Aubrey S Madkour1, Yiqiong Xie2, Emily W Harville3. 1. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112. aspriggs@tulane.edu. 2. Payer and Provider Research, HealthCore, Inc., 123 Justison Street, Suite 200, Wilmington, DE 19801. yxie@healthcore.com. 3. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112. eharvill@tulane.edu.
Abstract
BACKGROUND: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. METHODS: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants after Wave I and before age 20, were still in secondary school while pregnant, and had complete data (N = 402) were included. Mothers reported infants' birthweight and gestational age. School administrators reported whether family planning counseling, diagnostic screening (including sexually transmitted diseases [STDs]), STD treatment, and prenatal/postpartum health care were provided on-site at school at Wave I. Multilevel models adjusted for individual and school characteristics were conducted. RESULTS: Few schools offered reproductive health care services on-site. In multilevel analyses, availability of family planning counseling (Est. β = 0.21, 95% confidence interval [CI] 0.04-0.38 p < 0.05) and prenatal/postpartum health care (Est. β = 0.21, 95% CI 0.02-0.40 p < 0.05) were significantly associated with increased infant birthweight. No services examined were significantly associated with increased gestational age. CONCLUSIONS: Some school-based reproductive health services may improve subsequent birth outcomes among adolescent mothers. Future analyses should examine the mechanisms by which services impact birth outcomes.
BACKGROUND: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. METHODS: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants after Wave I and before age 20, were still in secondary school while pregnant, and had complete data (N = 402) were included. Mothers reported infants' birthweight and gestational age. School administrators reported whether family planning counseling, diagnostic screening (including sexually transmitted diseases [STDs]), STD treatment, and prenatal/postpartum health care were provided on-site at school at Wave I. Multilevel models adjusted for individual and school characteristics were conducted. RESULTS: Few schools offered reproductive health care services on-site. In multilevel analyses, availability of family planning counseling (Est. β = 0.21, 95% confidence interval [CI] 0.04-0.38 p < 0.05) and prenatal/postpartum health care (Est. β = 0.21, 95% CI 0.02-0.40 p < 0.05) were significantly associated with increased infant birthweight. No services examined were significantly associated with increased gestational age. CONCLUSIONS: Some school-based reproductive health services may improve subsequent birth outcomes among adolescent mothers. Future analyses should examine the mechanisms by which services impact birth outcomes.
Authors: Joyce A Martin; Brady E Hamilton; Stephanie J Ventura; Michelle J K Osterman; Elizabeth C Wilson; T J Mathews Journal: Natl Vital Stat Rep Date: 2012-08-28