Factors influencing repeated teenage pregnancy: a review and meta-analysis

Maravilla, Joemer C., Betts, Kim S., Couto e Cruz, Camila and Alati, Rosa (2017) Factors influencing repeated teenage pregnancy: a review and meta-analysis. American Journal of Obstetrics & Gynecology, 217 5: 527-+. doi:10.1016/j.ajog.2017.04.021

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Author Maravilla, Joemer C.
Betts, Kim S.
Couto e Cruz, Camila
Alati, Rosa
Title Factors influencing repeated teenage pregnancy: a review and meta-analysis
Journal name American Journal of Obstetrics & Gynecology   Check publisher's open access policy
ISSN 1097-6868
0002-9378
Publication date 2017-04-19
Year available 2017
Sub-type Article (original research)
DOI 10.1016/j.ajog.2017.04.021
Open Access Status Not yet assessed
Volume 217
Issue 5
Start page 527
End page +
Total pages 19
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Subject 2729 Obstetrics and Gynaecology
Abstract OBJECTIVE: Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus.
Formatted abstract
Objective: Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus.

Data Sources: We used PubMed, EMBASE, CINAHL, ProQuest, PsychINFO, ScienceDirect, Scopus, and Web of Science databases from 1997-2015 and the reference list of other relevant research papers and related reviews.

Study Eligibility Criteria: Eligibility criteria included (1) epidemiologic studies that analyzed factors associated with repeated pregnancy or birth among adolescents <20 years of age who were nulliparous or experienced at least 1 pregnancy, and (2) experimental studies with an observational component that was adjusted for the intervention.

Study Appraisal and Synthesis Methods: We performed narrative synthesis of study characteristics, participant characteristics, study results, and quality assessment. We also conducted random-effects and quality-effects metaanalyses with meta-regression to obtain pooled odds ratios of identified factors and to determine sources of between-study heterogeneity.

Results: Twenty-six eligible epidemiologic studies, most from the United States (n=24), showed >47 factors with no evidence of publication bias for each metaanalysis. Use of contraception (pooled odds ratio, 0.60; 95% confidence interval, 0.35-1.02), particularly long-acting reversible contraceptives (pooled odds ratio, 0.19; 95% confidence interval, 0.08-0.45), considerably reduced repeated teenage pregnancy risk. Among studies about contraception, the number of follow-up visits (adjusted coefficient, 0.72; P=.102) and country of study (unadjusted coefficient, 2.57; permuted P=.071) explained between-study heterogeneity. Education-related factors, which included higher level of education (pooled odds ratio, 0.74; 95% confidence interval, 0.60-0.91) and school continuation (pooled odds ratio, 0.53; 95% confidence interval, 0.33-0.84), were found to be protective. Conversely, depression (pooled odds ratio, 1.46; 95% confidence interval, 1.14-1.87), history of abortion (pooled odds ratio, 1.66; 95% confidence interval, 1.08-2.54), and relationship factors, such as partner support, increased the repeated teenage pregnancy risk.

Conclusion: Contraceptive use, educational factors, depression, and a history of abortion are the highly influential predictors of repeated teenage pregnancy. However, there is a lack of epidemiologic studies in low- and middle-income countries to measure the extent and characteristics of repeated teenage pregnancy across more varied settings.
Keyword Adolescent
Factor
Metaanalysis
Repeated teenage pregnancy
Review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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