Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women.
Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women.
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DOI：
10.3402/gha.v7.23719
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发表时间：
2014
影响因子：
2.6
通讯作者：
Sterk C
中科院分区：
文献类型：
--
作者：
Christofides NJ;Jewkes RK;Dunkle KL;McCarty F;Jama Shai N;Nduna M;Sterk C
虽然南非的少女怀孕率有所下降，但其短期和长期的健康和社会后果是一个潜在的公共卫生问题。这项纵向研究旨在描述南非东开普省一组青春期女性在2年随访期间意外怀孕和计划外怀孕的风险和保护因素范围。它还调查了性别不平等与基于性别的暴力之间的关系，以及随后的计划外怀孕和意外怀孕。本分析纳入了15-18岁的青少年女孩（n=19），她们是一项集群随机对照试验的志愿参与者，并且拥有至少一次随访的数据。为了评估意外怀孕或计划外怀孕的风险和保护因素，我们构建了多变量多分类回归模型，将采样聚类作为潜在变量进行调整。协变量包括年龄、基线前怀孕、教育、访谈间隔时间、研究干预组、避孕药具使用、亲密伴侣暴力经历、少女和男友是共同主要伴侣的信念以及社会经济地位。总体而言，在2年的随访期内发生了174例妊娠。对关系控制的信念与意外怀孕和计划外怀孕无关，15岁以下的强迫第一次性行为或强迫性行为的经历也无关。激素避孕对意外怀孕有保护作用（OR 0.40; 95% CI 0.21-0.79）;然而，使用避孕套没有保护作用。身体虐待（OR 1.69; 95% CI 1.05-2.72）是一个危险因素，基线前怀孕可防止意外怀孕（OR 0.25; 95% CI 0.07-0.80）。较高的社会经济地位对计划外和意外怀孕都有保护作用（OR 0.69; 95%CI 0.58-0.83和OR 0.78; 95%CI 0.64-0.96）。相信少女和她的男朋友是共同的主要合作伙伴，报告计划外和意外怀孕的几率增加了一倍（OR 2.58 95% CI 1.07-6.25，OR 2.21 95% CI 1.13-4.29）。虽然一些衡量性别不平等的标准与计划外怀孕和意外怀孕无关，但有证据表明性别权力和社会经济地位都发挥了作用。这一点很明显，经历过身体暴力的少女更有可能意外怀孕。预防青少年怀孕的干预措施需要根据社会经济地位进行调整，因为一些青少年可能会将怀孕视为拥有更安全未来的一种方式。如果要防止意外怀孕和计划外怀孕，就必须采取干预措施，促进青少年的关系动态。
Although teenage pregnancies in South Africa have declined, the short and longer term health and social consequences are a potential public health concern. This longitudinal study aimed to describe the range of risk and protective factors for incident unwanted and unplanned pregnancies occurring over 2 years of follow-up among a cohort of adolescent women in the Eastern Cape, South Africa. It also investigated the relationship between gender inequality and gender-based violence and subsequent unplanned and unwanted pregnancies among the cohort. Teenage girls, aged 15–18 years (n=19), who were volunteer participants in a cluster randomized controlled trial and who had data from at least one follow-up were included in this analysis. To assess risk and protective factors for incident unwanted or unplanned pregnancies, we constructed multivariate polytomous regression models adjusting for sampling clusters as latent variables. Covariates included age, having a pregnancy prior to baseline, education, time between interviews, study intervention arm, contraceptive use, experience of intimate partner violence, belief that the teenage girl and her boyfriend are mutual main partners, and socioeconomic status. Overall, 174 pregnancies occurred over the 2-year follow-up period. Beliefs about relationship control were not associated with unwanted and unplanned pregnancies, nor were experiences of forced first sex or coerced sex under the age of 15. Hormonal contraception was protective against unplanned pregnancies (OR 0.40; 95% CI 0.21–0.79); however, using condoms was not protective. Physical abuse (OR 1.69; 95% CI 1.05–2.72) was a risk factor for, and having a pregnancy prior to baseline was protective against an unwanted pregnancy (OR 0.25; 95% CI 0.07–0.80). Higher socioeconomic status was protective for both unplanned and unwanted pregnancies (OR 0.69; 95% CI 0.58–0.83 and OR 0.78; 95% CI 0.64–0.96). Believing that the teenage girl and her boyfriend were mutual main partners doubled the odds of reporting both an unplanned and unwanted pregnancy (OR 2.58 95% CI 1.07–6.25, and OR 2.21 95% CI 1.13–4.29). Although some of the measures of gender inequity were not associated with unplanned and unwanted pregnancies, there is evidence of the role of both gender power and socioeconomic status. This was evident in teenage girls who experienced physical violence being more likely to have an unwanted pregnancy. Interventions to prevent teenage pregnancies need to be tailored by socioeconomic status because some teenagers may see having a pregnancy as a way to have a more secure future. Interventions that engage with relationship dynamics of teenagers are essential if unwanted and unplanned pregnancies are to be prevented.
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DOI：
10.1363/3015604
发表时间：
2004-12-01
期刊：
INTERNATIONAL FAMILY PLANNING PERSPECTIVES
影响因子：
--
作者：
Koenig, MA;Zablotska, I;Gray, R
通讯作者：
Gray, R
影响因子：
5.4
作者：
Jewkes, R;Vundule, C;Jordaan, E
通讯作者：
Jordaan, E
影响因子：
2.1
作者：
Grant, Monica J.;Hallman, Kelly K.
通讯作者：
Hallman, Kelly K.
影响因子：
3.8
作者：
Pulerwitz, J;Gortmaker, SL;DeJong, W
通讯作者：
DeJong, W
DOI：
10.1080/15374410701662709
发表时间：
2007-10-01
影响因子：
4.2
作者：
Moore, David R.;Florsheim, Paul;Butner, Jonathan
通讯作者：
Butner, Jonathan