Citation

Bol. Asoc. Chil. Prot. Fam. 1985; 21(1-6): 3-11.

Vernacular Title

Embarazo en adolescentes: perspectivas epidemiologicas.

Copyright

(Copyright © 1985, Asociacin̤ Chilena de Proteccin̤ de la Familia (APROFA))

DOI

unavailable

PMID

12267245

Abstract

A specialized obstetrical section for single adolescent mothers was created at a University of Chile hospital to test the hypothesis that adequate and appropriate medical care could improve the outcome for adolescent mothers and their infants. The team consisted of an obstetrician-gynecologist, a pediatrician, a psychologist, a midwife, a nurse, a social worker, and a nurse's aide. A nutritionist and a psychiatrist were later added. Between November 1981-March 1985, 610 pregnancies were followed and 490 deliveries were attended. The psychosocial characteristics of the 1st 300 adolescents were studied, the obstetrical and preinatal outcomes of the 1st 200 deliveries were compared with those of 200 deliveries of adolescents not participating in the prenatal program but delivering at the same hospital, and a 2nd control group of 100 single primaparas was used to compare maternal morbidity and mortality and neonatal pathology. 11.6% were aged 11-14, 32.7% were 15-16, 30.3% were 17, and the remainder were 18 or 19. 5% of the fathers were under 15, 33.3% were 15-19, and the rest were 20 or above. The father's age and other characteristics were unknown in 6 pregnancies resulting from rape. 1.3% of the mothers had no education, 67% had some basic education, and 31.7% had a middle level or higher. Of the adolescent mothers and the fathers respectively, 50.3% and 23.0% were students, 17.0% and 26.3% had stable employment, 32.7% and 12.0% had no economic activity, and 32.0% of fathers were subemployed. Only 35.7% of the adolescents mothers lived in stable family environments. 94.7% of the adolescents had negative attitudes on learning of their pregnancies, but 79.7% had positive attitudes when they began receiving prenatal care. 89.7% of the 213 legitimate adolescent mothers but only 64.4% of the 87 illegitimate mothers had positive attitudes toward their pregnancies at the end of the prenatal period. Cases were younger than either group of controls, with 27.0% of cases and 58.9% and 64% of controls aged 18-19. 58.1% of the 1st control group was married. 67.5% of cases but 53% of controls had some form of maternal morbidity, with morbidity more frequent at lower ages. The frequency of spontaneous deliveries increased with age for both cases and controls. Controls had more low Apgar scores of 1-4, especially at the youngest maternal ages. There was no difference between cases and controls in proportions of newborns weighing under 2500 g, but more babies of cases weighed 3501 g or more. The frequency of congenital malformations was slightly greater among cases, especially those under 15, but respiratory difficulties and asphyxia were less frequent in cases. Neonatal morbidity and mortality rates were significantly lower among cases. Overall maternal factors during pregnancy did not differ greatly between cases and controls, but among cases there was better secondary prevention due to early diagnosis of maternal morbidity, and the outcome for infants of study subjects was better than for those of controls.

Language: es