine worldwide peer-reviewed evidence and UK-generated grey literature to find and evaluate interventions to reduce repeat unintended teenage pregnancies. We searched the following electronic databases: MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database), EMBASE (Excerpta Medicadatabase), British Nursing Index, Educational Resources Information Center, Sociological Abstracts, Applied Social Sciences Index and Abstracts, BiblioMap (the Evidence for Policy and Practice Information and Co-ordinating Centre register of health promotion and public health research), Social Sciences Citation Index (supported by Web of Knowledge), Research Papers in Economics, EconLit (American Economic Association’s electronic bibliography), OpenGrey, Scopus, Scirus, Social Care Online, National Research Register, National Institute for Health Research Clinical Research Network Portfolio and Index to THESES. Searches were conducted in May 2013 and updated in June 2014. In addition, we conducted a systematic search of Google (Google Inc., Mountain View, CA, USA) in January 2014. Database searches were guided by an advisory group of stakeholders.Review methodsTo address the topic’s complexities, we used a structured, innovative and iterative approach combining methods tailored to each evidence stream. Quantitative data (effectiveness, cost-effectiveness, risk factors and effect modifiers) were synthesised with reference to Cochrane guidelines for evaluating evidence on public health interventions. Qualitative evidence addressing facilitators of and barriers to the uptake of interventions, experience and acceptability of interventions was synthesised thematically. We applied the principles of realist synthesis to uncover theories and mechanisms underpinning interventions (what works, for whom and in what context). Finally, we conducted an overarching narrative of synthesis of evidence and gathered service user feedback.ResultsWe identified 8664 documents initially, and 816 in repeat searches. We filtered these to 12 randomised controlled trials (RCTs), four quasi-RCTs, 10 qualitative studies and 53 other quantitative studies published between 1996 and 2012. None of the RCTs was based in the UK. The RCTs evaluated an emergency contraception programme and psychosocial interventions. We found no evidence for effectiveness with regard to condom use, contraceptive use or rates of unprotected sex or use of birth control. Our primary outcome was repeat conception rate: the event rate was 132 of 308 (43%) in the intervention group versus 140 of 289 (48%) for the control goup, with a non-significant risk ratio (RR) of 0.92 [95% confidence interval (CI) 0.78 to 1.08]. Four studies reported subsequent birth rates: 29 of 237 (12%) events for the intervention arm versus 46 out of 224 (21%) for the control arm, with a RR of 0.60 (95% CI 0.39 to 0.93). Many repeat conceptions occurred in the context of poverty, low expectations and aspirations, and negligible opportunities. Service user feedback suggested that there were specific motivations for many repeat conceptions, for example to replace loss or to please a partner. Realist synthesis highlighted that context, motivation, planning for the future and letting young women take control with connectedness and tailoring provide a conceptual framework for future research.LimitationsIncluded studies rarely characterised adolescent pregnancy as intended or unintended, that is interventions to reduce repeat conceptions rarely addressed whether or not pregnancies were intended. Furthermore, interventions were often not clearly defined, had multiple aims and did not indicate which elements were intended to address which aims. Nearly all of the studies were conducted in the USA and focused largely on African American or Hispanic and Latina American populations.ConclusionsWe found no evidence to indicate that existing interventions to reduce repeat teenage pregnancy were effective; however, subsequent births were reduced by home-based interventions. Qualitative and realist evidence helped to explain gaps in intervention design that should be addressed. More theory-based, rigorously evaluated programmes need to be developed to reduce repeat teenage pregnancy in the UK.Study registrationThis study is registered as PROSPERO CRD42012003168. Cochrane registration number: i=fertility/0068.FundingThe National Institute for Health Research Health Technology Assessment programme.

show abstract

Section: Realist Synthesismentioning

confidence: 99%

“…These 34 studies included 20 non-comparative studies, 94,95,[98][99][100][101][102][103]106,108,109,[112][113][114][115][116][117][118][119]128 seven prospective cohort studies 97,105,[120][121][122][123][124] and eight retrospective cohort studies. 86,104,107,110,111,[125][126][127] Qualitative studies…”

Section: Studies Used To Identify Risk Factorsmentioning

confidence: 99%

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Whitaker¹,

Hendry

Aslam

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Patients beginning prenatal care between February 2003 and April 2005 with planned delivery at Washington Hospital Center in Washington, DC were eligible for enrollment in a comprehensive adolescent parenting program, the Teen Alliance for Prepared Parenting (TAPP) Program. This program provides comprehensive obstetric and postpartum care, with integrated social work services at an urban academic medical center (10). Patients are seen by attending physician providers or by resident physicians with attending supervision.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and Repeat Infection Among Pregnant Urban Adolescents

Berggren

Patchen²

2011

Sexually Transmitted Diseases

View full text Add to dashboard Cite

BACKGROUND Negative maternal and fetal consequences associated with Chlamydia trachomatis and Neisseria gonorrhoeae during pregnancy make diagnosis essential. The CDC recommends routine screening for sexually transmitted infections at the first prenatal visit, and third trimester repeat screening, specifically for C. trachomatis, is recommended for women under age 25 or at increased infection risk. The impact of repeat screening on diagnosis during pregnancy is not well documented among adolescents. METHODS A prospective cohort of 125 pregnant adolescents with at least one prenatal screen for C. trachomatis and N. gonorrhoeae was analyzed. All participants received prenatal care and delivered at one urban teaching hospital in Washington, DC. Screening results were documented for both sexually transmitted infections. Descriptive and univariate analyses were performed to describe disease prevalence. RESULTS Thirty-one percent of pregnant adolescents were diagnosed with either C. trachomatis or N. gonorrhoeae infection during pregnancy. Of the 75% (95/125) of patients who had more than one screening test, 11% (10/95) had a re-infection, and 7% (7/95) had a new infection on repeat testing. Nine percent (9/95) had recurrent C. trachomatis, while 4% (4/95) had a new diagnosis. Three percent (3/95) had recurrent N. gonorrhoeae, while 4% (4/95) had a new diagnosis. Some experienced co-infection at either initial or repeat testing. CONCLUSIONS Screening for C. trachomatis and N. gonorrhoeae is recommended during pregnancy. In this sample of pregnant adolescents, the overall high incidence and recurrence of C. trachomatis and N. gonorrhoeae support CDC screening and re-screening recommendations, regardless of initial test results.

show abstract

“…One study found that depressive symptoms among low-income African American teen mothers during the prenatal period presented an independent risk factor for rapid subsequent pregnancy (Barnet, Liu, & DeVoe, 2008). Another study found that poorer mental health experiences were found among low-income, urban teens who experienced rapid subsequent pregnancies than those who do not (Patchen, Caruso, & Lanzi, 2009). A study of black and Mexican American teen mothers found that not being in a relationship with the biological father three months postpartum was a predictor of a subsequent pregnancy within 24 months (Raneri & Wiemann, 2007).…”

Section: Pregnancy Intentionsmentioning

confidence: 99%

Pregnancy Intentions, Long‐Acting Contraceptive Use, and Rapid Subsequent Pregnancies Among Adolescent and Adult First‐Time Mothers

Waggoner

Lanzi

Klerman

2012

Child Adoles Psych Nursing

View full text Add to dashboard Cite

Problem Greater understanding is needed related to qualitatively-assessed pregnancy intentions and rapid subsequent pregnancies among adolescent and adult mothers. Methods 4-site prospective study of 227 adolescent and adult mothers. Data analyzed to understand the relationship between pregnancy intentions, adolescent status, and use of long-acting contraceptives and rapid subsequent pregnancy. Findings The findings from this study provide evidence of the importance of goal-oriented pregnancy intentions, long-acting contraceptive use, and older age in delaying a second pregnancy. Conclusion Findings reveal the need for clinician awareness of the qualitative pregnancy intentions of young women and potential desired use of long-acting contraceptives.

show abstract

Poor maternal mental health and trauma as risk factors for a short interpregnancy interval among adolescent mothers

Cited by 15 publications

References 5 publications

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and Repeat Infection Among Pregnant Urban Adolescents

Pregnancy Intentions, Long‐Acting Contraceptive Use, and Rapid Subsequent Pregnancies Among Adolescent and Adult First‐Time Mothers

Contact Info

Product

Resources

About