Trends and factors related to adolescent pregnancies: an incidence trend and conditional inference trees analysis of northern Nicaragua demographic surveillance data

Abstract

Background We aimed to identify the 2001–2013 incidence trend, and characteristics associated with adolescent pregnancies reported by 20–24-year-old women. Methods A retrospective analysis of the Cuatro Santos Northern Nicaragua Health and Demographic Surveillance 2004–2014 data on women aged 15–19 and 20–24. To calculate adolescent birth and pregnancy rates, we used the first live birth at ages 10–14 and 15–19 years reported by women aged 15–19 and 20–24 years, respectively, along with estimates of annual incidence rates reported by women aged 20–24 years. We conducted conditional inference tree analyses using 52 variables to identify characteristics associated with adolescent pregnancies. Results The number of first live births reported by women aged 20–24 years was 361 during the study period. Adolescent pregnancies and live births decreased from 2004 to 2009 and thereafter increased up to 2014. The adolescent pregnancy incidence (persons-years) trend dropped from 2001 (75.1 per 1000) to 2007 (27.2 per 1000), followed by a steep upward trend from 2007 to 2008 (19.1 per 1000) that increased in 2013 (26.5 per 1000). Associated factors with adolescent pregnancy were living in low-education households, where most adults in the household were working, and high proportion of adolescent pregnancies in the local community. Wealth was not linked to teenage pregnancies. Conclusions Interventions to prevent adolescent pregnancy are imperative and must bear into account the context that influences the culture of early motherhood and lead to socioeconomic and health gains in resource-poor settings.

Sociodemographic and gestational factors of adolescent mothers associated with prematurity

“…A baixa escolaridade tem sido fortemente relacionada à gravidez na adolescência, em que muitas adolescentes não frequentam ou desistem da escola em decorrência da gravidez (7,9,(18)(19)(20) . A preocupação em torno disso recai nas consequências futuras que a pouca escolaridade e o baixo nível educacional poderão gerar nas condições socioeconômicas, como menor emprego e renda, bem como limitado acesso à informação e a cuidados de saúde de qualidade, impactando negativamente no crescimento e desenvolvimento infantil.…”

“…Entretanto, é relevante considerar que a ruptura prematura de membranas foi a principal condição clínica apresentada pelas adolescentes, além de gestação prolongada, restrição do crescimento fetal, pré-eclâmpsia, doença hipertensiva específica da gestação, dentre outras. Evidencia--se que gestantes adolescentes estão mais expostas a complicações obstétricas, como ruptura prematura de membranas (11) , pré-eclâmpsia e restrição do crescimento fetal (20) , sendo que estas complicações também podem ser associadas ao parto prematuro (2) . Destaca--se que 15% da amostra foi classificada como "gravidez de risco não especificada", o que deixa uma lacuna e dificulta a compreensão acerca dos reais motivos desta gravidez ter sido considerada de risco.…”

“…Para verificar a associação entre as variáveis de desfecho e as variáveis preditoras, utilizaram-se dos testes Qui-quadrado ou exato de Fisher. A fim de controlar possíveis fatores confundidores, as variáveis que apresentaram valor p<0, 20…”

A Structural Equation Modeling Analysis of Attitudes and Behaviors on Early Fertility Among Young Women in Selected Regions in Nicaragua

“…Several studies in Nicaragua have focused on adolescent pregnancies and childbearing. Studies from the Nicaraguan Demographic and Health Surveys (Pe´rez et al, 2021;Samandari & Speizer, 2010) showed that adolescent pregnancies and live births decreased from 1987 to 2009 but increased thereafter up to 2013. Additionally, adolescent pregnancy was associated with living in low socioeconomic households, especially those with low education.…”