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  • Title: [Maternity in adolescents at high social risk].
    Author: Nebot M, Rohlfs I, Díez E, Valero C.
    Journal: Aten Primaria; 1993 Mar 31; 11(5):213-4, 216-7. PubMed ID: 8471701.
    Abstract:
    OBJECTIVE: To analyse for the 1987-1990 period the indicators of prenatal care and the social-health follow-up of adolescent girls included in the mother-child programme of Ciutat Vella (Barcelona). This programme was aimed at pregnant women resident in the district and with high social risk profiles. DESIGN: Descriptive and retrospective study. MEASUREMENTS AND MAIN RESULTS: 175 adolescent mothers were included in the programme during the period under study. This represented 82.9% coverage of all births in the district to this age group. In 10.9% of cases the mother stated she lived alone. 10.2% had had a previous child. There were drug addiction antecedents in 5% of the mothers. The first prenatal check took place during the first three months only in 56% of the pregnancies, with the proportion of low weight births (LWB: weight at birth below 2,500 grams) at 13.1%. During the period under study the proportion of pregnant women checked in the first three months went up from 45.6% to 62.5%, while the proportion of LWB's went down from 19.3% to 6.3%. CONCLUSIONS: There has been both a striking improvement in the indicators of prenatal care and less low weight births during the first four years of this programme. It is worth noting the worrying fact that one third of pregnant adolescents do not attend for a prenatal check-up before three months of their pregnancy have elapsed. Trends are analyzed for 1987-90 in indicators of prenatal care and follow-up of adolescents in the maternal-child health program of Ciutat Vella, a low-income district of Barcelona. The maternal-child health program was established in 1986 to prevent unwanted pregnancies and make prenatal and postnatal care more accessible for residents of the district who were deemed to be at high social risk. Records for 175 adolescents served by the program during the 4 study years were examined. 56.6% stated that the pregnancy was unplanned and only 28% that it was planned. The duration of pregnancy was under 37 weeks in 8.6% and over 42 weeks in 1.7%. The first prenatal consultation took place in the first trimester for 56.6%, in the second trimester for 22.9%, and in the third trimester for 9.1%. 88% of deliveries took place in 2 public facilities. A significant proportion of the adolescent mothers presented social risk factors. Of the 175 adolescents, 4 were prostitutes, 9 had histories of treatment for alcohol or heroin use, 19 had no partner, 6 lived alone, and 18 had older children. Prostitution, history of treatment for addiction, and lack of a partner were associated with increased risk for low birth weight, although statistical significance was marginal. Over the course of the 4 study years, the proportion of low birth weight infants declined from 19.3% to 6.3% and the proportion of mothers seeking care in the first trimester increased from 45.6% to 62.5%. The proportion of adolescents with social risk factors remained stable at around 25%. The fact that the study was descriptive and lacked a control group and the method of data collection through semistructured questionnaires constitute limitations on the generalizability of the findings.
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