Adolescent pregnancies and adherence to puerperal consultation*  <span class="so-article-trans-title" dir="auto"> Translated title: Gestações na adolescência e adesão à consulta puerperal* </span> <span class="so-article-trans-title" dir="auto"> Translated title: Embarazos en adolescentes y adherencia a la consulta puerperal </span>

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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.

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.

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Most cited references 46

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Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

Aluisio Barros, Vânia Hirakata (2003)

Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.

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A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding

Josephine McNamara, Michelle Townsend, Jane Herbert (2019)

Background An emerging body of literature suggests there is a relationship between a pregnant woman’s psychological wellbeing and the development of maternal-fetal attachment (MFA) and early postpartum bonding. The nature of this relationship is not well understood because of the limited theoretical framework surrounding the construct of MFA and variations in study methods and data collection points. In this systematic review, we synthesize the published literature to determine the nature of the relationship from the antenatal to early postnatal period and to provide recommendations for future research and clinical practice. Method Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, four electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on at least one domain of maternal wellbeing/mental health and MFA during pregnancy or MFA during pregnancy and the mother-infant relationship during the early postpartum period (up to 12 weeks). No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42018096174). Results 25 studies examining maternal mental health and MFA/postpartum bonding were selected for inclusion in this review. Key findings identified from the review were: a need to validate existing mental health measures or develop new measures specific for use in antenatal populations; inconsistencies in data collection points throughout pregnancy and postpartum; a lack of consensus about the construct of MFA and the way it is assessed; and a continued focus on postpartum outcomes. Conclusion Scientific gaps remain in our understanding of the relationship between maternal mental health and both MFA and postpartum bonding which limit our theoretical understanding of the MFA construct. Recommendations for future research are to employ prospective longitudinal designs that span the full pregnancy and postpartum period, and for consistency in the terminology and methodology used when considering MFA. A re-focus of research attention on the theory behind MFA will allow a richer and more holistic account of the emerging relationship between mother and baby.

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Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

Zemenu Tadesse Tessema, Lake Yazachew, Getayeneh Antehunegn Tesema … (2020)

Introduction Globally, over 65% of maternal deaths occur during the first 42 days of postpartum while the same proportion of neonatal deaths occur during the first 7 days of life. In sab- Saharan Africa, 4.7 million mothers, newborns, and children die on annual basis. As to our knowledge, there is no study on postnatal care utilization that incorporates all sub-Saharan Africa countries that had DHS data. Therefore, this study aimed at identifying pooled magnitude and determinants of postnatal care utilization in sub-Saharan Africa. Method A population-based cross-sectional study from the most recent Demographic and Health Surveys data from the period of 2006 to 2018 of 36 SSA countries were used. A total weighted sample of 286,255 reproductive-age women who gave birth 5 years preceding the survey were included in the study. A meta-analysis of DHS data of each Sub-Saharan countries was conducted to generate pooled magnitude and a forest plot was used to present it. A multilevel logistic regression model was fitted to identify determinants of postnatal care utilization. The AOR (Adjusted Odds Ratio) with their 95% CI and p-value ≤0.05 was used to declare that determinates associated with postnatal care utilization. Result The pooled magnitude of postnatal care utilization in sub-Saharan Africa countries was 52.48% [95% CI: 52.33, 52.63], with the highest postnatal care utilization in the Central Region of Africa (73.51%) and the low postnatal care utilization in Eastern Regions of Africa (31.71%). In the multilevel logistic regression model region, residence, age group, maternal education, maternal occupation, media exposure, ANC visit, place of delivery, and accessing health care were determinants of postnatal care utilization in Sub-Saharan Africa. Conclusion The coverage of postnatal care service utilization was low with high disparities among the region. Being in rural residence, young age group, low education level, had no occupation, not exposed to media, a big problem to access health care, not had ANC visit, and home delivery was associated with low postnatal care service utilization. This study evidenced that there is a wide gap in postnatal care utilization between SSA countries. Special attention is required to improve health accessibility, utilization, and quality of maternal health services to increase postnatal care service utilization in the region.

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Author and article information

Contributors

Ingrid Rosane Pinto:

ORCID: http://orcid.org/0000-0003-0040-6716

Role: concepção e desenho da pesquisaRole: obtenção de dadosRole: análise e interpretação dos dadosRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Jéssica Aparecida da Silva:

ORCID: http://orcid.org/0000-0002-4308-5978

Role: concepção e desenho da pesquisaRole: obtenção de dadosRole: análise e interpretação dos dadosRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Patrícia Casale Parra:

ORCID: http://orcid.org/0000-0003-2407-4146

Role: concepção e desenho da pesquisaRole: análise e interpretação dos dadosRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Monika Wernet:

ORCID: http://orcid.org/0000-0002-1194-3261

Role: concepção e desenho da pesquisaRole: análise e interpretação dos dadosRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Luciana Mara Monti Fonseca:

ORCID: http://orcid.org/0000-0002-5831-8789

Role: concepção e desenho da pesquisaRole: análise e interpretação dos dadosRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Mariana Torreglosa Ruiz:

ORCID: http://orcid.org/0000-0002-5199-7328

Role: concepção e desenho da pesquisaRole: análise e interpretação dos dadosRole: análise estatísticaRole: redação do manuscritoRole: revisão crítica do manuscritoRole: aprovação do texto

Journal

Journal ID (nlm-ta): Rev Lat Am Enfermagem

Journal ID (iso-abbrev): Rev Lat Am Enfermagem

Journal ID (publisher-id): rlae

Title: Revista Latino-Americana de Enfermagem

Publisher: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo

ISSN (Print): 0104-1169

ISSN (Electronic): 1518-8345

Publication date (Electronic, pub): 03 October 2022

Publication date (Electronic, collection): 2022

Volume: 30

Issue: spe

Electronic Location Identifier: e3703

Affiliations

[1 ]Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.

[2 ]Universidade Federal de São Carlos, São Carlos, SP, Brasil.

[3 ]Universidade Federal de São Carlos, Departamento de Enfermagem, São Carlos, SP, Brasil.

[4 ]Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil.

[5 ]Universidade Federal do Triângulo Mineiro, Departamento de Enfermagem na Assistência Hospitalar, Uberaba, MG, Brasil.

Author notes

Autor correspondente: Mariana Torreglosa Ruiz E-mail: marianatorreglosa@ 123456hotmail.com https://orcid.org/0000-0002-5199-7328

Editor Associado: Pedro Fredemir Palha

Conflito de interesse: os autores declararam que não há conflito de interesse.

Author information

Ingrid Rosane Pinto http://orcid.org/0000-0003-0040-6716

Jéssica Aparecida da Silva http://orcid.org/0000-0002-4308-5978

Patrícia Casale Parra http://orcid.org/0000-0003-2407-4146

Monika Wernet http://orcid.org/0000-0002-1194-3261

Luciana Mara Monti Fonseca http://orcid.org/0000-0002-5831-8789

Mariana Torreglosa Ruiz http://orcid.org/0000-0002-5199-7328

Article

Other ID: 00205

DOI: 10.1590/1518-8345.6269.3702

PMC ID: 9647911

PubMed ID: 36197392

SO-VID: 3a518cb4-64fa-4cb2-942b-cc0dc67aedb0

License:

Este é um artigo publicado em acesso aberto sob uma licença Creative Commons

History

Date received : 04 May 2022

Date accepted : 25 June 2022

Page count

Figures: 0, Tables: 6, Equations: 0, References: 47

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Adolescent pregnancies and adherence to puerperal consultation* Translated title: Gestações na adolescência e adesão à consulta puerperal* Translated title: Embarazos en adolescentes y adherencia a la consulta puerperal

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Most cited references 46

Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding

Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

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