Adverse Neonatal Outcomes in Overweight and Obese Adolescents Compared with Normal Weight Adolescents and Low Risk Adults

Study Objective

To evaluate the association between maternal body mass index and neonatal outcomes in adolescents and to compare neonatal outcomes between overweight and obese adolescents and obstetric low-risk adult women.

Pregnancy Among Unmarried Adolescents and Young Adults

Objective(s)

To determine the risk factors for pregnancy among unmarried adolescents and young adults.

Method(s)

Case–control study was done over a period of 2 years. Data collected from 181 unmarried abortion seekers and 181 unmarried non-pregnant controls (≤24 years) attending three Medical Colleges of Kerala.

Results

Logistic regression analysis showed a strong association between unmarried adolescent pregnancy and lack of parental supervision and control (OR 8.74, P = 0.000), poor intra-family relationship (OR 7.01, P = 0.000), family problem (OR 4.41, P = 0.000), lack of knowledge on sexual and reproductive health (OR 4.95, P = 0.0003), and non-engagement of adolescent in any productive activity (OR 4.41, P = 0.0373).

Conclusion(s)

Lack of parental control, family problem, poor intra-family relationship, lack of knowledge on sexual and reproductive health, and lack of engaging in any productive activity were found to be significant predictors for unmarried adolescent pregnancy.     

低出生体重与脑性瘫痪

目的　确定不同出生体重脑性瘫痪患病率。　方法　１９９７ 年５ 月至６ 月在江苏南部七个市进行了０～６ 岁小儿脑性瘫痪现况调查。　结果　随着出生体重的增加,脑性瘫痪患病率呈现出下降、平台和上升三种变化。出生体重在３ ５００ ～３ ９９９ ｇ 组的脑性瘫痪患病率最低。低出生体重儿（ ＜２ ５００ ｇ）占全部儿童的２－０％ ,而在脑性瘫痪患儿中低出生体重儿却占２４％ 。低出生体重儿脑性瘫痪患病率为１９－４‰（９５％ 可信区间：１６－３‰～２２ ．５ ‰）,而正常出生体重儿（ ≥２ ５００ ｇ） 为１－２‰（９５ ％ 可信区间：１－１ ‰～１ ．３‰）;低出生体重儿脑性瘫痪患病率是正常出生体重儿的１６ 倍（ＲＲ＝１６－１,９５％ 可信区间：１３－４ ～１９－４）。　结论　低出生体重儿脑性瘫痪患病率明显高于正常出生体重儿;调查地区出生体重不足２ ０００ ｇ 的儿童的存活质量有待进一步提高;随着低出生体重儿存活率的上升,脑瘫患病率可能会呈上升趋势。     

Tattoos and Piercings in Female Adolescents and Young Adults

This article covers body art in female adolescents and young adults, including tattoos, piercings, and intimate piercings. We review the epidemiology, definitions, motivations, proactive counseling, regulations, complications, and removal practices. Providers are likely to encounter and manage young women with tattoos and piercings and should be familiar with how to support young women before and after obtaining body art. Providers should be familiar with the treatment of the most frequent complications of body art in young women, which include allergic reactions and localized soft tissue infections. Finally, we review the techniques and indications for body art removal.     

Prevalence of Low Birth Weight,Premature Birth,and Stillbirth Among Pregnant Adolescents in Canada: A Systematic Review and Meta-analysis

Although most studies show that adolescent pregnant women are at a higher risk for adverse birth outcomes, there has been limited research examining this relationship in Canada. This systematic review and meta-analysis investigated the prevalence of low birthweight (LBW), preterm birth (PTB), and stillbirth in Canadian adolescent women compared to adult women. Studies were included if they were primary research and included a sample of adolescent mothers (≤19 years) and adult mothers (≥20 years) who gave birth to singleton infants in Canada. Birth outcomes must have been measured consistently in at least 3 studies for inclusion. Comprehensive electronic literature searches were conducted from database inception until August 2020 in 5 databases. Random effects meta-analysis models were used to estimate pooled odds ratios (pOR) for LBW, PTB, and stillbirth between adolescent and adult pregnant women. Outcomes reported included PTB (8 studies), LBW (6 studies), and stillbirth (3 studies). Compared to adult mothers, adolescent mothers had a 56% increase in the prevalence of LBW (pOR 1.56, 95% confidence interval [CI] 1.24, 1.97), a 23% increase in PTB (pOR 1.23, 95% CI 1.06, 1.42), a 20% increase in stillbirth (pOR 1.20, 95% CI 1.05, 1.37). Heterogeneity, as assessed by I², was high for LBW and PTB and was low for stillbirth. A subgroup analysis did not remove the high heterogeneity, and some studies did not adjust for confounding variables and were missing information on sociodemographic and behavioral factors. Future research is needed to investigate the mechanisms surrounding these differences by maternal age.     

Intrauterine Devices and Sexually Transmitted Infection among Older Adolescents and Young Adults in a Cluster Randomized Trial

Study ObjectiveProvider misconceptions regarding intrauterine device (IUD) safety for adolescents and young women can unnecessarily limit contraceptive options offered; we sought to evaluate rates of Neisseria gonorrhoeae or Chlamydia trachomatis (GC/CT) diagnoses among young women who adopted IUDs.DesignSecondary analysis of a cluster-randomized provider educational trial.SettingForty US-based reproductive health centers.ParticipantsWe followed 1350 participants for 12 months aged 18-25 years who sought contraceptive care.InterventionsThe parent study assessed the effect of provider training on evidence-based contraceptive counseling.Main Outcome MeasuresWe assessed incidence of GC/CT diagnoses according to IUD use and sexually transmitted infection risk factors using Cox regression modeling and generalized estimating equations.ResultsTwo hundred four participants had GC/CT history at baseline; 103 received a new GC/CT diagnosis over the 12-month follow-up period. IUDs were initiated by 194 participants. Incidence of GC/CT diagnosis was 10.0 per 100 person-years during IUD use vs 8.0 otherwise. In adjusted models, IUD use (adjusted hazard ratio [aHR], 1.31; 95% confidence interval [CI], 0.71-2.40), adolescent age (aHR, 1.28; 95% CI, 0.72-2.27), history of GC/CT (aHR, 1.23; 95% CI, 0.75-2.00), and intervention status (aHR, 1.12; 95% CI, 0.74-1.71) were not associated with GC/CT diagnosis; however, new GC/CT diagnosis rates were significantly higher among individuals who reported multiple partners at baseline (aHR, 2.0; 95% CI, 1.34-2.98).ConclusionIn this young study population with GC/CT history, this use of IUDs was safe and did not lead to increased GC/CT diagnoses. However, results highlighted the importance of dual sexually transmitted infection and pregnancy protection for participants with multiple partners.     

Evaluation and Management of Primary Ovarian Insufficiency in Adolescents and Young Adults

Study Objective

To identify clinical features associated with primary ovarian insufficiency (POI) and collect data on the evaluation and treatment received.

Association of Periodontal Disease and Pre-term Low Birth Weight Infants

The incidence of pre-term low birth weight still prevails in developed as well as developing countries though the numbers may vary. Periodontitis is a chronic inflammatory process with multifactorial etiology and adversely affects the outcome of pregnancy which becomes a major public health problem. The association of periodontitis as risk factor for pre-term birth has been in extensive research in the past two decades when a number of studies investigated this relationship. However, definite connection has not been proved yet and research is still ongoing. This article describes about the possible relationship that can exist between pre-term low birth weight infants and periodontal disease.     

580例低出生体质量儿的临床分析

目的:了解低出生体质量儿的发生率;低出生体质量儿发生的高危因素、并发症及其转归,探讨针对性的干预措施,减少低出生体质量儿的发生,降低死亡率。方法:对2009年及2010年二年内在本院出生的低出生体质量儿分二组对其病因、并发症及其转归情况进行汇总、分析及随访。结果:低出生体质量儿发生率为3.03%;其中小于胎龄儿占39.7%,早产儿占60.3%。早产低出生体重儿的前4位高危因素分别为胎膜早破、双胎、妊娠期高血压、母亲贫血。早产低出生体重儿的并发症主要是呼吸困难、病理性黄疸、感染和低血糖。足月小样儿组的前4位高危因素分别为孕期感染、阴道流血史、母亲贫血、双胎。足月小样儿组的并发症主要是感染、病理性黄疸。足月小样儿的转院率为3.9%。死亡率为0.4%,早产儿组的转院率达38.3%;死亡率达4%,明显高于足月小样儿组。结论:提高产检率,及时发现并治疗母亲原发病包括感染、高血压、贫血,尽快纠正缺氧等是减少低出生体质量儿的关键。足月小样儿和早产低出生体质量儿在并发症和转归方面有很大的不同,管理上要有不同侧重点来改善预后。     

超低出生体重儿八例临床分析

目的　探讨提高超低出生体重儿（ＥＬＢＷＩ）存活率、降低病残率的办法。　方法　８例ＥＬＢＷＩ平均胎龄２５．６±１．７周,平均体重（７６９±１１３）ｇ,均有一种或多种并发症,经产前胎内运转,产时积极复苏,重视护理、保暖及呼吸管理,积极防治并发症,保持液体、酸碱平衡及合理的静脉营养,防治感染,并早期干预。　结果　８例全部成活,平均住院（４６±１２）天,出院体重（２．１３±０．２４）ｋｇ。随访１年。３个月时智测４例异常,其中３例轻度脑发育不良;１岁时智测１例轻度异常,脑ＣＴ均正常。　结论　正确合理的救治,可提高ＥＬＢＷＩ的存活率,而早期干预,则可降低其病残率     

Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives

Study ObjectiveTo describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24).MethodsData collection occurred between June and December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At 6 of these sites, we conducted a total of 6 focus group discussions (FGDs) with facility staff and 48 in-depth interviews (IDIs) with facility clients ages 16-24.ResultsStaff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one-quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the “forgettable” nature of the methods and their duration were some of LARC's most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients.ConclusionIncorporating young women's perspectives on LARC methods into publicly funded family planning facilities' efforts to provide these methods to a younger population may increase their use among young women.