Factors influencing repeated teenage pregnancy: a review and meta-analysis
© 2017 Elsevier Inc. 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 conse...
| Main Authors: | , , , |
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| Format: | Journal Article |
| Published: |
Mosby, Inc.
2017
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| Online Access: | http://hdl.handle.net/20.500.11937/72189 |
| _version_ | 1848762683791245312 |
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| author | Maravilla, J. Betts, K. Couto e Cruz, C. Alati, Rosa |
| author_facet | Maravilla, J. Betts, K. Couto e Cruz, C. Alati, Rosa |
| author_sort | Maravilla, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2017 Elsevier Inc. 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. |
| first_indexed | 2025-11-14T10:51:28Z |
| format | Journal Article |
| id | curtin-20.500.11937-72189 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:51:28Z |
| publishDate | 2017 |
| publisher | Mosby, Inc. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-721892018-12-13T09:34:32Z Factors influencing repeated teenage pregnancy: a review and meta-analysis Maravilla, J. Betts, K. Couto e Cruz, C. Alati, Rosa © 2017 Elsevier Inc. 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. 2017 Journal Article http://hdl.handle.net/20.500.11937/72189 10.1016/j.ajog.2017.04.021 Mosby, Inc. restricted |
| spellingShingle | Maravilla, J. Betts, K. Couto e Cruz, C. Alati, Rosa Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title | Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title_full | Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title_fullStr | Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title_full_unstemmed | Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title_short | Factors influencing repeated teenage pregnancy: a review and meta-analysis |
| title_sort | factors influencing repeated teenage pregnancy: a review and meta-analysis |
| url | http://hdl.handle.net/20.500.11937/72189 |