outcomes of caring teenage mothers and their infants...
TRANSCRIPT
Outcomes of caring teenage mothers and their infants in young
family clinic
Supinya In-iw, M.D. Faculty of Medicine, Siriraj Hospital, Mahidol University
Background
• Teen birth rates were approximately 14 million worldwide
• More than 90% were in developing countries
Health information unit,Bureau of Health policy and Strategy, Thailand
Background
• It was accounted for 58.3 per 1,000 adolescent pregnant aged 15-19-year-olds which was very high compared to other countries in Southeast Asia
• Approximately 50% of all pregnancies were not planned, and more than 90% of teenage pregnancies were unplanned
Background
• The negative health consequences of adolescent pregnancy were anemia, preterm deliveries, very low birth weight infants, and postpartum complications
• The adverse outcomes of teenage mothers were low income, less academic achievement, and unemployment
Background
• Risk factors for repeated pregnancy were associated with dropping out of school, staying at home as a parental role, and receiving child care assistance from grandmothers
• Children born to adolescent girls increased risks of infant mortality, congenital anomalies, and child maltreatment
Background
• The aim of services was to prevent subsequent pregnancy, promote child-rearing, and prevent child maltreatment
Background
• Continuity care for teenage mothers and their children (Young family clinic :YFC) was established in Siriraj Hospital in 2010
• It is a hospital-based clinic as an one-stop service
Continuity care (YFC)
Obstetric care
Health care providers
A health educator Social workers
Background
• The services in YFC include
– Health education sessions from the health educator (eg. condom use, contraception, child-rearing, and risk reduction counselling)
– Home visit (teenage mothers who were lost to follow-up)
– Providing non-formal education program resources by social workers
– Developmental screening
Objectives
Primary objective
– to evaluate the outcomes of teenage mothers and their children
Secondary objective
– to assess behaviors of teenage mothers after childbirth
Methods
• Design
– Retrospective cohort study by a chart review after approving by the Ethics Committee of the Faculty of Medicine, Siriraj Hospital, Mahidol University
• Participants
– Teenage mothers and their children who were followed-up regularly in YFC at least two-year follow-up
Methods
• Procedure – All data were collected from medical health records
including • Subsequent pregnancy
• Types of contraception
• Education or employment status
• Parenting skills
• Depression
• Risky behaviors
• Children’s growth and development
• Duration of breastfeeding
• Child maltreatment
Methods
• 54 teenage mothers and their children who were followed-up in YFC at least two years were included through a chart review
• Outcome measurements were repeated pregnancy, types of contraception, depression, parenting skills, child development and maltreatment
• A descriptive analysis by SPSS version 18 (Chicago, IL)
Results
• Table 1 Demographic data
Mean SD
Age (years) 17.5 ± 1.8
Gestational age at first antenatal care
(weeks)
20.9 ± 6.6
Gestational age at delivery
(weeks)
Term
Preterm
38.92 ± 1.1
35.5 ± 1.7
Birth weight (g) Term
Preterm
3075 ± 361
2358 ± 463
Results
Table 1 Demographic data 32
N (%)
Education
Primary school
Secondary school
University
19 (35.2)
34 (63)
1 (1.8)
Substance use during
pregnancy
Alcohol
Smoking
Illicit drug
2 (3.7)
5 (9.3)
12 (22)
Illicit drug Amphetamine
Marijuana
Others
9 (75)
1 (8.4)
2 (16.6)
Antenatal care Yes 49 (90.7)
Maternal outcomes N (%)
Subsequent pregnancy in two-year follow-up 0 Pap smear at 6 weeks postpartum care 100
Depression 0
Contraceptive use after delivery 49 (90.7)
Types of contraception LARC
Others
48 (88.6)
6 (11.4)
Status after delivery Return to school
Unemployment
7 (13)
47 (87)
Alcohol consumption
Smoking
Amphetamine use
0 (100)
4 (7.4)
0 (100)
Breast feeding at least 4 months 35 (65.2)
Results
Results
Children’s outcomes N (%)
Male gender 32 (60.4)
Congenital anomalies 3 (5.7)
Normal growth parameter 46 (86.7)
Suspected delay
developmental milestones
6 (11.3)
Denver screening test 23 (42.6)
Immunization 100
Child maltreatment 0 (100)
Discussion
• The outcomes of teenage mothers and their children was excellent because of the quality of service care and multidisciplinary team
• The percentage of employed teenage mothers remained low and only a few of them returned to school
Conclusions
• Outcomes of our young family clinic showed a good quality of comprehensive health care service for teenage mothers and their children
• Promoting this hospital-based clinic should be provided to prevent negative consequences of adolescent mothers and her children