Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies

2021 ◽  
Author(s):  
S. Amjad ◽  
M. Adesunkanmi ◽  
J. Twynstra ◽  
J.A. Seabrook ◽  
M.B. Ospina
Keyword(s):  
Social Determinants Of Health ◽  
Adolescent Pregnancy ◽  
Birth Outcomes ◽  
Adolescent Mothers ◽  
Social Determinants ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Determinants Of Health ◽  
Adolescent Pregnancies ◽  
Adverse Pregnancy

AbstractThe association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.

scholarly journals Adolescent Pregnancy Outcomes Among Sisters and Mothers: A Population-Based Retrospective Cohort Study Using Linkable Administrative Data

2017 ◽  
Vol 133 (1) ◽  
pp. 100-108 ◽  
Author(s):  
Elizabeth Wall-Wieler ◽  
Leslie L. Roos ◽  
Nathan C. Nickel
Keyword(s):  
Adolescent Pregnancy ◽  
Adolescent Girls ◽  
Adolescent Mothers ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adolescent Mother ◽  
Administrative Databases ◽  
Logistic Regression Models ◽  
Targeted Interventions ◽  
Adolescent Pregnancies

Objectives: Female family members affect both the likelihood of adolescent pregnancy and the outcome of that pregnancy. We examined the degree to which an older sister’s adolescent reproductive outcomes affect her younger sister’s reproductive behavior, and whether relationships in adolescent pregnancy among sisters born to adolescent mothers differ from those born to nonadolescent mothers. Methods: We followed a birth cohort in Manitoba, Ontario, Canada, to age 20 using linkable administrative databases housed at the Manitoba Centre for Health Policy. The cohort consisted of 12 391 girls born in Manitoba between April 1, 1984, and March 31, 1996, who had 1 older sister. We used logistic regression models to examine the relationships among familial adolescent pregnancy outcomes. Results: Compared with adolescent girls whose older sister did not have an adolescent pregnancy, adolescent girls whose older sister had an adolescent pregnancy were more likely to have a pregnancy (adjusted odds ratio [aOR] = 2.57), regardless of whether that pregnancy was completed (aOR = 2.56) or terminated (aOR = 2.59). Relationships in adolescent pregnancy among sisters were much stronger for those born to nonadolescent mothers (aOR = 3.16 [older sister completed adolescent pregnancy] and 3.18 [older sister terminated adolescent pregnancy]) than to adolescent mothers (aOR = 1.65 [older sister completed adolescent pregnancy] and 1.77 [older sister terminated adolescent pregnancy]). For younger sisters having an adolescent pregnancy, the odds of her completing the pregnancy were reduced if her older sister had terminated an adolescent pregnancy and her mother had not been an adolescent mother (aOR = 0.38). Conclusions: Younger sisters of adolescents who had a pregnancy may benefit from targeted interventions to reduce their likelihood of adolescent pregnancies.

scholarly journals Air Pollution and Racial Disparities in Pregnancy Outcomes in the United States: A Systematic Review

2021 ◽  
Author(s):  
Bonaventure Suiru Dzekem ◽  
Briseis Aschebrook-Kilfoy ◽  
Christopher O. Olopade
Keyword(s):  
United States ◽  
Air Pollution ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
The United States ◽  
Epidemiologic Studies ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy ◽  
The Impact

Abstract Background Exposure to air pollutants and other environmental factors increases the risk of adverse pregnancy outcomes. There is growing evidence that adverse outcomes related to air pollution disproportionately affect racial and ethnic minorities. This paper explores the importance of race as a risk factor for air pollution-related poor pregnancy outcomes. Methods We systematically reviewed epidemiologic studies investigating the effects of exposure to air pollution on pregnancy outcomes in the United States. Results Findings across all reviewed studies show more adverse pregnancy outcomes (preterm birth, small for gestational age, low birth weight and stillbirths) due to air pollution among Blacks and Hispanics than among non-Hispanic Whites. Conclusion This paper enhances our general understanding of the impact of air pollution on birth outcomes and, specifically, of disparities in birth outcomes for infants born to Black and Hispanic mothers.

scholarly journals Praegnatio Perturbatio – Impact of Endocrine Disrupting Chemicals

2021 ◽  
Author(s):  
Vasantha Padmanabhan ◽  
Wenhui Song ◽  
Muraly Puttabyatappa
Keyword(s):  
Risk Factor ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
Endocrine Disrupting Chemicals ◽  
Adverse Pregnancy Outcomes ◽  
Endocrine Disrupting ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
The Impact ◽  
Pregnancy And Birth

Abstract The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes that is receiving considerable attention in recent years is gestational exposure to endocrine disrupting chemicals (EDCs). Humans are exposed to multitude of environmental chemicals with known endocrine disrupting properties and evidence suggest that exposure to these EDCs have the potential to disrupt maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes - a risk factor for adult onset non-communicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediaries involved, and the research directions to focus future investigations on to help alleviate the adverse effects from EDC exposures.

scholarly journals Hemoglobin concentrations and adverse birth outcomes in South Asian pregnant women: findings from a prospective Maternal and Neonatal Health Registry

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Sumera Aziz Ali ◽  
Shiyam Sunder Tikmani ◽  
Sarah Saleem ◽  
Archana B. Patel ◽  
Patricia L. Hibberd ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Outcomes ◽  
South Asian ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Birth Outcomes ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Health Registry ◽  
The Relationship

Abstract Background While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women. Methods For this study, we used data collected from two South Asian countries (Pakistan – Sindh Province and two sites in India - Belagavi and Nagpur) in a prospective maternal and newborn health registry study. To assess the association between Hb concentrations and various maternal and fetal outcomes, we classified the Hb concentrations into seven categories. Regression analyses adjusting for multiple potential confounders were performed to assess adverse pregnancy outcomes across the range of Hb concentrations. Findings Between January 2012 and December 2018, 130,888 pregnant women were enrolled in the South Asian sites had a Hb measurement available, delivered and were included in the analyses. Overall, the mean Hb concentration of pregnant women from the sites was 9.9 g/dL, 10.0 g/dL in the Indian sites and 9.5 g/dL in the Pakistan site. Hb concentrations < 7 g/dL were observed in 6.9% of the pregnant Pakistani women and 0.2% of the Indian women. In both the Pakistani and Indian sites, women with higher parity and women with no formal education had lower Hb concentrations. In the Pakistani site, women > 35 years of age, women with ≥4 children and those who enrolled in the third trimester were more likely to have Hb concentrations of < 7 g/dL but these associations were not found for the Indian sites. When adjusting for potential confounders, for both India and Pakistan, lower Hb concentrations were associated with stillbirth, preterm birth, lower mean birthweight, and increased risk of low birthweight. In the Pakistani site, there was evidence of a U-shaped relationship between Hb concentrations and low birth weight, and neonatal mortality, and in India with hypertensive disease. Interpretation This study documented the relationship between maternal Hb concentrations and adverse pregnancy outcomes in women from the Pakistani and Indian sites across the range of Hb values. Both low and high Hb concentrations were associated with risk of at least some adverse outcomes. Hence, both low and high values of Hb should be considered risk factors for the mother and fetus.

Characterizing Social Determinants of Health for Adolescent Mothers during the Prenatal and Postpartum Periods

2017 ◽  
Vol 27 (5) ◽  
pp. 565-572 ◽  
Author(s):  
Natasha R. Kumar ◽  
Christina A. Raker ◽  
Crystal F. Ware ◽  
Maureen G. Phipps
Keyword(s):  
Social Determinants Of Health ◽  
Adolescent Mothers ◽  
Social Determinants ◽  
Determinants Of Health

scholarly journals Association between antenatal care visits and adverse pregnancy outcomes: a retrospective cross-sectional study among Ghanaian women

2021 ◽  
Author(s):  
ALHASSAN SIBDOW ABUKARI ◽  
Shamsudeen Mohammed ◽  
Ibrahim Yakubu ◽  
Waliu Jawula Salisu ◽  
Yakubu H. Yakubu
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Adolescent Mothers ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Older Mothers ◽  
Adverse Pregnancy ◽  
Ghanaian Women ◽  
Antenatal Visits

Abstract Background The study aimed to determine the association between antenatal visits and adverse pregnancy outcomes among Ghanaian women in the North East Region.Methods We analysed data on the birth records of 2907 women who delivered at Baptist Medical Centre between January 2018 to December 2018. Binary logistic regression was used to assess the association between antenatal visits and four adverse pregnancy outcomes – preterm birth, low birth weight, small-for-gestational-age, and stillbirth. Results Our analysis showed that ANC attendance offered some protection against preterm birth, low birth weight, small-for-gestational-age, and stillbirth in the study sample, albeit with variations in the protective effect depending on the number of visits attended. An increase in the number of ANC visits was associated with a decrease in the occurrence of the adverse pregnancy outcomes, except for low birth weight where the protective effect was observed only after four ANC visits. Adolescent mothers attended the least number of ANC visits during the study period. Our analysis suggests that the effect of ANC attendance on preterm birth and low birth weight differed depending on the age of the mother. Among mothers who never attended any ANC visits, adolescent mothers and older mothers had higher odds of low birth weight compared to mothers aged 20-30years. Surprisingly, the odds of preterm birth among the mothers who never attended any ANC visits was lower in adolescent mothers and older mothers compared to mothers aged 20-30years. For mothers who attended four or more ANC visits, the odds of low birth weight were higher in adolescent mothers and lower in older mothers compared to mothers aged 20-30years. However, the odds of preterm birth among the mothers who attended more than four ANC visits was higher in adolescent mothers and older mothers compared to mothers aged 20-30years. Conclusion The findings highlight the importance of ANC in preventing adverse pregnancy outcomes and the need for every pregnant woman to initiate and ensure adequate ANC contacts. The results also highlight the need to prioritise adolescents and older pregnant women for ANC.

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