Relationship between school dropout and teen pregnancy among rural South African young women
Relationship between school dropout and teen pregnancy among rural South African young women
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DOI：
10.1093/ije/dyv007
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发表时间：
2015-06-01
影响因子：
7.7
通讯作者：
Tollman, Stephen
中科院分区：
文献类型：
--
作者：
Rosenberg, Molly;Pettifor, Audrey;Tollman, Stephen
背景：由于学校提供的结构化和监督环境、所获得的教育以及入学期间遇到的更安全的同伴网络，在入学期间发生性活动的可能性较小。我们研究了南非的入学率是否与青少年怀孕有关。方法：利用阿金库尔乡村分区的纵向人口监测数据，我们重建了 2000 年至 2011 年 15 457 名 12-18 岁年轻女性的入学状况，并将其与这段时间内每次怀孕的预计受孕日期联系起来。我们使用 Cox 比例风险模型研究了随时间变化的入学率对青少年怀孕的影响，并调整了： 年龄；历年；家庭社会经济状况；家庭规模；户主的性别、教育程度和就业情况。二次分析按日历时间（学期与学校假期）比较了学校入学者的怀孕发生率。结果：入学与较低的青少年怀孕率相关[调整后的风险比（95% 置信区间）：0.57 (0.50, 0.65)]。这种关联对于学校入学的潜在错误分类是强有力的。对于在校学生来说，学期期间怀孕的发生率低于学校假期期间的发生率[发生率比（95% 置信区间）：0.90 (0.78, 1.04)]。结论：辍学的年轻女性青少年怀孕的风险可能更高，并且可能受益于获得方便且高质量的性健康服务。旨在让年轻女性继续上学或解决辍学根本原因的预防性干预措施也可能有助于降低青少年怀孕的发生率。
Background: Sexual activity may be less likely to occur during periods of school enrolment because of the structured and supervised environment provided, the education obtained and the safer peer networks encountered while enrolled. We examined whether school enrolment was associated with teen pregnancy in South Africa.Methods: Using longitudinal demographic surveillance data from the rural Agincourt sub-district, we reconstructed the school enrolment status from 2000 through 2011 for 15 457 young women aged 12-18 years and linked them to the estimated conception date for each pregnancy during this time. We examined the effect of time-varying school enrolment on teen pregnancy using a Cox proportional hazard model, adjusting for: age; calendar year; household socioeconomic status; household size; and gender, educational attainment and employment of household head. A secondary analysis compared the incidence of pregnancy among school enrolees by calendar time: school term vs school holiday.Results: School enrolment was associated with lower teen pregnancy rates [adjusted hazard ratio (95% confidence interval): 0.57 (0.50, 0.65)]. This association was robust to potential misclassification of school enrolment. For those enrolled in school, pregnancy occurred less commonly during school term than during school holidays [incidence rate ratio (95% confidence interval): 0.90 (0.78, 1.04)].Conclusions: Young women who drop out of school may be at higher risk for teen pregnancy and could likely benefit from receipt of accessible and high quality sexual health services. Preventive interventions designed to keep young women in school or addressing the underlying causes of dropout may also help reduce the incidence of teen pregnancy.