Panorama atual da gravidez na adolescência no Brasil

Abstract

Adolescent pregnancy remains an object of concern for government agencies, health professionals and society as a whole around the globe. Worldwide, approximately 21 million girls between 15 and 19 years of age and 1 million girls under 15 have children each year, with a higher frequency of live births (NV) to adolescente mothers in developing countries. The knowledge of gestational outcomes aids the development of public policies aimed at the population at risk. Objectives: To trace the panorama of teenage pregnancy in Brazil in the years 2018 and 2019, establishing its frequency, obstetric and perinatal outcomes, the recurrence rate of adolescence pregnancy, in addition to analyzing the occurrence of pregnancy in minors under 14 years old, classified in Brazil as statutory rape. Method: Cross-sectional study by searching the Information System on Live Births (SINASC). The study included all pregnant women aged 10-34 years who had live births (NV) in 2018 to 2019. Results: Despite the 37.2% reduction in the incidence of teenage pregnancy observed over 20 years (2000-2019), its inverse relationship with the human development index (HDI) is clear. Thus, the frequency of teenage pregnancy is higher in the North and Northeast regions, where the HDI is lower. Most teenager mothers are primigravid (74.3%) and black (74.3%), the adherence to prenatal care was 98%, more than half had seven consultations or more (59.6%),and 2% did not have any consultation when compared with the 20-34 years old group, the chance of having between 1 and 6 consultations doubles in the teenagers (OR=2.17); the teenage child has a higher chance of being born prematurely (OR=1.25) than the 20-34 years old mother. The fertility rate increased by 11.5% among girls <14 years old in Brazil due to the increase in the less developed regions (North and Northeast). These data confirm the association with socioeconomic factors and reveal the invisibility of statutory rape in the country. The recidivism of pregnancy among adolescents remained high and stable, representing 4.7% between 10-14 years and 27.3% between 15-19 years old. It is associated with early marriage or consensual union among girls aged 10-14 years old (OR=1.96; 95% CI 1.85-2.09) and among older adolescents (OR=1.40; 95% CI 1.39-1.41). Low education (< 8 years) increased the chance of repeat pregnancy by 64% among 10-14 years (OR=1.64; 95%CI 1.53-1.75) and by 137% among 15-19 years (OR=2.37; 95%CI 2.35-2.38). Conclusion: Adolescent pregnancy is related to socioeconomic factors being inversely proportional to the HDI of the region evaluated. Adolescent mothers have a higher chance of prematurity and lower adherence to prenatal care than adult mothers. The Picture demonstrates the need to intensify public policies to further reduce the frequency and promote the fall of recidivism of pregnancy and statutory rape in our country