社会经济因素增加少女怀孕的风险:巴西一个城市的时空分析。

Camila Meireles Fernandes, Gleice Margarete de Souza Conceição, Zilda Pereira da Silva, Fernando Kenji Nampo, Francisco Chiaravalloti Neto
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摘要

目的评估少龄母亲(PTM)比例在时间和空间上的分布及其与社会经济指标和社会脆弱性的关系:在 2013 年至 2019 年期间,对居住在福斯-杜伊瓜苏(巴西巴拉那州)322 个人口普查区的未成年母亲进行了生态研究。通过空间扫描确定了未成年母亲的空间集群,并将其划分为不同流行率的阶层。通过皮尔逊卡方检验评估了这些阶层与母亲个人社会脆弱性之间的关联。通过调整线性回归模型,评估了人口普查区的 PTM 与社会经济因素之间的关系,以及不同阶层的 PTM 的时间趋势:我们在该市周边地区发现了 5 个高发病群,在中部地区发现了 6 个低发病群。从比例上看,高发病率阶层中脆弱指数较低的未成年母亲人数多于低发病率阶层。社会经济条件较差的地区的 PTM 值较高,这种情况并没有随着时间的推移而改变。巴西贫困指数和负责家务的妇女比例每增加一个单位,PTM 分别增加 3.8%(95%CI 3.1-4.4)和 0.086%(95%CI 0.03-0.14)。在部分时间段内,全球 PTM 有所下降,这出现在发病率较高的阶层,但在研究的最后几年,比例又趋于稳定:结论:少女怀孕主要集中在社会经济条件较差、孕产妇脆弱性较大的地区,这些地区的少女怀孕情况随时间的推移也有所不同。
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Socioeconomic factors increase the risk of teenage pregnancy: spatial and temporal analysis in a Brazilian municipality.

Objective: To evaluate the distribution of the proportion of teenage mothers (PTM) in time and space and its relationship with socioeconomic indicators and social vulnerability.

Methods: An ecological study was carried out with teenage mothers living in 322 census tracts in Foz do Iguaçu (state of Paraná, Brazil) between 2013 and 2019. Spatial clusters of teenage mothers were identified by spatial scanning and grouped into strata with different prevalence. The association between these strata and the individual social vulnerability of the mothers was evaluated using the Pearson's Chi-square test. Linear regression models were adjusted to evaluate the association between PTM and socioeconomic factors by census tract and temporal trend in PTM in different strata.

Results: We identified five high prevalence clusters in peripheral regions and six with low prevalence in the central region of the municipality. Proportionally, there were more teenage mothers with a worse vulnerability index in the high prevalence stratum than in the low prevalence stratum. Places with worse socioeconomic conditions present higher PTM, a profile that did not change over time. For the increase of one unit in the Brazilian Deprivation Index and proportion of women responsible for the household, the PTM increased, respectively, by 3.8 (95%CI 3.1-4.4) and 0.086% (95%CI 0.03-0.14). There was a reduction in the global PTM in part of the period, which occurred later in the higher prevalence strata, but the proportions were stable again in the last years of study.

Conclusion: Teenage pregnancy is concentrated in regions with worse socioeconomic conditions and greater maternal vulnerability and its behavior over time occurred differently in these areas.

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