Birth Outcomes Among Adolescents

描述（由申请人提供）：青少年生育的妇女低出生体重（LBW）和早产（PTB）的风险增加。这些并发症对母亲和儿童都有深远的医疗和经济影响。然而，大多数少女母亲都生下了健康的婴儿。年龄较小和体重不足与不良出生结果的高风险相关；除此之外，几乎没有已知的风险或保护因素。我们将可能影响女孩怀孕健康的三个层面概念化。女孩自己的资源将有助于她有积极的健康行为，获得适当的医疗保健，并控制她的压力水平。其次，她所处的微观系统——尤其是她的家庭——提供了工具、信息和情感上的支持，以鼓励或阻碍身体健康。第三，她所在的社区和学校的环境将为女孩的态度和行为提供背景。全国青少年健康纵向研究（Add Health）收集了四波青少年的数据，包括怀孕和分娩的信息。参与者报告了他们生活和家庭的几个方面，还从父母、朋友和学校管理人员那里收集了数据，以便对参与者的成长环境有一个广泛的了解。在第三次浪潮中，913名女性至少经历过一次青春期怀孕（在20岁之前）。我们的具体目标是：1)研究个体资源（自尊、智力、心理健康、自我效能）如何影响青春期女孩的出生体重和胎龄；2)研究微观系统优势和劣势（家庭亲密度、家庭劣势、虐待、父母关系质量、父母支持）和社区/学校资源（学校劣势、卫生保健可获得性、少女怀孕频率、教育质量）如何影响少女的生育结果，并研究高层和个人层面之间的相互作用；3)研究这些资源与产前护理和健康行为等潜在中介之间的关系。该项目服务的公共卫生目标包括确定这一高危群体中的高风险和低风险亚群，并确定采取干预措施的机会，以减少这些分娩对年轻母亲的负面影响。

DESCRIPTION (provided by applicant): Women who give birth as adolescents are at increased risk for low birth weight (LBW) and preterm birth (PTB). These complications have far-reaching medical and financial implications for both mother and child. However, the majority of teenage mothers give birth to healthy babies. Younger age and underweight are associated with higher risk of poor birth outcome; otherwise, few risk or protective factors are known. We conceptualize three levels that may affect a girl's pregnancy health. The girl's own resources will contribute to her ability to have positive health behaviors, access adequate medical care, and control her stress levels. Second, the micro system in which she operates - particularly her family - provides the instrumental, informational, and emotional support to encourage or discourage good health. Third, the context of the neighborhood and school she attends will provide the backdrop for a girl's attitudes and behavior. The National Longitudinal Study of Adolescent Health's (Add Health) collected data on adolescents across 4 Waves, including information on pregnancies and births. Participants reported on several aspects of their lives and families, and data were also gathered from parents, friends, and school administrators, allowing for a broad picture of the context in which participants were developing. As of Wave III, 913 women experienced at least one adolescent pregnancy (before age 20). Our specific aims are: 1) To examine how individual resources (self-esteem, intelligence, mental health, self- efficacy) affect birth weight and gestational age in adolescent girls; 2) To examine how micro system strengths and weaknesses (family closeness, family disadvantage, mistreatment, parental relationship quality, parental support), and neighborhood/school resources (school disadvantage, availability of health care, frequency of teen pregnancy, quality of education) affect birth outcomes in teenage girls, and to examine interactions among the higher levels and individual levels, and 3) To examine the relationship between these resources and potential intermediates such as prenatal care and health behaviors. The public health goals served by this project include identifying high- and low-risk subsets within this high-risk group, and identifying opportunities for interventions which could decrease the negative consequences of these births to young mothers. PUBLIC HEALTH RELEVANCE: Overall, women who give birth as adolescents are at increased risk for low birth weight (LBW) and preterm birth (PTB); however, few risk or protective factors are known within this group. Data from the National Longitudinal Study of Adolescent Health (Add Health) will be used to examine individual, family, and neighborhood/school influences on pregnancy outcome among adolescents and intermediates such as prenatal care and smoking during pregnancy. The public health goals served by this project are identifying high- and low-risk subsets within this high-risk group, and identifying opportunities for interventions which could decrease the negative consequences of these births to young mothers.