Determinants of adolescent fertility and its consequences for maternal health, with special reference to rural Bangladesh.
Determinants of adolescent fertility and its consequences for maternal health, with special reference to rural Bangladesh.
复制标题
青少年生育力的决定因素及其对孕产妇健康的影响，特别是孟加拉国农村地区。
DOI：
10.1111/j.1749-6632.1994.tb30390.x
复制
发表时间：
1994
影响因子：
5.2
通讯作者：
Riley,AP
中科院分区：
文献类型：
--
作者：
Riley,AP
本文第二部分阐述了青少年生长发育与家庭形成模式的理论模型及其对母婴健康的影响。本文随后的部分研究了支持模型中假设的特定关系的证据，重点是来自孟加拉国Matlab的纵向数据。尽管重点放在发展中国家人口，但也审查了发达国家的文献。证据的重要性表明，在发达国家，虽然生殖成熟与随后的生殖行为之间存在正相关关系，但年轻孕产妇年龄对妊娠结局的负面影响与社会经济因素相混淆。在社会和经济处境不利的人中，少女怀孕或至少少女生育的情况不成比例。此外，在美国，青少年生育，尤其是婚外生育，违反了社会规范，至少在白色人群中是这样。在美国，不良饮食可能是一个问题，但它似乎不会导致身体生长和发育的明显延迟，青春期生长延迟或受损，或初潮年龄晚。有限的证据表明，初潮早可能与成熟月经周期活动的更快开始有关，但这些发现尚未在其他地方复制。发展中国家的情况则大不相同。首先，早婚和早育是社会大多数阶层所希望和普遍的。第二，营养不良很普遍，严重到足以推迟青少年的快速生长，并使初潮的平均年龄比发达国家人口高出两到三岁。孟加拉国的情况肯定就是这样。在这种情况下，对营养状况、青少年发育和生殖的关系进行了一些观察。首先，营养不良会延迟生长和生殖成熟，早熟的女性（即初潮时年龄较小的女性）比晚熟的女性结婚年龄更小。此外，体重似乎对结婚年龄（初潮年龄除外）有独立的影响，因此体重较重的妇女比体重较轻的妇女结婚年龄小。对这一发现的解释包括体重和第二性征的发展之间的相关性，也许是一种文化观念，即较重（即正常体重）的女性更有吸引力，或更健康，伴侣。月经初潮和营养状况对婚姻的影响令人担忧，营养状况的改善和初潮年龄的增加将导致更年轻的婚姻和首次生育，以及更高的终身生育率。（400字处截断摘要）
The second section of this paper set forth a theoretical model relating adolescent growth and development to family formation patterns and their implications for maternal and child health. Subsequent sections of the paper examine the evidence to support specific relationships hypothesized in the model, focusing on longitudinal data from Matlab, Bangladesh. Despite the emphasis on developing country populations, literature from developed countries was also reviewed. The weight of the evidence suggests that in the developed countries, while there is a positive relationship between reproductive maturation and subsequent reproductive behavior, the negative effects of young maternal age on pregnancy outcome is confounded with socioeconomic factors. Teenage pregnancy, or at least teenage birth, occurs disproportionately among the socially and economically disadvantaged. Moreover, teenage childbearing in the US, especially when it occurs outside of marriage, violates social norms, at least in the white population. Poor diet may be a problem in the US but it does not appear to result in notable delays in physical growth and development, delayed or compromised adolescent growth, or late age at menarche. Limited evidence suggests that early menarche may be associated with more rapid onset of mature menstrual cycle activity but these findings have not been replicated elsewhere. In developing countries the situation is quite different. First, early marriage and childbearing are desired and common across most segments of society. Second, malnutrition is widespread, and is sufficiently severe to delay the adolescent growth spurt and raise average age at menarche by two to three years compared with developed country populations. This is certainly the case in Bangladesh. In this setting, several observations regarding the relationship of nutritional status, adolescent development and reproduction have been made. First, undernutrition delays growth and reproductive maturation, and women who mature early (ie, women with young age at menarche) marry at younger ages than later maturers. In addition, body weight appears to have an independent effect on age at marriage, net of age at menarche, such that relatively heavy women marry at younger ages than their lighter counterparts. Explanations for this finding include correlation between body weight and development of secondary sex characteristics, and perhaps a cultural perception that heavier (ie, normal body weight) women are more attractive, or healthier, mates. The effect of menarche and nutritional status on marriage gives rise to concern that an improvement in nutritional status, and an increase in the age at menarche, would lead to younger marriage and first birth, and higher lifetime fertility.(ABSTRACT TRUNCATED AT 400 WORDS)