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The effectiveness of adolescent-specific prenatal interventions on improving attendance and reducing harm during and after birth: a systematic review

  • Brenda Tibingana-Ahimbisibwe EMAIL logo , Catherine Katabira , Lena Mpalampa and Roger A Harrison
Published/Copyright: August 18, 2016
International Journal of Adolescent Medicine and Health
From the journal International Journal of Adolescent Medicine and Health Volume 30 Issue 3

Abstract

Background:

Adolescent pregnancy has been associated with poor pregnancy outcomes including pre-term birth (PTB), low birth weight (LBW) and perinatal death.

Objective:

To systematically review the effect of adolescent-specific interventions on reducing PTB, LBW, and perinatal death and increasing prenatal care attendance.

Search strategy:

Possible studies for inclusion were identified by a comprehensive search of OvidSP MEDLINE (limits: humans, 1990–present), EMBASE (limits: humans, 1990–2015), Popline and Global Health Database from the World Health Organisation (WHO) and PubMed International scientific databases, and references of identified articles were searched from 1990 to present.

Selection criteria:

All types of controlled studies of prenatal interventions were exclusive to adolescents and at least one of the outcomes of interest.

Data collection and analysis:

Investigators identified relevant studies and entered the data in a pro forma. Data were summarised as forest plots and narrative synthesis.

Main results:

Twenty-two studies (three randomised controlled trials (RCTs), four prospective cohort studies, nine retrospective cohort studies, five case controls and one natural experiment) were included with all but one study being carried out in higher-income countries. Seven of the 16 studies reporting on PTB found a statistically significant reduction in PTB rates between adolescent-specific prenatal care (intervention) and non-age specific prenatal care odds ratio (OR) and 95% confidence intervals (CIs) ranged from OR: 0.15 (95% CI: 0.03–0.83) to OR: 0.59 (95% CI: 0.45–0.78). Nine of the 12 studies reported statistically significant higher mean prenatal attendance rates among the intervention group compared to controls (ranging from a mean number of visits of 14.3 vs. 10.7 p<0.001 to 10.8 vs. 7.6 visits p<0.001). The type and construct of the interventions, their implementation and local population differed sufficiently that a statistical synthesis was deemed inappropriate.

Conclusion:

There is some evidence that adolescent-specific programs can increase prenatal attendance and reduce the risk of PTB and low birth rate but their effect on perinatal death is uncertain. There is a distinct lack of evidence of the effectiveness of these interventions for adolescents living in low-middle income countries, despite having the majority of adolescent pregnancies, and associated risk of harm. No high-quality intervention studies were identified. Robust, cluster-based RCTs are an urgent necessity to quantify the impact of these interventions and to identify factors contributing to their success.

Keywords: adolescent pregnancy; interventions; prenatal
Corresponding author: Brenda Tibingana-Ahimbisibwe, MRes (MPH), The University of Manchester; Western University, 1151 Richmond St, London, Ontario N6A 3K7, Canada, Phone: +1 519 681 1456

  1. Contribution to authorship: BTA contributed to the study concept, design, acquired and screened references, analysed the data, and drafted the manuscript. LM reviewed the studies for inclusion and critically reviewed the manuscript. CK reviewed the papers for inclusion and critically reviewed the manuscript. RA was the study supervisor and contributed to the study design, analysis and interpretation of data and drafting the manuscript.

  2. Disclosure of interest: The study was conducted in fulfilment of a public health Master’s degree from the University of Manchester (www.manchester.ac.uk/phpc).

  3. Funding: None of the authors received any funding.

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Received: 2016-6-15
Accepted: 2016-7-13
Published Online: 2016-8-18

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/ijamh-2016-0063
Keywords for this article
adolescent pregnancy; interventions; prenatal

Articles in the same Issue

  1. Editorial
  2. Redacted reflections on the kidney from the Sumerians to Moses Maimonides: lessons for 21st-century clinicians and researchers
  3. Reviews
  4. Is vaping a gateway to smoking: a review of the longitudinal studies
  5. Integrated oral, mental and sexual health management for adolescents: a call for professional collaboration
  6. The effectiveness of adolescent-specific prenatal interventions on improving attendance and reducing harm during and after birth: a systematic review
  7. Original Articles
  8. Feasibility of a transition intervention aimed at adolescents with chronic illness
  9. Pattern of menarche age (normal, early and late) and its relationship with some demographic characteristics in girls and their parents
  10. Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents
  11. Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia
  12. Influence of body mass index on mindfulness awareness and coping methods for stress in adolescents
  13. Association between exposure to sexually explicit content in the electronic media and sexual intentions of in-school adolescents in Southwest Nigeria
  14. Adolescent workplace exposures reported to Texas poison centers
  15. Accelerometer-measured physical activity among adolescents in a multicultural area characterized by low socioeconomic status
  16. Physical and social factors associated with early adolescent headache and stomachache pain
  17. Who is teaching the kids to cook? Results from a nationally representative survey of secondary school students in New Zealand
  18. Case Report
  19. Listening to music from the urinary bladder! Case report of a headset in a urinary bladder
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