Sana Amjad1, Isaiah MacDonald2, Thane Chambers3, Alvaro Osornio-Vargas4, Sujata Chandra2, Don Voaklander1, Maria B Ospina1,2. 1. School of Public Health, University of Alberta, Edmonton, Alberta, Canada. 2. Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada. 3. John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada. 4. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: Adverse outcomes in adolescent pregnancies have been attributed to both biological immaturity and social determinants of health (SDOH). The present systematic review evaluated the evidence on the association between SDOH and adverse maternal and birth outcomes in adolescent mothers. METHODS: Comprehensive literature searches were conducted to identify observational studies evaluating the relationship between SDOH and adverse adolescent pregnancy outcomes. Study selection, risk of bias appraisal, and data extraction of study characteristics were independently performed by two reviewers. Pooled odds ratios (pOR) with 95% confidence intervals (95% CI) were calculated to assess the association between SDOH and adverse birth outcomes. RESULTS: Thirty-one studies met the inclusion criteria. The most frequently evaluated SDOH was race while the most commonly reported maternal and birth outcomes were caesarean section and preterm birth (PTB), respectively. The risk of bias of included studies was fair on the Newcastle-Ottawa Scale. Meta-analyses of retrospective cohort studies showed that, compared to White adolescent mothers, African American teens had increased odds of PTB (pOR 1.67; 95% CI 1.59, 1.75) and low birthweight (pOR 1.53; 95% CI 1.45, 1.62). Rural residence was consistently linked with PTB while low maternal socio-economic (SES) and illiteracy were found to increase the risk of adolescent maternal mortality and LBW infants. CONCLUSION: Social determinants of health contribute to the risk of adverse pregnancy outcomes in adolescent mothers. African American race, rural residence, inadequate education, and low SES are markers for poor pregnancy outcomes in adolescent mothers. Further research needs to be done to understand the underlying causal pathways to inequalities in adolescent pregnancy outcomes.
BACKGROUND: Adverse outcomes in adolescent pregnancies have been attributed to both biological immaturity and social determinants of health (SDOH). The present systematic review evaluated the evidence on the association between SDOH and adverse maternal and birth outcomes in adolescent mothers. METHODS: Comprehensive literature searches were conducted to identify observational studies evaluating the relationship between SDOH and adverse adolescent pregnancy outcomes. Study selection, risk of bias appraisal, and data extraction of study characteristics were independently performed by two reviewers. Pooled odds ratios (pOR) with 95% confidence intervals (95% CI) were calculated to assess the association between SDOH and adverse birth outcomes. RESULTS: Thirty-one studies met the inclusion criteria. The most frequently evaluated SDOH was race while the most commonly reported maternal and birth outcomes were caesarean section and preterm birth (PTB), respectively. The risk of bias of included studies was fair on the Newcastle-Ottawa Scale. Meta-analyses of retrospective cohort studies showed that, compared to White adolescent mothers, African American teens had increased odds of PTB (pOR 1.67; 95% CI 1.59, 1.75) and low birthweight (pOR 1.53; 95% CI 1.45, 1.62). Rural residence was consistently linked with PTB while low maternal socio-economic (SES) and illiteracy were found to increase the risk of adolescent maternal mortality and LBW infants. CONCLUSION: Social determinants of health contribute to the risk of adverse pregnancy outcomes in adolescent mothers. African American race, rural residence, inadequate education, and low SES are markers for poor pregnancy outcomes in adolescent mothers. Further research needs to be done to understand the underlying causal pathways to inequalities in adolescent pregnancy outcomes.
Authors: Jayalakshmi Ravindran; Barbra A Richardson; John Kinuthia; Jennifer A Unger; Alison L Drake; Lusi Osborn; Daniel Matemo; Janna Patterson; R Scott McClelland; Grace John-Stewart Journal: J Infect Dis Date: 2021-12-15 Impact factor: 5.226
Authors: Luciana Guerra Gallo; Jorge Martinez-Cajas; Henry Maia Peixoto; Ana Carolina Esteves da Silva Pereira; Jillian E Carter; Sandra McKeown; Bruno Schaub; Camila V Ventura; Giovanny Vinícius Araújo de França; Léo Pomar; Liana O Ventura; Vivek R Nerurkar; Wildo Navegantes de Araújo; Maria P Velez Journal: BMC Public Health Date: 2020-06-01 Impact factor: 3.295