Adolescent pregnancies and adherence to puerperal consultation

Pinto, Ingrid Rosane; Silva, Jéssica Aparecida da; Parra, Patrícia Casale; Wernet, Monika; Fonseca, Luciana Mara Monti; Ruiz, Mariana Torreglosa

doi:10.1590/1518-8345.6269.3702

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 30 (spe) • 2022 • https://doi.org/10.1590/1518-8345.6269.3702 copy

Adolescent pregnancies and adherence to puerperal consultation^* * This article refers to the call “Adolescent health and the role of nurses”. Edited by Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil. Publication of this supplement was supported by the Pan American Health Organization (PAHO/WHO). Articles have undergone the journal’s standard peer-review process for supplements. The views expressed in this supplement are those of the authors alone and do not represent the views of PAHO/WHO.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais.

Method:

cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher’s exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance.

Results:

we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women.

Conclusion:

adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance.

Descriptors:
Adolescent; Pregnancy in Adolescence; Postpartum Period; Prevalence; Disease Prevention; Patient Compliance

Highlights:

(1) Adolescent puerperal women had low educational level.

(2) Association between early age and absence of diseases during pregnancy.

(3) There were higher rates of normal vaginal deliveries among adolescents.

(4) Adolescents did not present negative obstetric and neonatal outcomes.

(5) There were no differences regarding adherence and age of puerperal women.

Variable	Adolescents		Non-adolescents		RR	95% CI	p*
Variable	n	%	n	%	RR	95% CI	p*
White skin color/race	9	7.4	47	38.8	0.862	0.501 - 1.484	0.641
White skin color/race	13	10.7	52	42.9	0.862	0.501 - 1.484	0.641
Cohabiting with a partner	14	11.6	56	46.3	1.125	0.785 - 1.612	0.637
Not cohabiting with a partner	8	6.6	43	35.5	1.125	0.785 - 1.612	0.637
Educational level lower than secondary education	20	16.5	47	38.8	1.876	1.470 - 2.395	<0.001
Educational level higher than secondary educational	2	1.6	50	41.3	1.876	1.470 - 2.395	<0.001
Smoker	4	3.3	18	15.0	1.273	0.463 -3.496	0.741
Non-smoker	14	11.7	84	70.0	1.273	0.463 -3.496	0.741
Alcoholic	2	1.6	20	16.5	0.692	0.168 - 2.850	1.000
Non-alcoholic	13	10.7	86	71.1	0.692	0.168 - 2.850	1.000
Use of illegal drugs	2	1.6	1	0.8	9.000	0.854 - 94.899	0.085
Non-use of illegal drugs	20	16.5	98	80.9	9.000	0.854 - 94.899	0.085
With pathologies	8	6.6	65	53.7	0.554	0.313 - 0.980	0.016
No pathologies	14	11.7	34	28.1	0.554	0.313 - 0.980	0.016
Primiparous	18	14.9	24	19.8	0.240	0.098 - 0.586	<0.001
Multiparous	4	3.3	75	62.0	0.240	0.098 - 0.586	<0.001
Normal delivery	17	14.0	50	41.3	1.530	1.135 - 2.063	0.032
Cesarean section	5	4.1	49	40.5	1.530	1.135 - 2.063	0.032
Preterm newborn	2	1.6	10	8.3	0.900	0.212 - 3.822	1.000
Full-term newborn	20	16.5	89	73.6	0.900	0.212 - 3.822	1.000
Low birth weight	0	-	5	4.1	1.053	1.006 - 1.102	0.583
Appropriate weight	22	18.2	94	77.7	1.053	1.006 - 1.102	0.583
Postpartum complications	3	2.5	5	4.1	2.700	0.697 - 10.465	0.158
Without complications	19	15.7	94	77.7	2.700	0.697 - 10.465	0.158
Attended puerperal return visit	7	5.8	35	28.9	0.900	0.462 - 1.754	0.810
Did not attend return visit	15	12.4	64	52.9	0.900	0.462 - 1.754	0.810

Variable	Coefficient ^*	(95%CI)		p
Adolescence	0.002	(-0.146)	(-0.151)	0.974
Educational level	0.074	(-0.041)	(0.189)	0.207
Use of illegal drugs	0.579	(0.012)	(0.249)	0.031
With pathology(ies)	-0.101	(-0.207)	(0.004)	0.060
Primiparity	-0.131	(-0.262)	(-0.01)	0.049
Cesarean section	0.045	(-0.065)	(-0.154)	0.426
Postpartum complications	0.093	(-0.063)	(-0.250)	0.243

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Mariana Torreglosa Ruiz E-mail: marianatorreglosa@hotmail.com https://orcid.org/0000-0002-5199-7328