https://orcid.org/0000-0002-5890-3574
Abstract
Background
Adolescent pregnancy is a public health concern worldwide, particularly in low-income settings. Adolescent mothers face higher risks during pregnancy and delivery compared to adult mothers and yet, may also experience worse quality of obstetrical care. This study evaluates adherence to meeting Brazilian recommendations for prenatal care by comparing first-time adolescent versus adult mothers in a rural, low-income setting.
Methods
Using data from the Adolescence and Motherhood Research (AMOR) project, we evaluated adherence to national recommendations as documented in the prenatal cards of 39 adolescents (13–18 years) and 37 adults (23–28 years) from a low-income area in northeast Brazil. Recommendations included ≥6 prenatal consultations, gestational age ≤12 weeks at the first visit, participation in 3 educational activities, 2 serology for syphilis (VDRL) and HIV, 1 Toxoplasmosis serology, 2 urine tests, 2 blood glucose and 2 hemoglobin/hematocrit (Hb/Ht) exams. Chi-square tests were used to compare the proportions of adolescents and adults with a record of these procedures in the prenatal cards.
Results
Compared to adult women, the adolescent group had lower attainment of almost all recommended components of prenatal care compared to the adult group, with statistically significant differences for 2 blood glucose tests (46.2% vs 78.4%; p=0.004), 2 VDRL tests (30.8% vs 54.1%; p=0.040), 2 Hb/Ht exams (35.9% vs 83.8%; p<0.001), and at least 6 consultations (84.6% vs 100%; p=0.013).
Conclusion
Despite greater health risks of adolescent fertility, the prenatal cards of adolescent mothers presented a poorer record of adherence to recommendations for adequate prenatal care compared to adult mothers from a low-income setting of Brazil. Health policies for both health professionals and the target population are needed to ensure adequacy of prenatal care and appropriate risk reduction for this vulnerable population.
Abbreviations
AMOR, Adolescence and Motherhood Research; CI, confidence interval; Hb/Ht, hemoglobin and hematocrit; HBsAg, hepatitis B surface antigen; HIV, human immunodeficiency virus; IgM, immunoglobulin M; PAHO, Pan American Health Organization; VDRL, Venereal Disease Research Laboratory.
Data Sharing Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics Approval and Consent to Participate
This study was conducted in accordance with the Declaration of Helsinki. The project was approved by the local Ethical Committee of the Faculty of Health Sciences of Trairi (CEP-FACISA) and the National Commission for Research Ethics (CONEP), approval number 1.902.815. All adult participants and legal guardians of the adolescent participants provided written consent for participation on this study. Moreover, all adolescent participants provided written assent to participate, according to ethical principles.
Acknowledgments
The authors would like to thank Juliana Barbosa, MSc, Sarah Hipp, MPH, and Sabrina Fernandes, MSc, for their assistance in the activities of this project. We would like also to thank the Graduate School of the Federal University of Rio Grande do Norte for their valuable support.
Disclosure
Dr Catherine M Pirkle reports grants from Fogarty International Center, during the conduct of the study. Dr Saionara MA Câmara reports grants from Fogarty International Center, National Institutes of Health, during the conduct of the study. The authors declare that they have no other potential conflicts of interest for this work.