This was a short lecture on teenage pregnancy given during the Phil Pediatric Society Central Visayas chapter Postgraduate Course last November 19, 2015 at the Marriott Hotel, Cebu City.

1. {
Teenage
Pregnancy
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
November 19, 2015
Philippine Pediatric Society Central Visayas Chapter Postgraduate Course 2015
Mariott Hotel, Cebu City
HVMadamba2015

2.  In 2013, a total of 273,105 babies were born to
women aged 15–19 years, for a live birth rate of
26.5 per 1,000 women in this age group
Teenage Pregnancy
Martin, JA, Hamilton BE, Osterman MJK, Curtin SC, Mathews TJ. Births: Final data for 2013. Natl Vital Stat Rep. 2015;64(1)
at http://www.cdc.gov/teenpregnancy/about/index.htm
HVMadamba2015

3.  Knowledge of sexual issues, HIV, other STDs,
and pregnancy (including methods of
prevention).
 Perception of HIV risk.
 Personal values about sex and abstinence.
 Attitudes toward condoms (pro and con).
 Perception of peer norms and sexual
behavior.
 Individual ability to refuse sex and to use
condoms.
Protective Factors
Kirby D, Laris BA, Rolleri L. The Impact of Sex and HIV Education Programs in Schools and Communities
on Sexual Behaviors Among Young Adults. Scotts Valley, CA: ETR Associates; 2006.
HVMadamba2015

4.  Intent to abstain from sex or limit number of
partners.
 Communication with parents or other adults
about sex, condoms, and contraception.
 Individual ability to avoid HIV/STD risk and
risk behaviors.
 Avoidance of places and situations that might
lead to sex.
 Intent to use a condom.
Protective Factors
Kirby D, Laris BA, Rolleri L. The Impact of Sex and HIV Education Programs in Schools and Communities
on Sexual Behaviors Among Young Adults. Scotts Valley, CA: ETR Associates; 2006.
HVMadamba2015

5. Christofides, N. J., Jewkes, R. K., Dunkle, K. L., Mccarty, F., Shai, N. J., Nduna, M., & Sterk, C. (2014). Risk
factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a
cohort of young South African women, 1(August), 1–9.
HVMadamba2015

6. Unwanted or unplanned pregnancies:
 Beliefs about relationship control – not
associated
 Experiences of forced first sex or coerced
sex under the age of 15 – not associated
 Hormonal contraception - protective
 Condom use - not protective.
 Higher socioeconomic status - protective
174 pregnancies in South Africa
Christofides, N. J., Jewkes, R. K., Dunkle, K. L., Mccarty, F., Shai, N. J., Nduna, M., & Sterk, C. (2014). Risk factors for unplanned and
unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women, 1(August), 1–9.
HVMadamba2015

7. Risk Factors for an unwanted pregnancy
 Physical abuse
 Having a pregnancy prior to baseline -
protective
 Believing that the teenage girl and her
boyfriend were mutual main partners
doubled the odds
174 pregnancies in South Africa
Christofides, N. J., Jewkes, R. K., Dunkle, K. L., Mccarty, F., Shai, N. J., Nduna, M., & Sterk, C. (2014). Risk factors for unplanned and
unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women, 1(August), 1–9.
HVMadamba2015

8.  Gender power and socioeconomic status
 Interventions to prevent teenage
pregnancies need to be tailored by
socioeconomic status.
 Interventions that engage with
relationship dynamics of teenagers are
essential if unwanted and unplanned
pregnancies are to be prevented.
Conclusion
HVMadamba2015

9. https://psa.gov.ph/content/one-ten-young-filipino-women-age-15-19-already-mother-or-pregnant-first-child-final-results
THE PHILIPPINE SCENARIO
HVMadamba2015

10. Early pregnancy and motherhood
HVMadamba2015

11. Early pregnancy and motherhood
HVMadamba2015

12. Age at first marriage
HVMadamba2015

13. In Latin America, teen mothers
are seven times more likely
than older mothers to be poor.
The poorer the country, the
higher the level of early
childbearing.
http://www.advocatesforyouth.org/publications/publications-a-z/432-the-impact-of-early-pregnancy-and-childbearing-on-
adolescent-mothers-and-their-children
HVMadamba2015

14.  Fertility levels among the least
educated and the most educated
women in Peru differ by five
children.
 The fertility level of unschooled
women is twice their stated ideal
family sized.
 Teenagers with some secondary
education are roughly one-third as
likely to have had a child as those
who have less education
http://www.advocatesforyouth.org/publications/publications-a-z/432-the-impact-of-early-pregnancy-and-childbearing-on-
adolescent-mothers-and-their-children
HVMadamba2015

15.  triple developmental crisis to
young women:
 that of adolescence,
 pregnancy, and
 establishing a relationship with a
member of the opposite sex.
Effect of Pregnancy on
Adolescent Health
Leppert PC. The effect of pregnancy on adolescent growth and development. Women Health. 1984 Summer-Fall;9(2-3):65-79
at http://www.ncbi.nlm.nih.gov/pubmed/6464482.
HVMadamba2015

16. Physiological adjustments of
pregnancy and adolescence
Psychological and intellectual
development
Poor contraceptive knowledge
Effect of Pregnancy on
Adolescent Health
Leppert PC. The effect of pregnancy on adolescent growth and development. Women Health. 1984 Summer-Fall;9(2-3):65-79
at http://www.ncbi.nlm.nih.gov/pubmed/6464482.
HVMadamba2015

17. Situationer on Teenage Pregnancy
Navarro J 2012.
A Retrospective Study on
the Maternal and Fetal
Outcome of Teenage
Pregnancy in Vicente Sotto
Memorial Medical Center
(January - December 2011)
HVMadamba2015

18. Teenage Pregnancies in 2011
Navarro 2012
Deliveries No. of cases Percent
Deliveries ≥ 20 yo 5139 88%
Teenage Pregnancy 698 12%
Total 5837 100%
HVMadamba2015

19. Navarro 2012
Include 19yo pregnant patients:
• 66% are ≤ 18 yo
• 33% are 19 yo
Age (years) No. of Cases Percent
15 37 5%
16 79 11%
17 135 19%
18 214 31%
19 233 33%
total 698 100%
HVMadamba2015

20. Navarro 2012
The main high risk complication is preterm labor
(18%) and severe preeclampsia, occurring in 6% of
teenage pregnancies.
TypeofHypertension
TotalNo.
ofCases Percent
Teenage
Pregnancy Percent p-value
Antepartum Eclampsia: 121 2% 19 3%
Severe Preeclampsia: 979 19% 42 6%
Gestationalhypertension: 284 6% 31 4%
Mildpreeclampsia: 654 13% 26 4% 0.000
FetalOutcome
Preterm: 702 14% 129 18%
Fullterm: 4421 86% 561 80%
Posterm: 16 0% 8 1% 0.000
HVMadamba2015

21. VICENTE SOTTO MEMORIAL MEDICAL CENTER
PROGRAM FOR
YOUNG PARENTS
HVMadamba2015

22. PROPONENTS
 Hospital Executive Committee
 Department of Pediatrics
 Department of Obstetrics and Gynecology
 Women and Child Protection Center
 Nursing Services
 Department of Internal Medicine
 HACT (HIV and AIDS Core Team)
 Department of Mental Health Services and
Behavioural Sciences
 Hospital Training Division
 Medical Social Services
 Support Services (Dietary Section, Dental Services
Pharmacy, Security etc.)
 Peer support groups
HVMadamba2015

23. PROGRAM FOR YOUNG PARENTS
Planning Workshop for the PYP Feb 1, 2014 at Be Resort, Mactan
HVMadamba2015

24. INAUGURATION OF THE PYP CLINIC
March 4, 2014 at the Outpatient Department, VSMMC
HVMadamba2015

25. Best Practices in
Preventing Teenage
Pregnancy
HVMadamba2015

26. HVMadamba2015

27.  Sixty-six focus group discussions
were conducted with 341 male and
female adolescents aged 15-19
years from rural and urban
communities on two islands of
Vanuatu.
 sexually transmitted infections and
HIV.
 prevention of pregnancy, condom use
 puberty, sexuality and relationships.
HVMadamba2015

28.  Parents were not a common source
but were preferred, particularly by
girls, despite considerable socio-
cultural barriers.
 Schools were an important but
underutilised source of
information, as were a range of
media sources.
Source of information
HVMadamba2015

29. Devine, S., Ph, D., Bull, S., Ph, D., H, M. P., Dreisbach, S., … H, M. P. (2014). Enhancing a Teen Pregnancy Prevention Program With Text
Messaging : Engaging Minority Youth to Develop TOP Ò Plus Text. Journal of Adolescent Health, 54(3), S78–S83.
http://doi.org/10.1016/j.jadohealth.2013.12.005
Denver, Colorado
HVMadamba2015

30. HVMadamba2015

31.  month-long version of TOP Plus Text with 96
teens at four sites
 computer-based survey
 teens’ values, social support, self-efficacy, and
behaviors relating to school performance, trouble
with the law, and sexual activity.
 three weekly sessions then collected
satisfaction measures.
 exit interviews with twelve purposively
selected pilot participants
Teen Outreach Program + Text
Devine, S., Ph, D., Bull, S., Ph, D., H, M. P., Dreisbach, S., … H, M. P. (2014). Enhancing a Teen Pregnancy Prevention Program With Text
Messaging : Engaging Minority Youth to Develop TOP Ò Plus Text. Journal of Adolescent Health, 54(3), S78–S83.
http://doi.org/10.1016/j.jadohealth.2013.12.005
HVMadamba2015

32. http://pdf.usaid.gov/pdf_docs/PA00K7KQ.pdf
HVMadamba2015

33. {
Teenage
Pregnancy
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
November 19, 2015
Philippine Pediatric Society Central Visayas Chapter Postgraduate Course 2015
Mariott Hotel, Cebu City
HVMadamba2015