INTRODUCTION: The societal norm in India is such that adolescents are expected to respect and follow traditional values and view early sexual debut as undesirable and deviant from the social mores. However, a dramatic shift in attitudes towards sex before marriage has been observed in India. We in this study, aim to study the factors associated with early sexual debut among unmarried adolescents. MATERIALS AND METHODS: The study used data from the Understanding the lives of adolescents and young adults (UDAYA) survey conducted in 2016 with 15,388 adolescents aged 10-19 years from two Indian states. Bivariate and logistic regression analyses were performed to determine the associated factors. RESULTS: Adolescent boys (9%) were more prone to early sexual debut compared to girls (4%). Both boys (17.2%) and girls (6%) who were school dropouts had significantly higher chances of early sexual debut. Boys who had rare [OR: 2.28; CI: 1.12-4.64] or frequent media exposure [OR: 2.70; CI: 1.36-5.32] were significantly more likely to report early sexual debut than those who had no media exposure. Further, the likelihood of early sexual debut was significantly higher among boys [OR: 3.01; CI: 2.34-3.87] and girls [OR: 1.87; CI: 1.12-3.12] who had exposure to pornography compared to their counterparts. The odds of early sexual debut were higher among boys [OR: 1.89; CI: 1.19-3.01] and girls [OR: 1.77; CI: 1.30-2.41] who had moderately-severe/severe depressive symptoms compared to their counterparts. CONCLUSIONS: The results highlight that Indian unmarried adolescents demand the appropriate knowledge to promote safer sexual behavior and lead a responsible and healthy lifestyle. The preventive efforts must be multifaceted with involvement at the individual and parental levels. Especially, interventions appear advantageous to be parents-focused emphasizing family life education that can prevent risky sexual behaviors among adolescent boys and girls. And the public programs should focus on sexual health promotion considering the physical and psychosocial changes during early ages of sex life.
T Muhammad, Shobhit Srivastava, Pradeep Kumar et al.
BACKGROUND: High fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion's share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia. METHODS: This is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables. RESULTS: Long acting contraceptive utilization was non-random (Moran's I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29-4.87), having one to two (AOR = 2.14, 95% CI: 1.43-3.22), and three to four children (AOR = 1.68, 95% CI: 1.02-2.76), urban (AOR = 1.59, 95% CI: 1.16-2.19), want no more children (AOR = 1.40, 95% CI: 1.08-1.83), working status of women (AOR = 1.33, 95% CI: 1.07-1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39-0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14-0.35) reduced the odds of LACs utilization in Ethiopia CONCLUSIONS: Significant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.
Peer-reviewed article·PubMed (US National Library of Medicine)·
We aimed to describe the characteristics of adolescent pregnancy, determine its effect on adverse maternal and perinatal outcomes and explore whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. This study included 2,366,559 women aged 10-24 years who had singleton pregnancies between 2012 and 2019 at 438 hospitals. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effects. Women aged 20-24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 even though common-law marriage in rural areas decreased. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57 ~ 2.23), severe anaemia (aOR 1.18, 95% CI 1.09 ~ 1.28), maternal near miss (MNM; aOR 1.24, 95% CI 1.12 ~ 1.37), and small for gestational age (SGA; aOR 1.30, 95% CI 1.28 ~ 1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent pregnancies and prevent adverse fertility outcomes among adolescent women in China at a time when adolescent fertility rate is rebounding.
Yanxia Xie, Xiaodong Wang, Yi Mu et al.
SurvivalProtection
Peer-reviewed article·PubMed (US National Library of Medicine)·
Unintended pregnancy is among the major challenges of public health and a major reproductive health issue, due to its implications on the health, economic and social life of a woman and her family mainly in low and middle-income countries, particularly sub-Saharan Africa. The study aimed to assess unintended pregnancy and associated factors among pregnant women in Ethiopia using multilevel analysis from the EDHS 2016. We used the data from the 2016 Ethiopian Demographic and Health Survey, comprised of 1122 pregnant women. The prevalence of unintended pregnancy was determined through descriptive statistics and multilevel logistic regression was performed to identify factors associated with unintended pregnancy. Variables with a p-value < 0.05 in the selected model were considered as significantly associated and an adjusted odds ratio was used to determine the strength and direction of the association. The prevalence of unintended pregnancy was 29.7% (CI 27.0%, 32.4%), of which 20.4% were mistimed and 9.3% unwanted. Being multi-para and fertility preference to have no more child were associated with a higher risk of unintended pregnancy whereas husbands' polygamy relation, having no women autonomy, and living in Afar and Somali regions showed a less likely risk of experiencing an unintended pregnancy. This study showed that the proportion of women who experienced unintended pregnancy is considerably high. Parity, fertility preference, polygamy relation, women autonomy, and region were identified factors associated with unintended pregnancy. Therefore, policymakers at all levels, reproductive health experts, and concerned organizations should emphasize minimizing unintended pregnancy targeting the regional variation at large. Researchers have to explore the regional variations through a qualitative study.
BACKGROUND: The annual collection of fertility, marriage, sexual behaviour, and contraceptive use data in the nationally representative rounds of Performance Monitoring and Accountability (PMA) surveys in sub-Saharan Africa may contribute to the periodic monitoring of adolescent sexual and reproductive health (ASRH). However, we need to understand the reliability of these data in monitoring the ASRH indicators. We assessed the internal and external consistencies in ASRH indicators in five countries. METHODS: We included countries with at least three nationally representative rounds of PMA surveys and two recent DHS: Ethiopia, Ghana, Kenya, Nigeria, and Uganda. Our analysis focused on four current status indicators of ASRH among girls 15-19 years: ever had sex, currently married, has given birth or currently pregnant, and currently using modern contraceptives among sexually active unmarried girls. We compared the PMA survey and DHS data and tested for statistical significance and assessed trends over time using Jonckheere-Terpstra test statistic. RESULTS: PMA and DHS survey methodologies were similar and, where there were differences, these were shown to have minimal impact on the indicator values. The comparison of the data points from PMA and DHS for the same years showed statistically significant differences in 12 of the 20 comparisons, which was most common for sexual behaviour (4/5) and least for contraceptive use (2/5). This is partly due to larger confidence intervals in both surveys. The time trends were consistent between the annual PMA surveys in most instances in Ethiopia, Kenya, and Nigeria but less so for Ghana and Uganda. However, both surveys highlight slow progress in adolescent and reproductive health indicators with major disparities between the countries. CONCLUSIONS: Despite the differences between PMA 2020 surveys and DHS surveys conducted in the same year, and inconsistencies of the PMA survey time series for several indicators in some countries, we found no systematic issues with PMA surveys and consider PMA surveys a valuable data source for the assessment of levels and trends of ASRH beyond contraceptive use and family planning for indicators of fertility, marriage, and sex among adolescent girls in sub-Saharan Africa.
Peer-reviewed article·PubMed (US National Library of Medicine)·
BACKGROUND AND PURPOSE: Microcephaly with simplified gyral pattern (SGP) represents an often subtle subtype of malformation of cortical development that is commonly accompanied by epilepsy and neurodevelopmental delay. However, whether gyral simplification scales to reduced brain volume and whether MRI features predict clinical outcome still remain unclear. The aims of this study are therefore to apply a quantitative morphometric approach to distinguish a simplified gyral pattern from microcephaly-related effects and to correlate quantitative MRI-derived features with clinical outcome. MATERIALS AND METHODS: From a single-center cohort of 34 patients with microcephaly and visually confirmed SGP (shallow sulci, normal cortical thickness), 18 subjects (mean age 7.1 ± 6.5 years) who fulfilled the eligibility criteria were retrospectively included for final analysis. Twenty-six age- and sex-matched healthy controls were included. GM/WM volumes (GMVs/WMVs) and surface-based measures were derived using FreeSurfer. Scaling corrections based on log-log robust regression and cortical folding analyses were subsequently analyzed. Principal component analyses clustered along morphometric phenotypes. ANCOVA, Kendall τ correlations, and logistic regression were applied to evaluate group differences and clinical outcome predictors. RESULTS: Compared with healthy controls, patients showed significantly reduced WMV, cortical surface area, local gyrification index (LGI) (all Q < 0.003), and mildly increased cortical thickness. Allometric modeling indicated that, although WMV and LGI scaled proportionally to total brain volume, cortical surface area was disproportionately reduced, suggesting deviation beyond microcephalic scaling. Spectral folding analysis showed loss of specifically macroscale (primary) folding power. Morphometric clustering separated 4 subtypes differing in cortical thickness and area, of which the cluster with the lowest surface area and LGI exhibited universal developmental delay and included both early deaths. Across the cohort, neurodevelopmental delay correlated negatively with surface area. Logistic regression suggested lower surface area, WMV, and LGI as predictors of adverse clinical outcome (Q < 0.02). CONCLUSIONS: The presence of SGP may reflect additional disturbance of primary sulcation and tangential cortical expansion beyond scaling to microcephaly alone. Our results suggest reduced cortical surface area as a key morphometric marker and a strong MRI feature predictive of neurodevelopmental delay, underscoring the clinical value of quantitative morphometry for stratifying disease severity in microcephaly with an SGP.
Peer-reviewed article·PubMed (US National Library of Medicine)·
AIM: This study aimed to explore culturally and linguistically diverse (CALD) fathers' early parenting support needs in the perinatal period in Australia. DESIGN: A qualitative descriptive research study. Participant fathers were recruited using purposive and snowball sampling who self-identified as CALD. METHODS: Data were collected through semi-structured telephone interviews with 15 Australian fathers aged between 29 and 56 years in July-November 2022. Data were analysed using Braun and Clarke's six stages of thematic analysis to code, categorise and identify themes from the data. FINDINGS: Four major themes and six sub-themes emerged from the data, 'Under pressure', 'Slipping through the cracks', 'Gaining knowledge and support by health professionals', and 'Path ahead: changed roles and being supported by peers' that encompassed fathers' early parenting experiences and support needs in the perinatal period. CONCLUSION: Culturally and linguistically diverse fathers experience challenges in navigating maternal health care settings and at times interactions with health professionals. However, findings from this study showed that fathers were determined to navigate resources, services and networks that supported their transition to fatherhood in the early postpartum weeks. There is a need for maternity settings to be a 'father-inclusive' environment where informational and practical support is readily available to them. Legislation reform is needed that recognises fathers as parents who require adequate 'paid' parental leave entitlements that foster family relationships and recognises the role fathers play in the development of their child. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study provides insights into the support needs of CALD fathers in the perinatal period. Findings from this study have the potential to shape and design culturally appropriate health services and interventions tailored to CALD fathers that meet their nuanced needs through the lens of cultural competence and trauma informed maternity care. IMPACT: What problem did the study address?: The study explored the support needs of CALD fathers in the perinatal period. What were the main findings?: The findings revealed CALD fathers feel a sense of responsibility and pressure to live up to socio-cultural expectations and support the family unit while engaging in paid employment to earn a living. At times fathers were not encouraged to be parenting partners by health professionals, and there was an expectation that they would be familiar and have knowledge about pregnancy, labour, birth and the transition to fatherhood. Some fathers struggled with their transition to parenthood either due to lack of paid parental support or limited to no family support. However, some fathers found alternatives to manage and adjust in the early weeks postpartum, which included peer support groups and online information. Where and on whom will the research have an impact?: The research has the potential to impact all fathers, as the findings may be transferrable across a number of communities. The research also has the potential to influence cultural competence training for health care professionals and inform policy development that employs a family centred model of maternity care inclusive of culturally diverse families. REPORTING METHOD: The paper has adhered to the EQUATOR COREQ reporting guideline. NO PATIENT OR PUBLIC INVOLVEMENT: This study did not include patient or public involvement in its design, conduct or reporting.
Peer-reviewed article·PubMed (US National Library of Medicine)·
INTRODUCTION: Renal artery stenosis is one of the severe secondary hypertension (HTN) causes in children and may lead to hypertension-mediated organ damage (HMOD), including left ventricle hypertrophy (LVH). CASE REPORT/TREATMENT: We describe a case of a 4-year-old boy with severe renovascular HTN and LVH during infancy. Genetic testing revealed variant of unknown significance in SMAD3, a gene linked to Loeys-Dietz syndrome. The patient was treated with intensive pharmacotherapy and percutaneous intravascular intervention. CONCLUSIONS: Early onset of HTN and HMOD should prompt consideration of genetic evaluation to aid diagnosis and management. In this case, a heterozygous SMAD3 variant coexisted with renal artery stenosis without the development of aortic aneurysms.
Marianna Lichosik, Agata Błażejczyk, Andrzej Biełanowicz et al.
Coresidential three-generation families are becoming increasingly prevalent, but the contribution of grandparent coresidence stability during early childhood is poorly understood. Informed by the process-person-context-time theory, this study links grandmothers' behavioral health risk and mothers' psychopathology to child psychopathology (i.e., total internalizing and externalizing problems). We hypothesized mediation pathways through maternal psychological and physical aggression and tested grandmother coresidential stability as a moderator. A nationally representative sample of three-generation families was selected from the Future of Families and Child Well-Being Study. Most mothers in the sample were Black or Hispanic, single, young, and living in low-income households. Based on grandmother coresidence stability from Year 3 to Year 5, families were divided into a disrupted (N = 248) and continued (N = 189) group. Multigroup structural equation modeling results showed similar and unique pathways across the groups. Similarly, in both groups, grandmothers' behavioral health risk at Year 3 was related to maternal physical aggression at Year 5, whereas maternal psychopathology at Year 3 was related to maternal psychological aggression at Year 5. Uniquely in the disrupted group, but not in the continued group, evidence was found on the intergenerational transmission of psychopathology: maternal psychopathology at Year 3 had a direct link to children's psychopathology at Year 9, and this was also mediated by psychological aggression at Year 5. These findings demonstrate the heterogeneity of multigenerational families and emphasize developmental implications for risk and resilience. Grandmother coresidential stability appears to have a protective role for young children's socioemotional development in socioeconomically disadvantaged families. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
