Adolescent Pregnancy: A Concept Analysis

Authors

  • Atanga Vivian Manka’ah Ecole Supérieur de Santé-Université Catholique d’Afrique centrale-Yaoundé (ESS/UCAC)
  • Socpa Antoine Ecole Supérieur de Santé-Université Catholique d’Afrique centrale-Yaoundé (ESS/UCAC)
  • Mary Bi Suh Atanga Ecole Supérieur de Santé-Université Catholique d’Afrique centrale-Yaoundé (ESS/UCAC)
  • Ginyu Innocentia Kwalar Ecole Supérieur de Santé-Université Catholique d’Afrique centrale-Yaoundé (ESS/UCAC)

DOI:

https://doi.org/10.47672/ajhmn.2202

Keywords:

Concept, Analysis, Concept Analysis, Adolescent, Pregnancy, Adolescent Pregnancy

Abstract

Purpose: Adolescent pregnancy (ADOPREG), despite its serious public health & social concerns, are highly neglected worldwide especially in developing countries with restrictive abortion laws. While the concept of ADOPREG may have the same label across disciplines, locations & contexts, its representations and how it is lived vary greatly. Despite diverse representations, ADOPREG is still plagued with great debates and serious public health and socio-economic concerns including persistently high rates and associated consequences even lifetime. Thus this concept analysis of Adolescent pregnancy aimed at clarifying the meaning of the concept and develop an operational definition for it which is believed will lay a common ground for mutual understanding among stakeholders & ameliorate adolescent care.

Materials and Methods: The 8-stage concept analysis theoretical model of Walker and Avant (1994) was used for this work. There was a systematic search & selection of literature in 4 phases:broad preliminary search, Mesh controlled language, revision using Boolean Logic operators OR, “AND” and “Not”. Secondly, literature search on 9 electronic databases, then manual search & finally experts’ consultation. Study selection was done by a review process guided by PRISMA. Quality appraisal was then done for each selected study separately using appropriate standard tools. Totally, 4090 record were identified & 68 included in final study.

Findings: Key results revealed: ADOPREG has uses in Etymology, Literature; Health, Politics, & Sociology. As Attributes-prevalence, peripartum care, teenage friendly health centres, & role of health practitioner in reducing ADOPREG. As antecedents among others -biological factors (genes), demographic & socio-cultural factors (marital status,) & Health factors (contraception) ; non-constitutive family factors and socio-political factors.  Short-term consequences of among others include increased frequency of neonatal complications (LBW) & maternal complications (hemmorhage, abortion), & low rates of CS. Major long-term consequences are socio-economic (rejection); health (suicide) & political (taxpayers drain). Empirical referents-pregnancy rates etc. Conclusively, ADOPREG here is defined as a state in which there is the development of a human being in an individual aged 10-19 from time of conception; thus, aligning with the embryologic definition. However, the dynamic nature of this concept cannot be totally ignored.

Implications to Theory, Practice and Policy: More high quality concept analyses should be carried out on related issues to ADOPREG to better inform policy makers who should work collaboratively on better and operational definitions of adolescent pregnancy and its related issues.

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References

Abalkhail, B. A. (1995). "Adolescent pregnancy: Are there biological barriers for pregnancy outcomes?". The Journal of the Egyptian Public Health Association,70 (5–6), 609–625. PMID 17214178.

Atanga, V. M; Nkoum, A. B ; Doh, A. (2015). Quality of Parent-child communication on sexual and reproductive health: The case of Nkoldogo-Yaounde. Masters’ Thesis.

Agbor, V. N; Mbanga, C. M; &Tsi Njim (2017). Adolescent deliveries in rural Cameroon: an 8-year trend, prevalence, and adverse materno-foetal outcomes. Reproductive Health 14:122 DOI 10.1186/s12978-017-0382-6

Alemayehu T, Haider J, Habte D.(2010). Determinants of adolescent fertility in Ethiopia. Ethiopian J Health Dev, 24(1):30–8.

Ayele, B. G; Gebregzabher, T. G; Hailu, T. T; Assefa, B. A (2018). Determinants of teenage pregnancy in Degua Tembien District, Tigray, northern Ethiopia: a community based case control study. PLoS One, 13 (7):e0200898. https://doi.org/10.1371/journal.pone.0200898.

Azevedo, W. F; Diniz, M. B; Fonseca, E. S; Azevedo, L. M, & Evangelista, C. B. (2015). Complications in adolescent pregnancy: Systematic review of the literature. Einstein (Sao Paulo), 13 (4), 618–26. doi : 10.1590/S1679-45082015RW3127

American College of Obstetricians and Gnecologists (2013). Definition of Term pregnancy. Committee Opinion N° 579. Obstet Gynecol, 122, 1139-40.

Australian Human Rights Commission (2017). Children’s Rights Report 2017.

Beyene A, Muhiye A, Getachew Y, Hiruye A, Mariam DH, Derbew M, et al. Assessment of the magnitude of teenage pregnancy and its associated factors among teenage females visiting Assosa General Hospital. Ethiopian Med J, (Suppl 2), 25–37 Epub 2015/11/26.

BBC (2014). "Young mothers face stigma and abuse, say charities". BBC News.

Brownell, M. D; Chartier, M; Au W; Schultz, J. (2011). Program for expectant and new mothers: a population-based study of participation. BMC Public Health,11, 691.

Canadian Paediatric and Adolescent Gynaecology and Obstetricians (CANPAGO) committee (2015). SOCG Clinical Practice Guideline: Adolescent Pregnancy Guidelines.

Canadian Medical Protective Association (2010). Age of consent for sexual activity and duty to report. Ottawa (ON): CMPA. https://www.cmpa acpm.ca//age-of-consent-for-sexual-activityand-duty-to-report.

CDC (2015). "Few teens use the most effective types of birth control| CDC Online NewsroomCDC". www.cdc.gov.

Cherry, A. L; & Dillon, M. E. (2018). International Handbook of Adolescent Pregnancy: Medical, Psychosocial, and Public Health Responses. BJOG. 2010;117(10):1186-1196. 15. Health Volume ID 5784902. Springer. https://doi.org/10.1155/2018/5784902

Chin, H. B, Sipe, T. A; Elder, R; Mercer, S. L, Chattopadhyay, S. K, Jacob, V. (2012). The Effectiveness of Group-Based Comprehensive Risk-Reduction and Abstinence Education Interventions to Prevent or Reduce the Risk of Adolescent Pregnancy, Human Immunodeficiency Virus, and Sexually Transmitted Infections: Two Systematic Reviews for the Guide to Community Preventive Services. Am J Prev Med, 42(3), 272 –94 doi: https://doi.org/10.1016/j.amepre.2011.11.006.

Cooper, L. G; Leland, N. L; Alexander, G. (1995). Effect of maternal age on birth outcomes among young adolescents. Soc Biol, 42, 22-35.

Darroch et al (2016). Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. Guttmacher Institute.

Duncan, C., Cloutier, J., Bailey, P. (2007) Concept analysis: the importance of differentiating the ontological focus. Journal of Advanced Nursing. 58(3):293-300.

Durbin, C. G. (2006). Team model: advocating for the optimal method of care delivery in the intensive care unit. Critical care medicine. 2006;34(Supp 3):S12–7.

Eliason S, Baiden F, Yankey BA, Awusabo-Asare K. Determinants of unintended pregnancies in rural Ghana. BMC Pregnancy and Childbirth. 2014 Aug 8; 14:261. https://doi.org/10.1186/1471-2393-14- 261 PMID: 25104039

Essome, H; Eposse, E. C; Kedy, K. D.C; Egbe, O.T; Halle, E.G; Nana, N. T; Boten, M; Tocki, T. G; Penda, I. C; & Foumane P. (2020). Adolescent sexuality: practices and contraceptive problems in Douala. Obstetrics & Gynaecology International Journal,11(4). 267‒273.

Etymoline (2021). Etymology, Origin and Meaning of Pregnant By Etymoline. https://www.etymoline.com › word ›

Etymoline (2022). Definition of Pregnancy. Douglas Harper. Every Woman Every Child (2015). The Global Strategy For Women’s, Children’s And Adolescent’s Health (2016-2030).

Fleming, N, Ng N, Osborne C, Biederman S, Yasseen AS 3rd, Dy J, et al. (2013). Adolescent pregnancy outcomes in the province of Ontario: a cohort study. J Obstet Gynaecol Can, 35, 234–45.

Gasek, C. M. (2009). Conceiving “Pregnancy” U.S. Medical Dictionaries And Their Definitions Of “Conception” And “Pregnancy”. Family research council/ Washington.

Geraldine, M and Joyce. J, F. (2016). Nursing Concept Analysis: Applications to Research and Practice. DOI: 10.1891/9780826126825

Ghose, S and John, L. B. (2017). Adolescent pregnancy: an overview? Int J Reprod Contracept Obstet Gynecol, 6(10),4197-4203. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174393.

Gold, R. B. (2005). The Implications of Defining When a Woman Is Pregnant. Guttmacher Report on Public Policy 8:7.

Guilamo-Ramos, V, Bowman, A. S, Maria, M. D, Kabemba, F, Geronimo, Y.(2018). Addressing a critical gap in U.S. National Teen Pregnancy Prevention Programs: the acceptability and feasibility of father-based sexual and reproductive health interventions for Latino adolescent males. J Adolesc Health,62(3): S81 –S6. https://doi.org/10.1016/j.jadohealth.2017.08.015 .

Guttmacher Institute (2016). American Teens' Sexual and Reproductive Health. Guttmacher Institute.

Guttmacher Institute (2021). The implication of defining when a woman is pregnant. Guttmacher policy review,8, 2.

Heilborn, M. L., Branda˜o, E.R. and Da Silva, C. (2007). Teenage Pregnancy and Moral Panic In Brazil. Culture, Health & Sexuality 9 (4), 403–14

Hern, A. (2015). Is Broadband Responsible for Falling Teenage Pregnancy Rates? The Guardian.

Institute of Medicine (US) and National Research Council (US) Committee on the Science of Adolescence (2020). The science of adolescent risk-taking 2011. National Academies Press.

Izugbara C. (2015). Socio-demographic risk factors for unintended pregnancy among unmarried adolescent Nigerian girls. S Afr Fam Pract, 57(2), 121–5.

Jonas, K; Crutzen, R; Borne, B; & Reddy, P. (2017). Healthcare workers’ behaviours and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review. BMC Pregnancy and Childbirth, 17(86). DOI 10.1186/s12884-017-1268-x.

Jonas, K; Crutzen, R; Krumeich, a; Roman, N; Borne, B & Reddy, P. (2018). Healthcare workers’ beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study. BMC Health Services Research, 18,109. https://doi.org/10.1186/s12913-018-2917 0

Kassa et al. (2018). Prevalence and determinants of adolescent pregnancy in Africa: a systematic review and Meta-analysis. Reproductive Health, 15,195. https://doi.org/10.1186/s12978-018-0640-2.

Kassa, G. M; Arowojolu, A. O; Adukogbe, A. T and Yalew; A. W. (2021). Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLoS ONE 16(9): e0257485. https://doi.org/10.1371/journal.pone.025748

Khashan, A. S, Baker, P. N, Kenny, L. C. (2010). Preterm birth and reduced birthweight in first and second teenage pregnancies: A register-based cohort study. BMC Pregnancy Childbirth, 10,36. doi: 10.1186/1471-2393-10-36.

Kim, S. H; Kollak, I. (2006). Nursing Theories, conceptual and philosophical foundatations. 2nd ed. Springer publishing company, Inc.

Krugu, J. K, Mevissen, F. E.F, Prinsen, A, Ruiter, R. A.C. (2016). Who’s that girl? A qualitative analysis of adolescent girls’ views on factors associated with teenage pregnancies in Bolgatanga, Ghana. Reprod Health, 13(1), 39. https://doi.org/10.1186/s129780160161-9.

Kupoluyi, J. A, Njoku, E. O, Oyinloye , B. O. (2013). Factors associate with teenage pregnancy and childbearing in Nigeria.

Logsdon, M. C; Foltz, M. P, Stein ,B; Usui, W, Josephson, A. (2010). Adapting and testing telephone-based depression care management intervention for adolescent mothers. Arch Womens Ment Health, 13, 307–17.

Loaiza, E; Liang, M. (1999). Adolescent pregnancy: a review of the evidence.

Loto, O.M; Ezechi, O. C; Kalu, B.K; Loto, A; Ezechi, L; Ogunniyi, S.O. (2004). Poor Obstetric Performance of Teenagers: Is It Age- or Quality of Care-Related? Journal of Obstetrics&Gynaecology, 24(4),398.doi:10.1080/01443610410001685529.

Madigan, S, Wade, M, Tarabulsy, G, Jenkins, J. M, Shouldice, M. (2014). Association between abuse history and adolescent pregnancy: A meta-analysis. J Adolesc Health, 55(2),151–59. doi: 10.1016/j. jadohealth.2014.05.002.

Makinson, C. (1985). The Health Consequences Of Teenage Fertility. Family PlanningM Perspectives, 17(3), 132–139. doi:10.2307/2135024. JSTOR 2135024.

Malek, K. A; Abdul-Razak, S; Hassan, H. A; & Othman,S. (2019). Managing adolescent pregnancy: The unique roles and challenges of private general practitioners in Malaysia. Malays Fam Physician, 14, (3), 37–45.

Mann, L; Bateson, D; Black, K.I. (2020). Teenage pregnancy. The Royal Australian College of General Practitioners.

Marvin-Dowle, K; Burley, V. J, Soltani, H. (2016). Nutrient intakes and nutritional biomarkers in pregnant adolescents: A systematic review of studies in developed countries. BMC Pregnancy Childbirth,16, 268. doi: 10.1186/s12884-016-1059-9.

Mathewos ; M and Mekuria ; A. (2018). Teenage Pregnancy and Its Associated Factors among School Adolescents of Arba Minch Town, Southern Ethiopia. Ethiop J Health Sci, 28(3), 287–298. doi: 10.4314/ejhs.v28i3.6

Merrick ,T. (2015). Making the case for investing in adolescent reproductive health: a review of evidence and PopPov research contributions. Population and Poverty Research Institute and Population Reference Bureau; 2015.

McKenna H. Building theory through concept annalysis. UK: Nursing theories and models Taylor & Francis e-Library; 1997. pp. 55–84.

Mayor, S. (2004). Pregnancy And Childbirth Are Leading Causes Of Death In Teenage Girls In Developing Countries. BMJ, 328 (7449), 1152. doi:10.1136/bmj.328.7449.1152-a.

Medcine net (2021). Medical Definition of Pregnancy.

Mekonnen et al (2019). Maternal health service utilisation of adolescent women in sub Saharan Africa: a systematic scoping review. BMC Pregnancy and Childbirth, 19, 366. https://doi.org/10.1186/s12884-019-2501-6.

Moore, K. L and Persaud, T.V.N. (2008). The Developing Human: Clinically Oriented Embryology. 8th ed. SAGE.

Medicnet (2021). Medical Definition of pregnant.

Montgomery, H.(2009). An Introduction To Childhood: Anthropological Perspectives On Children’s Lives. West Sussex :Wiley-Blackwell.

Moore, K. L; and Persaud, T.V.N. (2007). The Developing Human: Clinically Oriented Embryology. 7th ed.

Ngowa, K. D. J; Neng, H. T; Domgue, J. F ; Nsahlai, C. J ;& Kasia, J.M. (2015). Voluntary induced abortion in Cameroon; prevalence: prevalence, Reasons and Complications. Open Journal of Obstetrics and Gynecology,05(09), ID:59089,5 pages 10.4236/ojog.2015.59069

Njim et al (2020). Prevalence of adolescent deliveries and its complications in Cameroon: a systematic review and meta-analysis. Archives of Public Health,78, 24 https://doi.org/10.1186/s13690-020-00406-1

Nkoum, B. A. (2019). Initiation à la Recherche : Une Nécessité Professionnelle. (6th ed). Press de l’ UCAC.

Norton, M; Chandra-Mouli, V, Lane, C. (2017). Interventions for preventing unintended, rapid repeat pregnancy among adolescents: A review of the evidence and lessons from high-quality evaluations. Glob Health Sci Pract, 5(4), 547–70. doi: 10.9745/GHSP D 17-00131.

Obrowski, S; Obrowski, M; Starski, K. (2016). Normal Pregnancy: A Clinical Review. Acad J PedNeonatol,1(1),555554. DOI: 10.19080/AJPN.2016.01.55555

Oxford Advanced American Dictionary (2022). Definition Of Pregnancy Noun. Oxford University press.

Oxford Learner’s dictionary (2022). Definition Of Pregnancy Noun. Oxford University press.

Patton, G.C; Sawyer, S. M; Santelli, J. S; Ross, D.A et al. (2016). Our Future: the Lancet Commission on Adolescent Health and Wellbeing. Lancet, 387, 2423–78.

Pradhan, R; Wynter, K, Fisher, J. (2015). Factors associated with pregnancy among adolescents in low-income and lower middle-income countries: a systematic review. J Epidemiol Community Health.69(9), 918.

Ramraj T, Jackson D, Dinh T, Olorunju S, Lombard C, Sherman G, et al (2018). Adolescent access to care and risk of early mother-to-child HIV transmission. J Adolesc Health. 62:434–43.

Reid, V, Meadows-Oliver, M. (2007). Postpartum depression in adolescent mothers: An integrative review of the literature. J Pediatr Health Care, 21(5), 289–98. doi: 10.1016/j. pedhc.2006.05.010.

Risjord, M. (2009) Rethinking concept analysis. Journal of Advanced Nursing. 65(3):684-691.

Rodgers, B. (2000). Concept Analysis: An Evolutionary View. In Rodgers, B., Knafl, K. (eds.) Concept Development in Nursing: Foundations, Techniques and Applications. 2nd ed. WB Saunders, Philadelphia: (77-102)

Sawyer S, Afifi RA, Bearinger LH, Blakemore S-J, et al. Adolescence: a Foundation for Future Health. Lancet Series on Adolescent Health 1. Lancet 2012; 379:1630-40.

Sax, L (2010). Being and becoming a body: moral implications of teenage pregnancy in a shantytown in Porto Alegre, Brazil, Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 12(3),323-334, DOI: 10.1080/13691050903342196

Siemieniuk, R and Guyatt, G. (2020). BMJ best practice: What is GRADE? BMJ Publishing Group Limited.

Sheehan et al. (2017). Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents. Lancet, 390, 1792–806.

Sherris, J; Bingham A, Burns MA, Girvin S, Westley E, Gomez PI. Misoprostol use in developing countries: results from a multicountry study. Int J Gynecol Obstet, 88(1):76 –81. https://doi.org/10.1016/j.ijgo.2004.09.006 .

Socpa, A & de Koning, K. (2018). Needs Assessment on Safe Abortion Advocacy : for the Society of Obstetricians and Gynecologist in Cameroon (SOGOC). Cameroon Country Report. Kit Royal Tropical Institute.

Sungwe, C. (2015). Factors associated with teenage pregnancy in Zambia. University of Zambia.

Stepp, G. (2009) Teen Pregnancy: The Tangled Web. vision.org

Tamambang, R. F; Njim, T; Njie, A. E; Mbuagbaw, L; Mafuta, A; Tchana, M; & Choukem, S (2018). Adolescent deliveries in urban Cameroon: a retrospective analysis of the prevalence, 6-year trend and adverse outcomes. BMC Research Notes,11, (469)

Trude, L. (2000). New Fertility Trends In Norway. Demographic Research. 2. doi:10.4054/DemRes.2000.2.3. JSTOR 26348001.

Tebeu, P. M; Tantchou, J, Abena, O. M. T; Onala, M. D, Leke, R. J. I. (2006). Delivery outcome of adolescents in far North Cameroon. Revue Medicale De Liege. 61(2):124–7

Tebeu, P.M., Belinga, E., Hall. E. G-E; Mossiang, L., Ekono, M.R; & Mbu, E. R. (2017).

Teenage Pregnancy Outcomes in Teaching Hospitals in Yaoundé. International Journal of Current Advanced Research, 6 (4), 3206-3208. http://dx.doi.org/10.24327/ijcar.2017. 3208.0226.

Tyndall, J. (2010). AACODS Checklist. Flinders University. http://dspace.flinders.edu.au/dspace/

Tyndall, J. (2013). Grey Literature for Health, a vital resource. Flinders University. Motherhood in childhood. Facing the challenge of adolescent pregnancy estimate of the world population report. UNFPA.

UN DESA (2017), Statistics Division. Sustainable Development Goals Indicators. Global Database.

UN IGME (2015). Levels And Trends In Child Mortality. UNICEF, WHO, World Bank and United Nations. UNESCO (2018). International Technical Guidance On Sexuality Education: An Evidence Informed Approach. UNESCO. ISBN 978-92-3-100259-5.

UNFPA (2022). Adolescent Pregnancy.

UNICEF (2019). Child And Adolescent Health And Wellbeing. UNICEF.

UNFPA (2015). Girlhood not motherhood: preventing adolescent pregnancy.

United Nations Population Fund (2013). Adolescent pregnancy: a review of the evidence. US Department of Health and Human Services. 2007. Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy And Parenthood.

UNFPA (2013). Adolescent Pregnancy.

UNICEF (2013). Ending Child Marriage: Progress and Prospects.

UNICEF-SOWC (2017); WHO Global health estimates 2015, (2016); 1991-2016 DHS;

UNDESA, Population Division. WPP (2017); The joint mission from UNICEF and WHO Africa Regional Office, (2017); WHO Global health observatory (2018); The World Bank (2018). Adolescent Health in Cameroon: Coubtry Peofile. WHO regional office for Africa.

Viner, R.M; Mathers, C; Bloem, P; Costello, A et al (2011). 50-Year Mortality Trends In Children And Young People: A Study Of 50 Low Income, Middle-Income, And High-Income Countries. Lancet, 377,1173.

Vivancos, R; Abubakar, I, Phillips-Howard, P, Hunter, P. R. (2013). School-based sex education is associated with reduced risky sexual behaviour and sexually transmitted infections in young adults. Public Health, 127(1):53 –7 doi:https://doi.org/10.1016/j.puhe.2012.09.016 .

Walker, L.O; Avant, K. C. Strategies for Theory Construction in Nursing . USA: Pearson/Prentice Hall; 2005.

WHO (2019). Preventing unsafe abortion.

WHO (2018). Adolescent pregnancy. World Health Organization. WHO.

WHO (2017). Global Accelerated Action for the Health of Adolescents (AAHA!). Guidance to Support Country Implementation. http://apps.who.int/iris/ bitstream/hand le/10665/255415/9789241512343-eng. pdf;jsessionid=1BC7566D91C86EA0B3 BBE835B92DD.

WHO (2016). Adolescent pregnancy.

WHO (2011). Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries.

WHO (2004). Adolescent Pregnancy . World Health Organization. 2004. ISBN 9789241591454.

WHO and hrp (2014). Adolescent pregnancy.

Wilson, J. (1971). Thinking with concepts. Cambridge: University Press.

Yakubu, I; Salisu, W. J. (2018). Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 15(1), 15. https://doi.org/10.1186/s129780180460-4.

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Published

2024-07-12

How to Cite

Manka’ah, A. V., Antoine, S., Atanga, M. B. S., & Kwalar, G. I. (2024). Adolescent Pregnancy: A Concept Analysis. American Journal of Health, Medicine and Nursing Practice, 10(4), 35–61. https://doi.org/10.47672/ajhmn.2202

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