Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women

Simple item page
dc.contributor.authorChristofides, N.J
dc.contributor.authorJewkes, R.K
dc.contributor.authorDunkle, K.L
dc.contributor.authoret al
dc.date.accessioned2016-02-15T12:28:51Z
dc.date.available2016-02-15T12:28:51Z
dc.date.issued2014
dc.departmentEpidemiology and Biostatistics
dc.descriptionKIMen_ZA
dc.description.abstractBACKGROUND: Although teenage pregnancies in South Africa have declined, the short and longer term health and social consequences are a potential public health concern. This longitudinal study aimed to describe the range of risk and protective factors for incident unwanted and unplanned pregnancies occurring over 2 years of follow-up among a cohort of adolescent women in the Eastern Cape, South Africa. It also investigated the relationship between gender inequality and gender-based violence and subsequent unplanned and unwanted pregnancies among the cohort. OBJECTIVE: Teenage girls, aged 15-18 years (n=19), who were volunteer participants in a cluster randomized controlled trial and who had data from at least one follow-up were included in this analysis. To assess risk and protective factors for incident unwanted or unplanned pregnancies, we constructed multivariate polytomous regression models adjusting for sampling clusters as latent variables. Covariates included age, having a pregnancy prior to baseline, education, time between interviews, study intervention arm, contraceptive use, experience of intimate partner violence, belief that the teenage girl and her boyfriend are mutual main partners, and socioeconomic status. RESULTS: Overall, 174 pregnancies occurred over the 2-year follow-up period. Beliefs about relationship control were not associated with unwanted and unplanned pregnancies, nor were experiences of forced first sex or coerced sex under the age of 15. Hormonal contraception was protective against unplanned pregnancies (OR 0.40; 95% CI 0.21-0.79); however, using condoms was not protective. Physical abuse (OR 1.69; 95% CI 1.05-2.72) was a risk factor for, and having a pregnancy prior to baseline was protective against an unwanted pregnancy (OR 0.25; 95% CI 0.07-0.80). Higher socioeconomic status was protective for both unplanned and unwanted pregnancies (OR 0.69; 95% CI 0.58-0.83 and OR 0.78; 95% CI 0.64-0.96). Believing that the teenage girl and her boyfriend were mutual main partners doubled the odds of reporting both an unplanned and unwanted pregnancy (OR 2.58 95% CI 1.07-6.25, and OR 2.21 95% CI 1.13-4.29). CONCLUSION: Although some of the measures of gender inequity were not associated with unplanned and unwanted pregnancies, there is evidence of the role of both gender power and socioeconomic status. This was evident in teenage girls who experienced physical violence being more likely to have an unwanted pregnancy. Interventions to prevent teenage pregnancies need to be tailored by socioeconomic status because some teenagers may see having a pregnancy as a way to have a more secure future. Interventions that engage with relationship dynamics of teenagers are essential if unwanted and unplanned pregnancies are to be prevented.en_ZA
dc.identifier.citationChristofides, N.J., Jewkes,R.K., Dunkle, K.L., et al. 2014. Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women.Global Health Action; 7:23719en_ZA
dc.identifier.urihttp://hdl.handle.net/10539/19524
dc.language.isoenen_ZA
dc.subjectSouth Africaen_ZA
dc.subjectContraceptionen_ZA
dc.subjectPregnancy in Adolescenceen_ZA
dc.subjectPregnancy, Unwanteden_ZA
dc.subjectAdolescenten_ZA
dc.titleRisk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African womenen_ZA
dc.typeArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Risk factors for unplanned and unwanted teenage pregnancies.pdf
Size:
178.16 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Research Outputs (Public Health)
Academic Wits Research Outputs (All submissions)