An Evaluation of Sociodemographic Characteristics and Pregnancy-Related Psychological Problems in Pregnant Adolescents

Abstract

Objectives: Pregnancy in adolescence may involve more psychological problems and socioeconomic difficulties compared to pregnancies in adulthood. The purpose of this study was to identify socioeconomic characteristics and psychological problems that may give rise to such difficulties.
Materials and Methods: This case-control study was performed with pregnant women presented to the Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital Gynecology and Obstetrics Department. The study group consisted of 85 pregnant adolescents aged 13-19 and the control group consisted of 50 pregnant adults aged 20 or over. Subjects were evaluated by face-to-face interviews using an information form prepared by specialist psychiatrists.
Results: The study group and their partners had lower levels of education compared to the control group. The members of the study group had more siblings than the control group. Adolescent pregnants were found to be as ready for motherhood as adults and desire to become pregnant as much as adult pregnants. There was no significant difference between the control group and the study group in terms of suicidal ideation and suicide attempt. The study group described no increase in psychological problems and difficulties during pregnancy. Indeed, periods of intense unease and distress during pregnancy were significantly less than the control group. 
Conclusion: Adolescent pregnancies are affected by large families and lower levels of education. Contrary to expectation, pregnant adolescents in Turkey reported no greater incidence of psychological problems. This may be due to a sociocultural perception of the functional value of motherhood in the country and to a positive attitude towards adolescent pregnancies. 

Keywords

• Adolescent pregnancy,risk factors,family characteristics,education

Gebe Adölesanlarda Sosyodemografik Özelliklerin ve Gebelikle İlgili Ruhsal Sorunların Değerlendirilmesi

Öz

Amaç: Adölesan dönemde yaşanan gebelik yetişkinlik dönemi gebeliklerine oranla daha çok ruhsal soruna ve sosyoekonomik zorluklara sahip olabilir. Çalışmamızın amacı, gebe adölesanlarda bu sorunlara neden olabilecek sosyodemografik özellikleri ve ruhsal sorunları tanımlamaktır.

Materyal ve Metot: Çalışmamız İstanbul Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’ne başvurmuş gebeliğe sahip hastalar ile yürütülen vaka-kontrol çalışmasıdır. Çalışma grubu 13-19 yaş aralığında gebeliğine sahip 85 adölesan gebeden, kontrol grubu 20 yaş ve üzeri gebeliğe sahip 50 yetişkin gebeden oluşmaktadır. Katılımcılar psikiyatri uzmanları tarafından hazırlanmış bilgi formu ile karşılıklı görüşmeler yapılarak değerlendirilmiştir.

Bulgular: Çalışma grubunun ve eşlerinin kontrol grubuna kıyasla daha düşük eğitim düzeyine sahip olduğu görüldü. Çalışma grubunun kontrol grubundan daha fazla sayıda kardeşe sahip olduğu saptandı. Adölesan gebelerin kendilerini erişkin gebeler kadar anneliğe hazır hissettikleri ve erişkin gebeler kadar gebeliği arzu ettikleri saptandı. Kontrol grubu ile çalışma grubu arasında intihar düşüncesi ve intihar girişimi açısından anlamlı fark saptanmadı. Çalışma grubunda gebelik dönemi ruhsal sorun ve sıkıntı tanımlarında artma olmadığı, hatta gebelikte yoğun sıkıntı ve bunaltı hissedilen dönemlerin kontrol grubundan anlamlı düşük olduğu görüldü.

Sonuç: Adölesan dönemi gebelikleri kalabalık aileler ve düşük eğitim seviyesi durumundan etkilenir. Beklenenin aksine adölesan gebelerde ruhsal sorun tanımının daha yüksek olmadığı görüldü. Bu durum, sosyo-kültürel olarak anne olmanın işlevsel değerli algılanmasıyla, ergen gebeliklere olumlu yaklaşımla ilişkili olabilir

Anahtar Kelimeler

• Adölesan gebelik,risk faktörleri,aile özellikleri,eğitim

References

1. Onur B. Theories of Adolescent Psychology. Ankara University Journal of Faculty of Educational Sciences 1994;27:875-904 (in Turkish).
2. Wills TA, Knight R. Adolescent Health and Health Behaviors. In: International Encyclopedia of the Social & Behavioral Sciences (Second Edition), (eds Wright JD). Oxford: Elsevier; 2015:121-7.
3. Richter M. Risk Behavior in Adolescence: Patterns, Determinants and Consequences. Wiesbaden, VS Verlag: Springer Science & Business Media; 2010.
4. World Health Organization, Adolescent health research priorities: report of a technical consultation, WHO reference number: WHO/FWC/MCA/15/07.
5. http://www.who.int/maternal_child_adolescent/topics/en/. Date of Access: Apr 3, 2017. Kuzma EK, Peters RM. Adolescent vulnerability, sexual health, and the NP's role in health advocacy. J Am Assoc Nurse Pract 2016;28:353-61.
6. Özdemir Y, Çok F. Autonomy Development in Adolescence. TPCGJ 2011;4:152-64 (in Turkish). Kütük S. Pregnancy in adolescents, risks and problems. The Turkish Journal of Family Practice 2012;16:31-4 (in Turkish).
7. Martin JA, Hamilton BE, Ventura SJ et al. Births: final data for 2009. Natl Vital Stat Rep 2011;60:1-70.
8. Hacettepe University Institute of Population Studies “2013 Turkey Demographic and Health Survey”,2014. http://www.hips.hacettepe.edu.tr/eng/TDHS_2013_main.report.pdf. Date of Access: Apr 3,2017.

9. Sayem AM, Nury AT. Factors associated with teenage marital pregnancy among Bangladeshi women. Reprod Health 2011;20(8):16, doi: 10.1186/1742-4755-8-16.
10. Lara LA, Abdo CH. Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls. J Pediatr Adolesc Gynecol 2016;29:417-23.
11. Wilson-Mitchell K, Bennett J, Stennett R. Psychological health and life experiences of pregnant adolescent mothers in Jamaica. Int J Environ Res Public Health 2014;11:4729-44.
12. Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HM. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol 2010;23:16-22.
13. Huang CC, Lin YC, Huang YT, Huang KH. Comparison of medical issues in antenatal and perinatal periods in early youth, adolescent, and young adult mothers in Taiwan: a 10-year nationwide study. BMC Pregnancy Childbirth. 2014;14:260, http://doi.org/10.1186/1471-2393-14-260.
14. Killoren SE, Zeiders KH, Updegraff KA, Umaña-Taylor AJ. The Sociocultural Context of Mexican-Origin Pregnant Adolescents' Attitudes Toward Teen Pregnancy and Links to Future Outcomes. J Youth Adolesc 2016;45:887-99. Mchunu G, Peltzer K, Tutshana B, Seutlwadi L. Adolescent pregnancy and associated factors in South African youth. Afr Health Sci 2012;12:426-34.
15. Capanzana MV, Aguila DV, Javier CA, Mendoza TS, Santos-Abalos VM. Adolescent Pregnancy and the First 1000 Days (the Philippine Situation). Asia Pac J Clin Nutr 2015;24759-66.
16. Duflo E, Dupas P, Kremer M. Education, HIV, and Early Fertility: Experimental Evidence from Kenya. Am Econ Rev. 2015;105:2757-97.
17. Beattie TS, Bhattacharjee P, Isac S, et al. Supporting adolescent girls to stay in school, reduce child marriage and reduce entry into sex work as HIV risk prevention in north Karnataka, India: protocol for a cluster randomised controlled trial. BMC Public Health 2015;15:292, doi: 10.1186/s12889-015-1623-7.
18. Sipsma HL, Ickovics JR, Lewis JB, Ethier KA, Kershaw TS. Adolescent pregnancy desire and pregnancy incidence. Womens Health Issues 2011;21:110-6.
19. Suciu LM, Pasc AL, Cucerea M, Bell EF. Teenage Pregnancies: Risk Factors and Associated Neonatal Outcomes in an Eastern-European Academic Perinatal Care Center. Am J Perinatol 2016;33:409-14.
20. Freitas GV, Botega NJ. Prevalence of depression, anxiety and suicide ideation in pregnant adolescents. Rev Assoc Med Bras 2002;48:245-9 (in Portuguese).
21. Noll JG, Shenk CE, Putnam KT. Childhood sexual abuse and adolescent pregnancy: a meta-analytic update. J Pediatr Psychol 2009;34:366-78.
22. Parra-Pingel PE, Quisiguiña-Avellán LA, Hidalgo L, Chedraui P, Pérez-López FR Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia. Adolesc Health Med Ther 2017;8:81-6.
23. Njim T, Agbor VN. Adolescent deliveries in semi-urban Cameroon: prevalence and adverse neonatal outcomes. BMC Res Notes 2017;10(1):227, doi: 10.1186/s13104-017-2555-3.
24. Hillis SD, Anda RF, Dube SR, et al. The Protective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences. Perm J 2010;14:18-27.
25. Tunç Aİ. Reasons why not go to scholl for girls Van sample. Journal of Yüzüncü Yıl University Faculty of Education .2009;6(1):237-69 (in Turkish).
26. Kaptanoğlu İY, Ergöçmen B. Factors that pave the way for becoming a child bride, Sociological Association, Turkey, Journal of Sociological Research 2012;20:128-61 (in Turkish).
27. Kershaw T, Murphy A, Divney A, Magriples U, Niccolai L, Gordon D. What’s Love Got to Do with It: Relationship Functioning and Mental and Physical Quality of Life Among Pregnant Adolescent Couples. Am J Community Psychol 2013;52:288-301.
28. Özdemir O, Özdemir PG, Kadak MT, Nasıroğlu S. Personality Development, Current Approaches in Psychiatry 2012;4:566-89 (in Turkish).
29. Uysal R, Bingöl TY. Examining adolescents' risk taking behavior in terms of self efficacy and other variables, ASOS Journal 2014;8:573-582 (in Turkish).
30. Suh EY, Ma P, Dunaway LF, Theall KP. Pregnancy Intention and Post-partum Depressive Affect in Louisiana Pregnancy Risk Assessment Monitoring System. Matern Child Health J 2016;20:1001-13.
31. Brahmbhatt H, Kågesten A, Emerson M, et al. Prevalence and determinants of adolescent pregnancy in urban disadvantaged settings across five cities. J Adolesc Health 2014;55:48-57.