Part of the public health problem posed by teenage pregnancies derives from the fact that they frequently occur in connection with poor social support and deficient maternal well-being. Although some studies suggest that a first teenage pregnancy is likelier to have an adverse perinatal outcome, this remains uncertain. The investigators reviewed morbidity records in Scotland, where teenage pregnancy rates are among the highest in western Europe, to identify all first and second singleton births during the years 1992-1998 that resulted in a live or stillborn infant. Maternal ages ranged from 15 to 29 years, and gestational age at birth ranged from 24 to 43 weeks; birth weights exceeded 500 g. Two cohorts, one of smokers and one of nonsmokers, were analyzed. The major study group included 110.233 nonsmoking women. Women 15 to 19 years of age who had a first birth were not at increased risk of adverse outcomes compared with those 20 to 29 years of age, according to multivariate analysis. Among second births, however, the younger women were at significantly increased risk of a moderately or extremely preterm birth and also of stillbirth. Parity aside, the younger mothers were less likely to require emergency cesarean delivery. Maternal age at delivery could not be related significantly to socioeconomic deprivation, height, year of delivery, or previous abortion. Women 16 to 18 years old were significantly less likely than 19-year old women to deliver an infant weighing less than the fifth centile for gestational age. Women aged 15 to 19 years who smoked had a relatively low risk of delivering a small-for-gestational-age infant or having emergency cesarean delivery regardless of whether the birth was a first or second one. These findings point to a causal relationship between second teenage births and adverse outcomes, which probably does not reflect differences in the interval between pregnancies. First teenage births do not, in general, carry an increased risk of negative pregnancy outcomes; in fact, they pose a reduced risk of emergency cesarean delivery. The risks of preterm delivery and stillbirth are nearly 3-fold greater for second teenage births.

Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: Population based retrospective cohort study

The Perceived Impact of Alternative Specialized Education Services on Former Teen Mothers by Malinda S. Hudson MA, Wilmington University, 2008 BS, Springfield College, 2004 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration

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The Perceived Impact of Alternative Specialized Education Services on Former Teen Mothers

................................................................................................................................................. iii Acknowledgements ................................................................................................................................ iv List of Acronyms .................................................................................................................................... v CHAPTER ONE .....................................................................................................................................

Male partner support among young unmarried pregnant women in Durban.

The persistent Black-White disparity in perinatal outcomes is a serious public health issue. Infants born to Black women are two times more likely than white infants to die before the age of one. Prior research has focused primarily on Black women’s exposure to risk and protective factors during pregnancy. The life course perspective serves as a useful framework for understanding how Black women’s early life experiences influence later health and birth outcomes. Prevention efforts guided by the life course perspective will be key in addressing adverse perinatal outcomes among Black women. The present study is a community-based participatory research partnership with the Kansas Infant Death and SIDS Network, Inc. A transcendental phenomenological approach was used to describe the life experiences, preceding fetal or infant death, among Black women. Five Black women (ages 20-36) were interviewed about their experiences from early childhood through adulthood. Results identified eight broad themes: early childhood context, personal relationships, exposure to multiple sources of stress, maintenance of mental wellness, sexual and reproductive health experiences, pregnancy experiences, health system experience and exposure to fetal/infant death. Life timelines were also generated for each participant to describe life course patterns. The essential, invariant structure described the essence of bereaved Black women’s lived experience and was validated through the process of member checking. The findings indicate that black women encounter multi-level risk and protective processes over the course of their life which may impact their own health and their reproductive health advantage. The present study is the only identifiable phenomenological, life course-informed study of black women who have experienced infant death. The results suggest that life course perspective is an appropriate framework for understanding the lived experience of Black women.

The mothers' voices project: A phenomenological study exploring the life experiences of African American women who have experienced fetal or infant death

Purpose. This study examines the prevalence of trauma subtypes, polytraumatization, and perinatal depression in a diverse sample of adolescent mothers to help inform perinatal depression prevention, screening, and treatment efforts. Methods. We conducted a secondary analysis of a convenience sample of adolescent mothers (N=210) from a prospective longitudinal study of perinatal depression. Participants were recruited from a county-based, public health prenatal clinic and data was collected in the prenatal and postpartum periods. Results. In this sample, 81% of adolescent mothers reported at least one trauma experience; 75% reported lifetime experience of IPV. The most prevalent trauma types among adolescent mothers reporting perinatal depression were sexual trauma (11.4%), childhood loss (28.3%), emotional adversity (17.1%), and polytraumatization (43%). Conclusions. Trauma is alarmingly prevalent among adolescent mothers. Results suggest standards of care for adolescent mothers should include screening adolescent mothers for trauma history and provision of appropriate referrals for IPV. Findings support the need for trauma-informed treatment in perinatal public health clinics to decrease potential health risks to both mother and baby.

Childhood trauma and adolescent mental health: A transdisciplinary approach for social work research and practice

PURPOSE
Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States.


METHODS
In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes.


RESULTS
Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support.


CONCLUSIONS
Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome.

Monisha Shah

Papers

Partner support and impact on birth outcomes among teen pregnancies in the United States