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

Thank you for your attention